Carpal tunnel syndrome

Your health Expert: Mr David J Murray, Consultant Orthopaedic Surgeon
Content editor review by Rachael Mayfield-Blake, Freelance Health Editor, September 2023
Next review due September 2026

Carpal tunnel syndrome (CTS) is when a nerve in your wrist is compressed (squeezed). It’s caused by pressure on the nerve, and you may get tingling, numbness, pain, and weakness in your hand. Carpal tunnel syndrome can sometimes get better on its own, but there are also treatments that can help.

Image showing the carpal tunnel and median nerve

About carpal tunnel syndrome

A nerve in your wrist, called the median nerve, controls the feeling in your thumb, index, middle, and half of your ring finger. It also controls muscles in your thumb.

Your median nerve runs through a narrow channel in your wrist called the carpal tunnel. The channel is formed from your wrist bones and a tough band of tissue known as the transverse carpal ligament, which is on the top. Anything that reduces the space or increases the pressure in your carpal tunnel can cause carpal tunnel syndrome.

Carpal tunnel syndrome affects people of all ages, but is more common in women aged between 40 and 60.

Causes of carpal tunnel syndrome

Carpal tunnel syndrome is caused by compression of a nerve in your wrist called the median nerve. There are lots of reasons why this may happen and it’s often difficult to identify one specific cause. It’s likely to be due to several things. You’re more likely to develop it if you:

  • are overweight
  • have other health conditions, including diabetes or an underactive thyroid
  • are pregnant – this may be due to the hormonal changes and fluid retention
  • injure your wrist, such as break (fracture) it
  • do repeated activities that put your wrist in an unnatural position – either bending or twisting it, for example
  • have an inflammatory health condition, such as rheumatoid arthritis
  • have a tumour or growth that presses on your nerve or makes your carpal tunnel narrower

Symptoms of carpal tunnel syndrome

Carpal tunnel symptoms tend to affect your thumb and fingers (apart from your little finger). Symptoms include:

  • numbness
  • a tingling feeling or pins and needles
  • weakness and finding it difficult to grip
  • pain or a burning feeling

Carpal tunnel syndrome can affect both hands, or just one. It can start to affect your whole hand and may also spread up your arm. Your symptoms may be mild at first, but they may gradually get worse. If your carpal tunnel syndrome is severe, you may have symptoms all the time and your muscles may become weak.

You can get carpal tunnel symptoms at any time but they’re often worse at night and may wake you up. When you wake up, you might find it difficult to stretch or flex your fingers.

Certain activities may also trigger your symptoms in the day. For example, holding a book, driving, or doing DIY.

Your carpal tunnel syndrome symptoms may feel better if you shake your wrist or change its position.

If you have any of these symptoms, contact your GP for advice.

Diagnosis of carpal tunnel syndrome

Your GP will ask you about your symptoms and your medical history. They’ll want to know when you get symptoms, what triggers them, and how they affect your daily life. They’ll examine both your hands, and look for signs of carpal tunnel syndrome, such as swelling, any muscle wasting, and low grip strength. They’ll also check the feelings in your fingers and thumb. They may do some tests to check your symptoms, such as:

  • ask you to bend your wrist with your palm towards your forearm
  • tap or press over your median nerve on the inside of your wrist
  • press on the ligament over your carpal tunnel in your wrist

Your GP may be able to diagnose carpal tunnel syndrome just by examining you and asking about your symptoms. But sometimes you may need to have some further tests, which may include the following.

  • Nerve conduction test. This measures the speed at which impulses travel along the median nerve and can show how bad any damage to your median nerve is. In the test, electrodes are placed on the surface of your skin to stimulate the nerve. How fast the impulse travels to another point is recorded, to show how fast the nerve is working.
  • Ultrasound. This allows your doctor to look inside your wrist, and can help to show if there’s any cause for your symptoms.

Self-help for carpal tunnel syndrome

There may be things you can do to manage your symptoms. If there are particular activities that seem to trigger your symptoms, try to avoid these if you can. It may help if you change the way you do these actions or reduce how often you do them.

If you’re overweight, losing excess weight may help to reduce your symptoms.

If you find your symptoms are worse at work, talk to your manager or occupational health department if you have one. They may be able to help with modifications to your workplace or a temporary change to your duties. For example, they may be able to give you a different style of keyboard, or provide you with some wrist rests that may help.

Treatment of carpal tunnel syndrome

You don’t always need carpal tunnel syndrome treatment. For about a third of people, the symptoms improve on their own within about 6 months. This is more likely if you’re under 30, and especially if your symptoms are because you’re pregnant.

