Carpal Tunnel Syndrome: what it is and how we help

Carpal tunnel syndrome at a glance

Carpal tunnel syndrome happens when the median nerve is squeezed as it passes through a narrow tunnel in the wrist. It causes tingling, numbness and pain in the thumb, index and middle fingers, often worse at night. Mild cases often improve with splinting and activity changes; persistent or severe cases may need an injection or a minor operation.

Symptoms of carpal tunnel syndrome

• Pins and needles or numbness in the thumb, index, middle and half of the ring finger
• Symptoms that wake you at night and ease when you shake the hand
• Aching in the hand, wrist or forearm
• Dropping things or weakness in the thumb

What does carpal tunnel feel like?

Most people first notice tingling or pins and needles in the thumb and first two or three fingers, often when waking at night or first thing in the morning. Shaking or flicking the hand usually brings relief. During the day it may appear while holding a phone, driving or reading a book. Some people describe a burning or aching feeling spreading into the forearm. The little finger is usually not affected, which helps tell carpal tunnel apart from a trapped nerve at the elbow.

What causes carpal tunnel syndrome?

Anything that increases pressure in the tunnel can cause it: repetitive wrist bending, pregnancy, the menopause, diabetes, an underactive thyroid, rheumatoid arthritis, wrist injury and excess body weight. It is three times more common in women.

How is carpal tunnel diagnosed?

Diagnosis is usually made from your symptoms and a simple examination. A clinician may tap over the nerve at the wrist or hold the wrist bent for a minute to see if tingling appears, and will check sensation and thumb strength. Nerve conduction studies are used when the diagnosis is unclear, symptoms are severe or surgery is being considered. For a fuller guide to symptoms, tests and treatment, see carpal tunnel syndrome symptoms.

How is carpal tunnel syndrome treated?

A wrist splint worn at night is the usual first step. A steroid injection can reduce symptoms, and carpal tunnel release surgery is recommended for severe or persistent cases, especially if there is muscle weakness. Pregnancy-related carpal tunnel often settles after birth.

How we help with carpal tunnel syndrome in Chiswick

• Physiotherapy: nerve and tendon gliding exercises, splinting advice and workstation changes.
• Manual therapy: soft tissue work for the forearm, neck and shoulder, which can contribute to similar symptoms.
• Acupuncture: some trials report symptom improvement in mild to moderate cases.
• Red light therapy: laser therapy has shown short-term benefit for mild to moderate carpal tunnel in some studies.
• Blood tests: checking thyroid function and blood sugar where relevant.

For more detail, read our guide to acupuncture for carpal tunnel syndrome.

Does carpal tunnel go away?

Mild carpal tunnel often does, particularly when it is linked to pregnancy, a temporary rise in repetitive work or fluid retention. Night splints and activity changes help many people within weeks to a few months. Symptoms that are constant, or that come with thumb weakness or muscle wasting, are less likely to settle on their own and need prompt review, because long-standing pressure can cause lasting nerve damage.

What does the evidence say?

Night splints and steroid injections both improve symptoms in the short term. Surgery gives the most reliable long-term result for moderate to severe cases. Evidence for exercise, acupuncture and laser therapy is more limited but supports them as options for mild to moderate symptoms.

What to expect at Omnia

Your physiotherapist checks sensation and grip strength and looks at the neck and shoulder, which can cause similar symptoms. You receive splint advice, nerve gliding exercises and practical changes to your desk, phone and tools. If we find signs of significant nerve compression, we write to your GP so you can be referred for nerve tests or a surgical opinion without delay.

What you can do at home

• Wear a wrist splint at night to keep the wrist straight
• Take regular breaks from repetitive gripping or typing
• Keep your wrist neutral at the keyboard
• Do gentle nerve gliding exercises taught by a physiotherapist

For a step-by-step home programme, including tendon and nerve glides and how to use a night splint, see our guide to carpal tunnel exercises.

Carpal tunnel syndrome is assessed at Omnia Lifestyle in Chiswick W4, two minutes from Turnham Green station. Book online or call 020 4515 0000.