for about 2 weeks and during this time you need to keep
the wrist and hand as dry as possible. For the first few
days after the operation, it often helps to keep the hand
elevated across the front of the chest on the opposite
shoulder, using some form of sling support.
What to watch out for during treatment: if there is
increasing pain after operation, then you should return to
the doctor for the wound to be inspected, as there may be
some bruising or occasionally infection. There are no
serious side-effects of treatment. The scar on the front of
the wrist in some people is tender but this always settle
down with time and local massage.
What to watch out for after treatment: the recurrence
rate of this condition is very low and there are no delayed
complications.
What would happen if the condition was not treated?
If the nerve is compressed for a long time, then it is less
likely to recover. The numbness and tingling in the
fingers may even be permanent and there may be
weakness of one of the muscles which moves the thumb.
This is more likely to occur in older patients.
What is involved for family and friends?
You will need some help and support while your hand is
bandaged, particularly if it is your dominant hand.
This sheet describes a medical condition or surgical
procedure. It has been given to you because it relates to
your condition and may help you to understand it better. It
does not necessarily describe your problem exactly. If you
have any questions, please ask your doctor.
Ref: www.prodogy.nhs.uk
Compiled at Pre Op Clinic, St Luke’s Hospital, Kilkenny.
Our ref: NM/MN
Reviewed: 10/08/07
Published by the Communications Dept., HSE South,
Ref: 09-06-0043
Designed and Printed by Modern Printers: 056 7721739
Patient information for
Carpal Tunnel Syndrome
What is it”?
Carpal tunnel syndrome can cause
pain and other symptoms in the
hand. It is caused by pressure on a
nerve going to the hand. Treatment
is usually effective.
What causes carpal tunnel syndrome?
Unknown: In most cases it is not clear why it occurs. It
is thought that some inflammation develops in a tendon
going through the carpal tunnel which causes swelling.
There is a little space to expand in the narrow carpal
tunnel, and this may lead to pressure on the nearby
median nerve. Tendon inflammation can occur if you
over-use your hand. Carpal tunnel syndrome is more
common in manual workers, especially if you have a job
where you use a lot of wrist movement such as
scrubbing or wringing.
Bone or arthritic conditions of the wrist such as
rheumatoid arthritis or wrist fractures may lead to carpal
tunnel syndrome.
Various other conditions are associated with carpal
tunnel syndrome. For example, pregnancy, obesity, an
underactive thyroid, diabetes, the menopause, other rare
medical illness, and a side effect of some medicines.
Some of these conditions cause water retention
(oedema) which may affect the wrist and cause carpal
tunnel syndrome.
Rare causes include cysts, growths, and swellings
coming from the tendons or blood vessels passing
through the carpal tunnel.
What is the carpal tunnel?
There are eight small bones called carpal bones in the
wrist. A ligament (also called retinaculum) lies across
the front of the wrist. Between this ligament and the
carpal bones is a space called the carpal tunnel. The
tendons that attach the forearm muscles to the fingers
pass through the carpal tunnel. A main nerve to the
hand (median nerve) also goes through this tunnel
before dividing into smaller branches in the palm.
The median nerve gives feeling to the thumb, index and
middle fingers, and half of the ring finger. It also
controls the movement to the small muscles at the base
of the thumb.
What is carpal tunnel?
This syndrome is a set of symptoms caused by
compression (squashing) of the median nerve in the
carpal tunnel. About 1 in 1,000 people develop this
syndrome each year. Most cases occur in people in their
40’s and 50’s, but it can occur at any age. It is also
common during pregnancy. Women are affected 2-3
times more often than men.
What does treatment/management involve?
A splint worn at night which keeps the wrist straight or
slightly less cocked up often controls the severe pain. Antiinflammatory drugs also help. If these two measures do
not work, then some doctors will advise a local anaesthetic
and cortisone injection into the front of the wrist. The
theory behind this treatment is that the cortisone
counteracts the inflammation and swelling in the carpal
tunnel, allowing more room for the nerve. If both these
treatments fail, then surgery is usually necessary.
Surgery
This takes the form of a small cut on the front of the
wrist running up towards the palm of the hand which
measure 1 – 2 inches long. The operation is done under
either local or general anaesthetic by discussion with the
surgeon. Usually you can go home the same day, with
the hand and wrist bandaged up. The stitches are left in