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[vc_row type=”in_container” full_screen_row_position=”middle” column_margin=”default” column_direction=”default” column_direction_tablet=”default” column_direction_phone=”default” scene_position=”center” top_padding=”30″ text_color=”dark” text_align=”left” row_border_radius=”none” row_border_radius_applies=”bg” overflow=”visible” overlay_strength=”0.3″ gradient_direction=”left_to_right” shape_divider_position=”bottom” bg_image_animation=”none”][vc_column column_padding=”no-extra-padding” column_padding_tablet=”inherit” column_padding_phone=”inherit” column_padding_position=”all” column_element_direction_desktop=”default” column_element_spacing=”default” desktop_text_alignment=”default” tablet_text_alignment=”default” phone_text_alignment=”default” background_color_opacity=”1″ background_hover_color_opacity=”1″ column_backdrop_filter=”none” column_shadow=”none” column_border_radius=”none” column_link_target=”_self” column_position=”default” gradient_direction=”left_to_right” overlay_strength=”0.3″ width=”1/1″ tablet_width_inherit=”default” animation_type=”default” bg_image_animation=”none” border_type=”simple” column_border_width=”none” column_border_style=”solid”][vc_column_text css=”” text_direction=”default”]Carpal tunnel syndrome (CTS) is a common nerve condition affecting the hand. The usual presentation is tingling and numbness affecting the thumb, index, and middle fingers. It is estimated that between 7 to 16% of the UK population is impacted. The incidence of CTS peaks in the late 50s, particularly in women, and the late 70s for men. In younger people the gender ratio is 3:1 in favour of females.

What is Carpal Tunnel Syndrome?

The condition occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed as it passes through the carpal tunnel in the wrist. The carpal tunnel is a narrow passageway made up of bones and ligaments. When the tissues around the tunnel become swollen or irritated, they can put pressure on the median nerve. This nerve compression leads to the symptoms of CTS.[/vc_column_text][/vc_column][/vc_row][vc_row type=”in_container” full_screen_row_position=”middle” column_margin=”default” column_direction=”default” column_direction_tablet=”default” column_direction_phone=”default” scene_position=”center” bottom_padding=”30″ text_color=”dark” text_align=”left” row_border_radius=”none” row_border_radius_applies=”bg” overflow=”visible” overlay_strength=”0.3″ gradient_direction=”left_to_right” shape_divider_position=”bottom” bg_image_animation=”none” shape_type=””][vc_column column_padding=”no-extra-padding” column_padding_tablet=”inherit” column_padding_phone=”inherit” column_padding_position=”all” column_element_direction_desktop=”default” column_element_spacing=”default” desktop_text_alignment=”default” tablet_text_alignment=”default” phone_text_alignment=”default” background_color_opacity=”1″ background_hover_color_opacity=”1″ column_backdrop_filter=”none” column_shadow=”none” column_border_radius=”none” column_link_target=”_self” column_position=”default” gradient_direction=”left_to_right” overlay_strength=”0.3″ width=”1/1″ tablet_width_inherit=”default” animation_type=”default” bg_image_animation=”none” border_type=”simple” column_border_width=”none” column_border_style=”solid”][vc_column_text css=”” text_direction=”default”]Common Symptoms 

The symptoms of CTS can vary from mild to severe and they often develop gradually. The most common signs include:

  • Numbness and Tingling: One of the hallmark signs of CTS is a sensation of tingling or “pins and needles” in the fingers, especially the thumb, index, middle fingers and half of the ring finger. This sensation often worsens at night or after prolonged use of the hands.
  • Pain: People with CTS often experience aching or sharp pain in the wrist, hand, or even up the arm. The pain may intensify when performing activities that require repetitive hand or wrist movements, such as typing or gripping objects.
  • Weakness: Individuals with CTS may notice a reduction in grip strength, making it harder to hold objects or perform tasks like writing or buttoning a shirt. Weakness is usually due to nerve compression, affecting the muscles in the hand and around the thumb.
  • Swelling: While not always visible, some individuals with CTS report a feeling of swelling or fullness in the wrist and hand, which can increase discomfort.
  • Worsening Symptoms at Night: CTS symptoms tend to get worse at night due to the natural position of the wrist while sleeping. The wrist may be bent or compressed, which exacerbates pressure on the median nerve.
  • Inability to Perform Fine Motor Skills: As the condition progresses, tasks that require fine motor skills, such as typing, writing, or using a phone, may become difficult or painful.

