What treatments are there for carpal tunnel syndrome?

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Many different treatments have been suggested for carpal tunnel syndrome but only a few have been proven to work. Not all cases are progressive and some may improve without any medical treatment. Importantly, if there’s a particular cause for your problem then your symptoms may improve simply by treating this.

Your doctor will advise you which treatments are available, and they will help to decide which is most appropriate for you. The decision is usually affected by how severe the compression of the nerve is. If it’s severe and your hand muscles are weak, then it’s important to get treatment quickly, and you’ll normally be advised to have surgery.

Simple treatments can often help, including:

  • a resting splint for your wrist – particularly if your symptoms are worse at night
  • a working splint – if your symptoms are brought on by particular activities. This should hold your wrist slightly extended (bent back)

Sleeping in a wrist splint can help

Read more about splints for arthritis of the wrist and hand.

An occupational therapist or physiotherapist will be able to advise you about the different types of splint. Similarly, some therapists recommend certain exercises at the wrist which might help prevent the median nerve becoming stuck to nearby tendons.

Drugs

steroid injection can be helpful, although the effect may wear off after weeks or months. A small quantity of steroid is injected into the carpal tunnel, which helps to reduce any swelling. The injection may rarely be uncomfortable, but it can be very effective. A steroid injection into the wrist joint itself may help if you have arthritis in your wrist.

Surgery

You may need surgery if there’s severe compression of the median nerve or if the numbness and pain doesn’t improve with other treatments.

Carpal tunnel release surgery relieves pain by reducing the pressure on the median nerve. Surgery usually takes place as a day-case and you can expect to recover in less than a month. The operation is normally carried out under a local anaesthetic and usually leaves only a small scar.

If you’ve had carpal tunnel syndrome for a long time – especially if you have muscle-wasting or loss of sensation – the operation may not bring a complete recovery, but the pain should be greatly reduced. For most people, the surgery is very successful, but, as with all surgical treatments, some people will have complications.

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