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Living with carpal tunnel syndrome

If you're living with carpal tunnel syndrome you know how uncomfortable it can be. Pain and tingling, or the weakness you can get in your hand can affect your ability to carry out your normal day-to-day tasks.

This guide will help you ease your symptoms and let you know the different treatment options that are available to you.

Image showing the carpal tunnel and median nerve

Details

  • Making life easier Making life easier

    Small changes to your lifestyle, exercise and home remedies can help reduce the pain of carpal tunnel syndrome and make your life easier.

    Cold therapy

    When your symptoms flare up, try applying a cold compress, such as an ice pack or ice wrapped in a tea towel to sooth your wrist. Make sure you don’t apply ice directly to your skin as it can damage it.

    Changing your activities

    If you find that repetitive hand movements are causing you problems, it may help if you change the way you carry out these actions. For example, vibrating electric tools are known to increase your chances of getting carpal tunnel syndrome, so if possible, use manual tools instead. It may also help to limit how often you do the things that make your symptoms worse.

    If you think your work might be causing your symptoms, have a chat with your manager or occupational health team. They’ll be able to give you advice about making changes to your equipment or working techniques that may help relieve your symptoms. You might also find it helps to do some stretching exercises and take regular rest breaks while you’re at work.

    Treating the cause

    As well as taking measures to ease your symptoms of carpal tunnel syndrome, it’s also important to consider the cause of your condition.

    Carpal tunnel syndrome is sometimes linked to:

    Have a chat with your doctor about any other health conditions that might be causing your carpal tunnel syndrome and how they can be treated.

    Splints

    It may help to wear a splint on your wrist, particularly at night. Wrist splints can help to keep your wrist straight and reduce the pressure on your compressed nerve.

    There are different types of wrist splints to choose from.

    • Resting splints. These are useful if your symptoms are worse at night.
    • Working splints. These can help if your symptoms are brought on by doing a particular activity.

    Your GP will help you choose the right splint for you. They may refer you to see a physiotherapist to get a custom fit splint if you can’t find one that’s comfortable.

    Your GP or physiotherapist will let you know how long you should wear a splint for. If your symptoms don’t improve after three months, you may need to consider other options.

    Exercise

    Exercise is a good idea for most people, so you should build some physical activity into your daily routine.

    One type of exercise you could try is yoga. It’s been found to reduce pain and improve the grip strength of people with carpal tunnel syndrome.

    It’s best to avoid any exercises that will put strain on your wrists though, such as cycling.

    Physiotherapy

    A physiotherapist can give you advice about exercises that can help carpal tunnel syndrome. They will involve stretching your wrist to help increase blood flow and encourage healing. They may also involve bending, lifting and flexing your wrist to help improve strength and flexibility.

    Here are some exercises you can try:

    • Rest your elbow on a table, with your arm pointing up and your wrist straight. Gently bend your wrist forward at a right angle and hold it for five seconds. Then straighten your wrist. Next, gently bend it backwards and hold for five seconds. Do three sets of 10 repetitions.
    • Place your palm on the table and lift your fingers up. Place your other hand across your knuckles at 90º and push down as your bottom hand tries to pull up. This should make the muscles of your forearms contract. Swap hands and repeat.
    • Keep your arm straight in front with your palm facing down and gently bend your wrist down. Use your opposite hand to press your stretching hand back towards you and hold for 15 to 30 seconds. Straighten your wrist. Next, gently bend your stretching hand backwards and use the opposite hand to pull your fingers back. Hold for 15 to 30 seconds. Try to do three sets with each wrist.
    • Hold your fingers out straight and then gently bend the middle joints of your fingers down toward your upper palm and hold for five seconds. Aim to do three sets of 10 repetitions.

    You can also use some weights or a tennis ball to do exercises like these:

    • Hold a light weight and stretch your arm out in front with your palm down. If you have any light dumbbells use those or even a tin of beans would do. Slowly bend your wrist up and then return to the starting position. Try to do three sets of 10 repetitions. Gradually increase the weight you hold.
    • Squeeze a tennis ball and hold for five seconds. Aim to do three sets of 10 repetitions.

