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    4. Carpal Tunnel Syndrome

    Carpal Tunnel Syndrome

    At Mayo Clinic Healthcare in central London, our orthopaedic specialists provide expert assessment, diagnosis and treatment for carpal tunnel syndrome. If you are experiencing numbness, tingling or weakness in your hand, our team will work with you to identify the cause of your symptoms and recommend the most appropriate treatment.

    Carpal tunnel syndrome develops when the median nerve becomes compressed as it passes through the carpal tunnel, a narrow passageway in the wrist. Early assessment can help relieve symptoms, improve hand function, and reduce the chance of lasting nerve problems.

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    • Carpal tunnel syndrome is a condition that occurs when the median nerve is compressed as it passes through the carpal tunnel in the wrist.

      The carpal tunnel is a narrow channel made up of bones and a strong band of tissue called the transverse carpal ligament. Along with the median nerve, several tendons that help move your fingers pass through this space.

      When pressure within the tunnel increases, the median nerve becomes compressed. This can affect feeling in the fingers and reduce the strength and function of your hand.

      Carpal tunnel syndrome is one of the most common nerve compression conditions and can affect one or both hands.

    • Carpal tunnel syndrome symptoms often develop gradually and may become more noticeable over time. Symptoms commonly affect the thumb, index finger, middle finger, and part of the ring finger.

      You may experience:

      • Numbness or tingling in the thumb, index, middle, or ring fingers
      • Pain in the wrist or hand that may spread into the forearm
      • Symptoms that are worse at night or first thing in the morning
      • Weakness when gripping or holding objects
      • Frequently dropping items
      • Difficulty with tasks that require fine finger movements, such as fastening buttons or writing
      • A sensation that your fingers are swollen, even if they do not look swollen

      Without treatment, ongoing compression of the median nerve can lead to persistent numbness, reduced hand strength, and loss of muscle strength or muscle size at the base of the thumb.

    • Carpal tunnel syndrome develops when pressure on the median nerve increases.

      Several factors can contribute to this pressure, including:

      • Repetitive hand or wrist movements
      • Wrist injuries, such as fractures or sprains
      • Arthritis affecting the wrist
      • Swelling of the tissues surrounding the tendons
      • Pregnancy, when fluid retention may increase pressure within the carpal tunnel
      • Diabetes
      • Thyroid disorders
      • Obesity
      • In some cases, no single cause can be identified

      Your consultant will consider your symptoms, medical history and any underlying health conditions to understand what may be contributing to your symptoms.

    • Diagnosis begins with a detailed consultation and physical examination.

      Your assessment may include:

      • A discussion about your symptoms, including when they occur and how they affect daily activities
      • Examination of your hand, wrist, and fingers
      • Assessment of sensation, grip strength, and thumb movement
      • Gentle clinical tests to assess irritation of the median nerve

      If further information is needed, your consultant may recommend additional tests, including:

      • Nerve conduction studies, which measure how well electrical signals travel through the median nerve
      • Electromyography (EMG), which evaluates how well the muscles supplied by the median nerve are functioning
      • Ultrasound, to assess swelling of the median nerve or surrounding structures
      • Magnetic resonance imaging (MRI), if another condition affecting the wrist is suspected

      Different people require different tests, and your diagnostic pathway will be tailored to your symptoms and examination findings.

    • Treatment depends on the severity of your symptoms and whether there are signs of nerve irritation or damage. 

      Many people improve with non-surgical treatment, particularly when symptoms are diagnosed early.

      Your treatment plan may include:

      Wrist splinting

      A wrist splint, particularly when worn at night, helps keep the wrist in a neutral position and may reduce pressure on the median nerve while you sleep.

      Activity modification

      Adjusting activities that place repeated strain on the wrist may help reduce symptoms and prevent them from worsening.

      Medication

      Anti-inflammatory medicines may help relieve pain for some people. In certain cases, your consultant may recommend a corticosteroid injection to reduce inflammation around the median nerve.

      Physiotherapy

      Exercises, nerve gliding techniques and advice on hand and wrist positioning may help improve movement and support recovery.

      Surgery

      If symptoms are severe, continue to worsen or do not improve with non-surgical treatment, surgery may be recommended to relieve pressure on the median nerve. Your consultant will discuss whether this is the right option for you based on your symptoms and test results.

      Although Mayo Clinic Healthcare in London does not offer surgery, we collaborate with leading healthcare professionals who are able to carry out these procedures.

    • Patients choose Mayo Clinic Healthcare for access to experienced orthopaedic specialists and coordinated care for conditions affecting the hand and wrist.

      Our approach includes:

      • Consultant-led assessment and diagnosis
      • Access to advanced imaging, including MRI, ultrasound, X-ray, and CT where appropriate
      • Personalised treatment plans based on your symptoms and lifestyle
      • Collaboration with orthopaedic, physiotherapy, and diagnostic imaging specialists
      • Evidence-based care informed by international clinical expertise

      As part of the globally recognised Mayo Clinic network, we are committed to helping you understand your condition and supporting you throughout your care.

    Private health insurance

    Mayo Clinic Healthcare works with all major private health insurance providers, including AXA PPP, Aviva, BUPA, Health Partners Group, Vitality Health and WPA. Self-pay arrangements are also available.

    Book a carpal tunnel appointment 

    If you are experiencing carpal tunnel syndrome symptoms, including numbness, tingling or weakness in your hand, our specialists can help assess the cause and recommend a treatment plan that fits your needs. 

    Request an appointment today or call +44 (0) 207 871 2575 to speak with our team. 

     

    Medically Reviewed by

    Mr Karthik Karuppaiah, Consultant Orthopaedic Surgeon

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