Carpal tunnel syndrome

On the palmar side of the wrist there is a broad tendon band. This tendon band holds the flexor tendons in place on their way from the forearm to the fingers. Together with the carpal bones, this tendon band forms a tunnel called the carpal tunnel (karpos = wrist in Greek).

Through the carpal tunnel run 9 flexor tendons as well as the median nerve, which is one of the three major nerves in the forearm and hand. This nerve supplies several muscles in the forearm and hand. It also contains the nerve fibres that give us sensation in the thumb and index finger, middle finger and half of the ring finger (lengthwise) – all on the palmar side.

If compression of the median nerve occurs (carpal tunnel syndrome), symptoms will arise and this can cause pain and problems using the hand.

Symptoms of carpal tunnel syndrome

• Pain in the hand
• Tingling and numbness in the fingers
• Reduced strength and sensation
• Clumsiness

Pre-examination

The consultant can make the diagnosis based on the typical symptoms and the findings from the examination of the hand and arm. In cases of doubt, the diagnosis can be confirmed with a so-called nerve conduction velocity study.

How is carpal tunnel syndrome treated?

The condition can disappear on its own without treatment by means of rest, as the irritation around the nerve will subside. If the condition does not disappear with rest, a corticosteroid injection will be tried first.

If rest and corticosteroids have no effect, surgery may be considered.

The procedure will typically be performed under local anaesthesia. The orthopaedic surgeon will split the tendon band so that the nerve has more space and is no longer compressed.