[/vc_column_text][/vc_column][/vc_row][vc_row type=”in_container” full_screen_row_position=”middle” column_margin=”default” column_direction=”default” column_direction_tablet=”default” column_direction_phone=”default” scene_position=”center” bottom_padding=”30″ text_color=”dark” text_align=”left” row_border_radius=”none” row_border_radius_applies=”bg” overflow=”visible” overlay_strength=”0.3″ gradient_direction=”left_to_right” shape_divider_position=”bottom” bg_image_animation=”none” shape_type=””][vc_column column_padding=”no-extra-padding” column_padding_tablet=”inherit” column_padding_phone=”inherit” column_padding_position=”all” column_element_direction_desktop=”default” column_element_spacing=”default” desktop_text_alignment=”default” tablet_text_alignment=”default” phone_text_alignment=”default” background_color_opacity=”1″ background_hover_color_opacity=”1″ column_backdrop_filter=”none” column_shadow=”none” column_border_radius=”none” column_link_target=”_self” column_position=”default” gradient_direction=”left_to_right” overlay_strength=”0.3″ width=”1/1″ tablet_width_inherit=”default” animation_type=”default” bg_image_animation=”none” border_type=”simple” column_border_width=”none” column_border_style=”solid”][vc_column_text css=”” text_direction=”default”]Risk Factors

Several factors can increase the likelihood of developing CTS, including:

  • Repetitive hand movements: Engaging in activities that require repeated use of the hands and wrists may provocate symptoms of carpal tunnel syndrome.
  • Age: CTS becomes more common with age, especially in individuals over 50 years old.
  • Gender: Women are more likely to develop CTS than men, likely due to smaller wrist structures.
  • Health conditions: Conditions such as diabetes, rheumatoid arthritis, obesity, and hypothyroidism can increase the risk of CTS.

[/vc_column_text][/vc_column][/vc_row][vc_row type=”in_container” full_screen_row_position=”middle” column_margin=”default” column_direction=”default” column_direction_tablet=”default” column_direction_phone=”default” scene_position=”center” bottom_padding=”30″ text_color=”dark” text_align=”left” row_border_radius=”none” row_border_radius_applies=”bg” overflow=”visible” overlay_strength=”0.3″ gradient_direction=”left_to_right” shape_divider_position=”bottom” bg_image_animation=”none” shape_type=””][vc_column column_padding=”no-extra-padding” column_padding_tablet=”inherit” column_padding_phone=”inherit” column_padding_position=”all” column_element_direction_desktop=”default” column_element_spacing=”default” desktop_text_alignment=”default” tablet_text_alignment=”default” phone_text_alignment=”default” background_color_opacity=”1″ background_hover_color_opacity=”1″ column_backdrop_filter=”none” column_shadow=”none” column_border_radius=”none” column_link_target=”_self” column_position=”default” gradient_direction=”left_to_right” overlay_strength=”0.3″ width=”1/1″ tablet_width_inherit=”default” animation_type=”default” bg_image_animation=”none” border_type=”simple” column_border_width=”none” column_border_style=”solid”][vc_column_text css=”” text_direction=”default”]Diagnosis 

Most cases of CTS can be diagnosed through a physical examination by a specialist hand surgeon like Mr Wee Sim Khor.

  • Physical examination: Your consultant will examine your hands, arms, shoulders, and neck to help determine if your symptoms are related to daily activities or to another disorder, and to rule out other causes. Your wrist will be examined to see if tapping or pressing on your median nerve, or flexing your wrist, causes a numbing or tingling sensation. Your fingers will be tested for sensation, and your muscles at the base of your hand will be tested for strength and signs of muscle loss or weakening.
  • Laboratory tests and X-rays: In most cases, further laboratory tests or X-rays are not indicated.
  • Tests using electric signals: In some cases where the signs or symptoms are not typical of CTS, further investigations can help confirm the diagnosis. A nerve conduction study measures how quickly signals are transmitted along a nerve to see if the signals are slowed down at the carpal tunnel.

