Treatment of Carpal Tunnel Syndrome | PAX Medicus Medical Tourism UK

Treatment of Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition caused by pressure on the median nerve inside the wrist. It leads to numbness, tingling, pain, and weakness in the hand and fingers, especially during daily activities.

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What is carpal tunnel syndrome?

Carpal tunnel syndrome is a compressive neuropathy of the median nerve. Compressive neuropathies occur when a nerve becomes irritated or dysfunctional due to pressure from surrounding structures or swelling. The median nerve passes through the carpal tunnel – a narrow passageway formed by carpal bones and ligaments. This tunnel contains tendons and nerves essential for normal hand movement.

The median nerve is most commonly compressed by a swollen synovial membrane surrounding the tendons. Other structures may also contribute, including bone fragments after injury, rheumatoid nodules, gout deposits, or ganglion cysts.

Who is affected?

Carpal tunnel syndrome affects around 0.5–1% of the population and is more common in women, especially during pregnancy. Obesity increases the risk. It may occur as an isolated condition or be associated with illnesses such as rheumatoid arthritis, hypothyroidism, or chronic kidney disease.

Risk factors

  • Female gender
  • Pregnancy-related swelling
  • Obesity
  • Rheumatoid arthritis or thyroid disorders
  • Chronic kidney disease

Lifestyle & activity links

  • Repetitive hand movements
  • Vibration exposure (e.g., cycling or machinery use)
  • Playing musical instruments
  • Genetically narrow carpal tunnel
  • Sports such as tennis or racquet games

Symptoms of carpal tunnel syndrome

Sensory symptoms

  • Wrist pain and discomfort
  • Paraesthesia (electric shock sensations)
  • Numbness or tingling in the thumb, index, and middle finger
  • Symptoms occurring during day and night

Motor symptoms

  • Weak grip strength
  • Difficulty holding objects
  • Reduced hand coordination
  • Muscle weakness at the base of the thumb

Treatment options for carpal tunnel syndrome

Surgery is the primary treatment for carpal tunnel syndrome. The procedure involves cutting the transverse carpal ligament, the structure forming the roof of the carpal tunnel. This increases the space inside the tunnel and relieves pressure on the median nerve.

Procedure steps include:

  • Performed under regional anaesthesia (arm numbed from shoulder down)
  • A longitudinal incision (approximately 5 cm) is made along the wrist
  • The transverse carpal ligament is exposed and carefully cut
  • The wound is closed with standard sutures

Surgical decompression remains the most effective method for relieving pressure on the median nerve and preventing long-term nerve damage.

How is carpal tunnel syndrome diagnosed?

Diagnosis is primarily based on a clinical examination. The doctor performs specific tests designed to provoke symptoms and evaluates hand sensation and muscle strength. A detailed medical and symptom history is also essential.

Clinical tests

  • Durkan’s test – pressure over the carpal tunnel
  • Tinel’s test – tapping over the median nerve
  • Phalen’s test – wrist flexion held for several seconds
  • Sensation testing with eyes closed

Additional tests

  • Electromyography (EMG) – evaluates electrical activity in muscle fibres
  • Used when diagnosis remains uncertain
  • Helps assess severity and nerve function

Recovery after carpal tunnel surgery

Immediately after surgery

  • Most patients go home the same day
  • Thick bandage applied to protect the wrist
  • Follow-up visit at 2–3 weeks for stitch removal
  • Regular finger movement recommended to prevent stiffness
  • Keep hand elevated to reduce swelling
  • Pain managed with oral painkillers

Rehabilitation & long-term outcome

  • Physiotherapy begins after dressing removal
  • Exercises restore mobility and speed up healing
  • Recovery time may range from several weeks to a few months
  • Full grip strength typically returns after about two months

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