Symptoms
Most people first notice pins and needles in the thumb, index and middle fingers, often at night or on waking. Shaking the hand tends to relieve it. As the condition progresses the numbness can become constant, grip may weaken, and everyday tasks like fastening buttons become clumsy.
What causes it
Often there is no single cause. It is more common in pregnancy, with diabetes or thyroid problems, after wrist fractures, and in jobs or hobbies involving repetitive gripping. It affects women more often than men.
Treatment without surgery
Mild or intermittent symptoms often settle with a night splint that keeps the wrist straight. A steroid injection into the carpal tunnel can reduce swelling around the nerve and may give lasting relief, particularly in early or pregnancy-related cases. This is not suitable for all cases, but it can be discussed during your consultation. Often we will arrange nerve conduction tests to look at how the nerve is functioning.
Surgery
Carpal tunnel release is a short operation, usually done under local anaesthetic as a day case. The ligament forming the roof of the tunnel is divided to take pressure off the nerve. Night symptoms usually improve quickly; numbness that has been present a long time recovers more slowly and sometimes incompletely, which is why persistent symptoms are worth assessing sooner rather than later.
Recovery
The hand can be used for light tasks within a few days. Most people return to desk work within a week or two and to heavier manual work by around six weeks. The scar can feel tender for a few weeks and firm pinch strength returns gradually.
This page is general information, not personal medical advice. The British Society for Surgery of the Hand also publishes helpful patient guides. For advice about your own hand, book an assessment.