    Acupuncture

    Acupuncture may help with any pain you’re having because of carpal tunnel syndrome. If you and your physiotherapist decide to try acupuncture, they will insert needles into your skin at various points. The needles will be left in place for up to 20 minutes. Although acupuncture may ease your pain over the short-term, it won’t cure your condition.

    Therapeutic ultrasound

    Your doctor or physiotherapist may suggest trying therapeutic ultrasound. They’ll press an ultrasound probe onto your wrist to deliver sound waves and try and relieve your pain.There’s little research however to show that ultrasound will relieve your pain any better than splints, exercise or medicines.

    Medicines

    Before considering surgery, your GP may recommend trying a steroid joint injection to help relieve the pain from carpal tunnel syndrome. Your GP will inject medicine into your hand where your carpal bones are (in the region of your wrist). Steroid injections may help your symptoms for several months.

    Non-steroidal anti-inflammatory drugs (NSAIDs) and diuretics are sometimes prescribed but are not generally recommended. You can discuss medicines, their effectiveness and side-effects with your GP.

  • Your options for treatment Your options for treatment

    Most people find they can manage the symptoms of carpal tunnel syndrome with self-help measures and medicines. It’s likely your symptoms will get better within six months, particularly if you’re under 30 or recently been pregnant.

    If your symptoms are affecting your everyday life and you feel you cannot manage them, as a last resort, you might consider surgery.

    When is surgery necessary?

    Your doctor will usually only recommend that you have surgery if you’ve tried other treatments, such as splints, medicines and physiotherapy and they haven’t worked. Normally you will need to have had steroid injections and tried wearing splints for at least a month first.

    If you have severe symptoms, including a weak thumb, and tests have shown you have nerve damage, your doctor will recommend you have surgery straightaway.

    Your options for surgery

    If you and your GP decide surgery will help treat your carpal tunnel syndrome, you’ll be referred to see an orthopaedic hand surgeon. There are different types of operations to treat carpal tunnel syndrome. The most common type is carpal tunnel release surgery but your surgeon will discuss which technique is most suitable for you.

    You and your doctor, and surgeon, can work together to make a decision about the treatment that’s right for you. This will be based on your doctor’s expert opinion and your personal values and preferences.

    Does surgery work?

    Surgery is initially very successful and helps nine out of 10 people with carpal tunnel syndrome. However, the effects don’t last for everybody and your symptoms may return.

    There are also surgical related complications to consider. After surgery you may have some pain related to your operation and weakness in your hand that will require physiotherapy.

  • Getting treatment with Bupa On Demand Getting treatment with Bupa On Demand

    If you'd like to pay for your own treatment without health insurance then Bupa on Demand might be able to help you.

    Bupa on Demand provides pay as you go access to private healthcare including initial consultations, diagnostics tests and treatment with no insurance needed. We use the Bupa provider network of over 16,000 consultants and 200 hospitals‡‡, which means we can quickly and easily arrange a location convenient for you.

    ‡‡ valid as of October 2017

    • no health insurance needed
    • only pay for the treatment you need
    • your own dedicated healthcare adviser
    • fast access to consultations, tests and treatments
    • access to Bupa’s extensive provider network

    Find out more about Bupa On Demand. If you’d like to discuss your options or find out more about carpal tunnel release surgery, our team of healthcare consultants are here to help. Request a callback >

    What will I need to get private treatment?

    You’ll need a referral letter from your GP stating that you’ve been refused the opportunity to see an orthopaedic consultant for your symptoms. You can choose to either go to the NHS for your consultation or pay a fixed fee of £250 and get an appointment with a Bupa recognised consultant.

    What if I don’t have a referral letter?

    If you don’t have a referral letter, don’t worry. You’ll have the option to pay for a 30 minute private GP appointment in a Bupa centre close to you.

    Call us on 0808 159 8594^ to discuss your options with one of our healthcare consultants.

    If you choose to see a Bupa recognised consultant, they may recommend further tests and scans on top of what you’ve already paid for. These tests and scans will be at an extra cost. You have no obligation to continue with Bupa and you’re free to return to the NHS for this or any further treatment that may be required.

