Introduction
Carpal Tunnel Syndrome is a common condition that occurs when the median nerve in the wrist becomes compressed. The median nerve controls sensation and movement in the thumb, index, middle, and part of the ring finger.
When pressure builds in the carpal tunnel (a narrow passageway in the wrist), it can lead to numbness, tingling, weakness, and pain. Carpal Tunnel Syndrome can affect everyday activities, such as typing, gripping, or even interfering with sleep.
What Causes Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome develops when relative pressure increases within the carpal tunnel (either due to the swelling of the contents e.g. tendonitis; or narrowing of the tunnel space e.g. wrist osteoarthritis). Contributing factors include:
- Repetitive hand movements (typing, assembly line work, manual labour)
- Wrist injuries or fractures
- Medical conditions (diabetes, thyroid disorders, rheumatoid arthritis)
- Fluid retention (common during pregnancy)
- Genetics (naturally smaller carpal tunnel in some people)
Symptoms of Carpal Tunnel Syndrome
Typical signs include:
- Numbness or tingling in the thumb, index and middle fingers, as well as part of the ring finger – can be temporary, transient or persistent
- Pain that can radiate up the arm
- Weak grip strength (dropping objects)
- Worse symptoms at night or during repetitive activities
- Relief by shaking or moving the hand
- Persistent numbness with wasting of the intrinsic muscles of the thumb would be the result of prolonged, untreated carpal tunnel syndrome
When to See a Specialist
You should consult a hand surgery or a plastic surgery specialist if you:
- Have ongoing tingling or numbness in your fingers
- Experience weakness or ‘clumsiness’ in the hand or thumb
- Find that symptoms interfere with daily tasks or waking up from sleep
- Notice symptoms are worsening despite self-care with medication or splint
Treatment Options for Carpal Tunnel Syndrome
- Non-Surgical Management
- Activity modification – Reduce repetitive wrist movements
- Wrist splinting – Keeps the wrist in a neutral position, especially at night
- Medications – Anti-inflammatory drugs may reduce swelling
- Corticosteroid injections – Targeted relief by reducing inflammation within the tunnel – this can often be done in office if needed after appropriate clinical assessment
- Surgical Management (Carpal Tunnel Release)
- Recommended when symptoms are severe or persistent
- Surgery involves releasing the tight ligament (which is essentially the roof of the carpal tunnel) that is causing pressure on the median nerve
- Can be performed via open surgery or endoscopic (keyhole) surgery
- Dr Cheng’s preference is to performed an open carpal tunnel release, which can be performed either under LA in rooms or under sedation/anaesthesia in private hospitals
- Typically improves symptoms quickly, with a short recovery period
Recovery After Carpal Tunnel Surgery
- Light use of the hand is possible within days
- Return to work varies — a few days for office tasks, longer for manual labour
- Therapy with Hand Therapist is recommended to help restore strength and flexibility
- Long-term outcomes are excellent in most patients, with significant symptom relief
- If numbness has been persistent and prolonged prior to treatment, the normal sensation may not completely return after surgery (as the damage of the median nerve may not be reversible if severe enough)
Living With and Preventing Carpal Tunnel Syndrome
- Take regular breaks during repetitive tasks
- Use ergonomic tools and wrist supports
- Keep wrists in a neutral position when typing or working
- Maintain good control of underlying health conditions (e.g., diabetes)
About Dr Paul Cheng
I’m Dr Paul Cheng, FRACS, a Specialist Plastic, Aesthetic & Reconstructive Surgeon based on the Gold Coast and in Ballina, NSW. I provide expert assessment and treatment for soft tissue hand conditions, including carpal tunnel syndrome, using both non-surgical and surgical approaches.
If you are experiencing hand numbness, weakness, or pain, please book a consultation for an expert diagnosis and tailored treatment plan.