If you have another health condition such as arthritis, and get treatment for it, it may improve your carpal tunnel symptoms.

Wrist splints for carpal tunnel syndrome

Wrist splints can help to keep your wrist straight and reduce pressure on your compressed nerve. This may help with symptoms at night and can reduce symptoms during the day too. Your doctor will usually advise you to wear wrist splints at night for at least a month. You can also wear splints during the day, but you may find that they get in the way as you go about your day.

You can buy a wrist splint online or from a pharmacy.

Steroid injections for carpal tunnel syndrome

Your GP may offer you a steroid injection into your carpal tunnel to try and reduce any inflammation around the nerve and relieve the pressure. You may be able to have this at your GP surgery or they may refer you to a specialist for the treatment.

Steroid injections work well for many people but it can take a few weeks to get the full effects. They don’t work for everyone. They can also wear off after a while and your symptoms may come back. If your symptoms do return, you may be able to have another injection but it doesn’t always work.

Carpal tunnel surgery

If your symptoms are severe or other treatments haven’t worked, your GP may refer you to a hand specialist or local musculoskeletal service. They’ll assess you to see if carpal tunnel surgery (also called carpal tunnel release surgery or carpal tunnel decompression) is an option for you.

The procedure involves dividing the ligament in your wrist that forms part of your carpal tunnel to relieve pressure on your median nerve.

There’s a chance that your symptoms may come back after carpal tunnel surgery but this is unlikely. It’s important to talk this over with your doctor before you decide whether or not carpal tunnel surgery is the right choice for you.

Other carpal tunnel syndrome treatments

Exercise therapy

Some people find that hand and wrist exercises can help with carpal tunnel syndrome symptoms. If you see a physiotherapist , they may recommend some of these. Some are simple exercises to improve the strength and flexibility in your wrist. Others, known as nerve glide exercises, aim to help your trapped nerve move more freely. There isn’t much evidence to show that these exercises help though.

Try and avoid activities (wherever possible) that make your symptoms worse. If you can’t avoid them, take regular breaks.

Complementary therapies

Some people find acupuncture helps to relieve the symptoms of carpal tunnel syndrome. But there’s not enough evidence to say for sure that it works. Yoga also helps to relieve carpal tunnel syndrome pain for some people, but again, more research is needed to know for sure.

If you decide to try a complementary therapy, check that your therapist is registered with a recognised organisation.

Looking for physiotherapy?

You can access a range of treatments on a pay as you go basis, including physiotherapy.

To book or to make an enquiry, call us on 0370 218 6528

Carpal tunnel syndrome may fix itself and you might not need any treatment – about a third of people get better within about 6 months. This is more likely if you’re under 30, and especially if your symptoms are because you’re pregnant. If you do need treatment, the best one will be individual to you. Treatment options include wrist splints, steroid injections, physiotherapy, and surgery.

See our treatment of carpal tunnel syndrome section for more information

The symptoms of carpal tunnel include a tingling feeling, pins and needles, pain or numbness in your fingers and thumb. You can have carpal tunnel symptoms in both hands or just one, but it can also spread up your arm – sometimes as far as your shoulder.

See our symptoms of carpal tunnel syndrome section for more information.

A number of things can trigger carpal tunnel syndrome. For example, carpal tunnel syndrome may be triggered by other health conditions, such as diabetes, or an underactive thyroid . If you’re pregnant, it can cause hormonal changes and fluid retention that may trigger carpal tunnel syndrome too. And if you do repeated activities that put your wrist in an unnatural position, this can also be a cause.

See our causes of carpal tunnel syndrome section for more information.

Yes, although carpal tunnel syndrome can get better by itself, or go away with treatment, it may return. Steroid injections may only work for a limited time. And symptoms may also come back after carpal tunnel surgery. Talk to your doctor if your symptoms come back again – they may suggest you try another treatment.

See our treatment of carpal tunnel syndrome section for more information.

If you have carpal tunnel syndrome, your symptoms may sometimes go away on their own within about six months. If your symptoms are due to being pregnant, they’re likely to go away soon after you have your baby. If they don’t get better, there are different treatments that you can try, including wrist splints, steroid injections, hand and wrist exercises, and surgery.

See our treatment of carpal tunnel syndrome section for more information.

At night, you’re more likely to sleep with your wrist bent without realising. This increases the pressure on your nerve as it passes through your carpal tunnel, leading to more symptoms. This is why wearing a splint at night is one of the first things that your doctor will usually advise you to do. A splint will keep your wrist in a neutral position, so you can’t bend it.

See our treatment of carpal tunnel syndrome section for more information.

More on this topic

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