The moment your hand falls asleep and you get the pins and needles in your fingers, the chances are good that you suffer from CTS.

CTS is a repetitive strain injury. Although there are many causes for carpal tunnel syndrome, by far the most common is doing repetitive motions as part of your job. Fragmentation of work to the point that one person does one task over and over has been blamed for the increase in cases of CTS in recent years.

CTS is due to a compression of the midpoint nerve as it crosses the wrist and enters the hand. At that point there is a stringy band which is non-flexible and when midpoint nerve compression occurs against the band, wrist swelling is the result.

Symptoms

The syndrome is characterised by numbness, tingling or weakness in the fingers. Usually the first three fingers are affected the most, but the whole hand can be affected. It can occur bilaterally. It is worse in the morning and may be relieved by shaking the wrists.

Causes

Some people have smaller carpal tunnels than other people do, which means that they are more likely to suffer from CTS. Other causes include performing assembly line work, wrist injury or swelling due to certain diseases, such as rheumatoid arthritis. Women are three times more likely to have CTS than men.

Treatment

The initial carpal tunnel syndrome treatment steps include medications and splints.

      • Anti-inflammatory medications can decrease inflammation in the carpal tunnel and can also decrease CTS symptoms.
      • Wrist braces help to stabilise the carpal tunnel in its neutral position. The carpal tunnel is at its widest diameter in this position and the nerve is least compressed. Wearing the splint at night is especially important, as well as during activities that tend to irritate your CTS.
      • The next step in CTS treatment can be a cortisone injection to the area to decrease inflammation around the nerve. The cortisone injection is effective in about 80% of cases because the medication is delivered to the source of the problem; however, steroids should be injected sparingly, and if the CTS returns, surgery may be considered.

Surgery

Surgical treatments are available and effective in the treatment of CTS. The most common procedure is to make an incision in the rubbery cover around the carpal tunnel. By releasing tension in the carpal tunnel, the pressure is removed from the nerve.

A carpal tunnel release most commonly performed by a “open” technique. To perform an open carpal tunnel release, the surgeon makes a 4 cm incision down the middle of the palm. He or she carefully dissects the tissues down to the carpal tunnel. The carpal tunnel is opened up to relieve the pressure on the nerve. The surgery only takes about 15 minutes, and can be performed under local, regional, or general anaesthesia.

Our Employee Wellbeing Programme (EAP) is available 24 hours a day if you want to know more about carpal tunnel syndrome.