  • Understanding your options Understanding your options

    If you choose to pay for your care privately, you’re still entitled to NHS care. Bupa On Demand can be used alongside NHS treatment so you get on the road to recovery as quick as possible.

    If you’re on a waiting list your position shouldn’t be affected if you decide to have a private consultation.

    People commonly use Bupa On Demand when:

    • they’re going to have to wait a long time for treatment or surgery
    • they’re unable to get an appointment with a consultant or specialist
    • they’ve been refused treatment but still suffer discomfort and pain
    • they would prefer to be treated in a private facility

    You can choose to combine Bupa On Demand private care with free of charge NHS care to speed up your recovery. For more information please visit NHS choices.

  • What to expect What to expect

    What happens during carpal tunnel release surgery?

    During carpal tunnel release surgery your carpal ligament, which helps connect the bones in your wrist, will be cut. This reduces the pressure on your median nerve, which runs through your wrist to your hand.

    If the operation is successful, your pain will probably go away immediately. But symptoms of numbness and tingling may take longer to improve as the nerve recovers more slowly.

    The operation can be done with open surgery, in which your surgeon will make one cut about 5cm long in your wrist. Alternatively you may be able to have keyhole surgery. In this type of operation, your surgeon will make two smaller cuts, just over 1cm long. They will then insert small instruments and a tube-like telescopic camera through the cuts and images will be displayed on a monitor to help guide your surgeon.

    Open and keyhole surgery are about as effective as each other in relieving symptoms of carpal tunnel syndrome but people recover faster from keyhole surgery. They can usually return to work about eight days sooner.

    Recovering from carpal tunnel release surgery

    Once the local anaesthetic from surgery has worn off, you may need pain relief medicine, such as paracetamol or ibuprofen, to help with any discomfort.

    People can often leave hospital the same day as their carpal tunnel release surgery, providing that there were no complications during the procedure.

    Following your surgery, it might take several hours for the feeling to come back into your wrist and hand. It’s important that during this time, you’re careful not to knock or bump your wrist.

    It usually takes around eight weeks to make a full recovery from carpal tunnel release surgery, but this varies from person to person. Your surgeon will let you know how long you should wait before you can carry out certain activities. Depending on your occupation, you may be able to return to work within a few weeks of surgery.

    It’s important that you look after your hand and wrist in the weeks after your surgery to encourage a quick recovery. Regularly lifting your hand above your heart and wiggling your fingers will help to reduce any swelling and stiffness you might encounter.

    Aftercare

    If you choose Bupa On Demand treatment, you’ll be assigned a Bupa healthcare adviser, who’ll be there throughout your recovery.

    It’s their job to make sure your treatment is as stress-free for you as possible, so you can focus on getting better. After your surgery, they’ll stay in contact with you to make sure you’re recovering well. They’ll arrange your appointments for you, including your follow up appointment with your consultant after surgery.

    You’ll also have access to our 24/7 helpline. If you have any health concerns outside of office hours, you can speak to a qualified nurse who will be able to give you advice.

    If there are any complications during or after your procedure, your treatment package will cover additional costs. You won’t have to worry about paying any unexpected fees. Subject to terms and conditions.

    Find out more about Bupa On Demand.

    Risks of surgery

    As with every operation, there are some risks associated with carpal tunnel release surgery. The chance of these happening is specific to you and differs for every person. Your surgeon will explain what the risks are, and how they apply to you.

  • Find more information Find more information

    Find out more about our private physiotherapy services to help with your carpal tunnel syndrome symptoms.

    If the pain of carpal tunnel syndrome is getting you down it may help to contact the PainSupport group. They have an online forum where you can chat to others, get advice and share experiences.

    If you’re concerned that your work may be causing carpal tunnel syndrome, your local Jobcentre Plus office may be able to help. They can put you in touch with a Disability Employment Advisor to advise you on changes to your equipment or working techniques.

  • Related information Related information

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    Produced by Dylan Merkett, Bupa Health Content Team, November 2015.

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