[/vc_column_text][/vc_column][/vc_row][vc_row type=”in_container” full_screen_row_position=”middle” column_margin=”default” column_direction=”default” column_direction_tablet=”default” column_direction_phone=”default” bg_image=”6205″ bg_position=”left top” background_image_loading=”default” bg_repeat=”no-repeat” scene_position=”center” top_padding=”5%” bottom_padding=”5%” text_color=”dark” text_align=”left” row_border_radius=”none” row_border_radius_applies=”bg” overflow=”visible” overlay_strength=”0.3″ gradient_direction=”left_to_right” shape_divider_position=”bottom” bg_image_animation=”none” parallax_bg=”true” parallax_bg_speed=”fast” shape_type=”” gradient_type=”default”][vc_column column_padding=”no-extra-padding” column_padding_tablet=”inherit” column_padding_phone=”inherit” column_padding_position=”all” column_element_direction_desktop=”default” column_element_spacing=”default” desktop_text_alignment=”default” tablet_text_alignment=”default” phone_text_alignment=”default” background_color_opacity=”1″ background_hover_color_opacity=”1″ column_backdrop_filter=”none” column_shadow=”none” column_border_radius=”none” column_link_target=”_self” column_position=”default” gradient_direction=”left_to_right” overlay_strength=”0.3″ width=”1/1″ tablet_width_inherit=”default” animation_type=”default” bg_image_animation=”none” border_type=”simple” column_border_width=”none” column_border_style=”solid”][divider line_type=”No Line” custom_height=”350″][/vc_column][/vc_row][vc_row type=”in_container” full_screen_row_position=”middle” column_margin=”default” column_direction=”default” column_direction_tablet=”default” column_direction_phone=”default” scene_position=”center” top_padding=”40″ text_color=”dark” text_align=”left” row_border_radius=”none” row_border_radius_applies=”bg” overflow=”visible” overlay_strength=”0.3″ gradient_direction=”left_to_right” shape_divider_position=”bottom” bg_image_animation=”none” shape_type=””][vc_column column_padding=”no-extra-padding” column_padding_tablet=”inherit” column_padding_phone=”inherit” column_padding_position=”all” column_element_direction_desktop=”default” column_element_spacing=”default” desktop_text_alignment=”default” tablet_text_alignment=”default” phone_text_alignment=”default” background_color_opacity=”1″ background_hover_color_opacity=”1″ column_backdrop_filter=”none” column_shadow=”none” column_border_radius=”none” column_link_target=”_self” column_position=”default” gradient_direction=”left_to_right” overlay_strength=”0.3″ width=”1/1″ tablet_width_inherit=”default” animation_type=”default” bg_image_animation=”none” border_type=”simple” column_border_width=”none” column_border_style=”solid”][vc_column_text css=”” text_direction=”default”]Treatment Options 

Treatment for CTS aims to relieve symptoms, prevent further nerve damage, and improve wrist and hand function. There are several treatment options, ranging from non-surgical measures to surgical intervention.

1. Non-Surgical Treatments

  • Wrist Splints: Wearing a wrist splint at night or during activities that aggravate symptoms can help keep the wrist in a neutral position, reducing pressure on the median nerve.
  • Ergonomic Adjustments: Adjusting your work environment can significantly reduce the strain on your wrists. This may involve altering the height of your desk, changing the position of your computer keyboard, or using a mouse that reduces wrist movement.
  • Medications: Over-the-counter anti-inflammatory medicines, like ibuprofen, can help reduce inflammation and alleviate pain.
  • Physiotherapy: A physiotherapist can provide exercises to strengthen the muscles around the wrist and improve flexibility. Stretching and strengthening exercises can sometimes relieve pressure on the nerve and improve symptoms.

2. Steroid injections

Steroid injections can be effective in milder cases of carpal tunnel syndrome.

3. Surgical Treatments

If non-surgical treatments do not relieve symptoms or if the condition is severe, surgery may be required. There are two main types of surgery for CTS:

  • Open Carpal Tunnel Release Surgery: This is the traditional method where a small incision is made in the palm of the hand to access the carpal tunnel and cut the ligament causing compression.
  • Endoscopic Carpal Tunnel Release Surgery: This minimally invasive procedure involves smaller incisions and the use of a camera to guide the surgeon in cutting the ligament. The recovery time is generally faster than with open surgery.

Both surgical options have high success rates and many individuals experience relief from their symptoms after surgery.

Revision Carpal Tunnel Surgery

Mr Wee Sim Khor also offers revision CTS surgery to treat recurrent or persistent carpal tunnel syndrome after a previous release. The hypothenar fat pad flap procedure involves using a section of fat tissue from the hypothenar eminence (the palm’s little finger side) to cover and protect the median nerve. This flap aims to prevent the nerve from re-adhering to the surrounding tissue and to improve the nerve’s gliding mechanism, relieving symptoms.

4. Lifestyle Changes and Preventive Measures

  • Breaks and Rest: Taking regular breaks from repetitive tasks can help alleviate strain on the wrists. Stretching and resting the hands every 20 to 30 minutes can prevent further irritation.
  • Exercise: Regular exercise to maintain a healthy weight and promote wrist flexibility and strength can reduce the risk of developing CTS or help manage mild cases.
  • Healthy Habits: Staying hydrated and managing underlying health conditions, such as diabetes or thyroid disorders, can reduce the risk of nerve damage and inflammation that leads to CTS.

If you are concerned about CTS, book a consultation with Consultant Plastic Surgeon, Reconstructive Surgeon and Hand Surgeon, Mr Wee Sim Khor.  [/vc_column_text][/vc_column][/vc_row]