Understanding Carpal Tunnel Syndrome
What patients commonly notice
Compression of the median nerve at the wrist can cause numbness, tingling, night symptoms and reduced hand strength. The exact pattern and severity can vary, so a clinical assessment is important before deciding on treatment.
Common symptoms
- Numbness or tingling in the thumb, index and middle fingers
- Night waking or symptoms while driving
- Weak grip, clumsiness or dropping objects
Causes and risk factors
There may be more than one contributing factor. Common possibilities include:
- Reduced space within the carpal tunnel
- Inflammatory conditions, pregnancy or diabetes
- Wrist fracture or repetitive hand loading
How is carpal tunnel syndrome assessed?
Assessment may include hand strength, sensation, dexterity, tendon movement and joint stability. X-rays, ultrasound, MRI or nerve-conduction studies are selected according to the suspected problem.
Treatment options
Treatment is matched to the diagnosis, symptom severity, general health and the activities you need to return to. Options may include:
- Night splinting and activity modification
- Injection for selected cases
- Carpal tunnel release when compression is persistent or severe
Surgery is not automatically the first step. When it is considered, the likely benefit, alternatives and recovery requirements should be discussed clearly.
Common questions
Why are my thumb, index and middle fingers numb at night?
Wrist position during sleep can increase pressure on the median nerve in the carpal tunnel. A correctly fitted night splint that keeps the wrist neutral often reduces early night symptoms.
Do I need a nerve-conduction test before treatment?
Not in every straightforward case, but testing can confirm severity, identify other nerve problems and help planning when symptoms are persistent, atypical or associated with weakness.
When should carpal-tunnel surgery be considered?
Release may be recommended for persistent symptoms, constant numbness, weakness, muscle wasting or severe nerve-test changes. Earlier assessment is important when hand strength is declining.
This page provides general patient information and does not replace a consultation or personalised medical advice.