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Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome (CTS) is a common condition that can cause tingling, numbness, aches or pains in the hand and wrist. It is caused by pressure on the median nerve as it passes through the wrist towards your hand.

What are the symptoms?

All symptoms can vary in intensity and may come and go.

  • Typical symptoms include altered sensation such as tingling or numbess and aches/pains felt in the thumb, index finger, middle finger and the thumb side of the ring finger
  • Symptoms are often worse at night and can disturb sleep 
  • Symptoms may affect one or both hands and may spread up into the wrists and forearm.
  • You may also experience some reduction in your grip strength and feel a little clumsy when using your hands to do things like fastening up buttons.

What are the causes?

The exact cause is not always known, but anything that increases pressure on the nerve can lead to symptoms, such as;

  • Repetitive hand or wrist actions such as gardening, assembly line work or forceful gripping actions
  • Obesity 
  • Peri-menopausal women. It is three times more likely in women than men 
  • Pregnancy 
  • Osteoarthritis & Rheumatoid arthrtitis effecting the wrist and hand
  • Vibration - such as from operating machinery 
  • Underlying health conditions such as diabetes or underactive thyroid
  • Cysts growing in the space around the nerve
  • Direct injury to the wrist such as a fall or trapping the wrist
  • Psychological factors such as low mood 


What can I do to help myself?

  • Reduce aggravating, repetitive activites. It may be helpful to speak with your employer if these are related to your work.
  • Wearing a wrist splint, especially at night. Splints help to keep the wrist in a neutral position, reducing pressure on the nerve.
  • Use painkillers such as paracetamol. Speak with a local pharmacist or GP if you are unsure about taking medication.
  • Ensure underlying health conditions are well controlled, such as diabetes.


What will physiotherapy do?

A physiotherapist will take a thorough history of your symptoms and will conduct a physical examination of the area to confirm the diagnosis.

Management will focus on advice to modify activities and advice on splints. Unfortuantly we do not provide splints but can advise on which to purchase. 

The use and risks of injections can be discussed with your physiotherapist or GP but self management and splints are always required in the first intance. Due to the coronavirus outbreak we will not be offering injections until further notice.

Exercises, acupuncture, electrotherapy and massage have not been shown to be useful for CTS and are therefore not offered. 


Symptoms to check

Click the plus sign to see a list of problems that could be a sign you may need to be checked urgently

Get advice from 111 now if:

  • the pain is severe and started after an injury or accident, like a fall
  • if you have cut yourself and can no longer move your fingers or wrist normally
  • you heard a snap, grinding or popping noise at the time of an injury
  • you are unable to move or hold things
  • your hand or wrist has changed shape or colour
  • you have a very high temperature, feel hot and shivery, and have redness or heat around the hand, wrist or fingers – this can be a sign of infection
  • you have any severe tingling or loss of sensation in your hand and it wont go away

Immediate medical advice is available by contacting NHS 111

Exercises & Resources area

Exercises & Resources

If you already have a diagnosis from a medical professional you may find some of the following links more helpful:

If your pain persists, or you are not sure what to do you can self-refer to see a local physiotherapist who can help you with your problem