Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

Adelaide Carpal Tunnel Specialist

Adelaide Shoulder and Upper Limb Clinic is an Adelaide based orthopaedic clinic, offering endoscopic carpal tunnel release surgery. Our approach for an optimal outcome will help you decide on the carpal tunnel treatment that is best for you.

What is Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a common, painful, progressive condition that is caused by compression of the median nerve at the wrist area.

Carpal Tunnel Syndrome is not a single condition. Rather, it is a collection of symptoms commonly caused by other underlying conditions. In simple terms, swelling inside the narrow carpal tunnel in the wrist is the cause of the pain. A variety of conditions contribute to carpal tunnel syndrome so your doctor will usually look for underlying causes.

The Carpal Tunnel is a narrow passageway between the wrist and the hand. The wrist bones lie underneath it and the transverse carpal ligament sits over the top. Inside the carpal tunnel is the median nerve, which gives feeling to the thumb, index finger, third finger and half of the ring finger. Several tendons also pass through this narrow space. When swelling occurs, these tendons squash or constrict the large median nerve. Symptoms of numbness and pain and reduced function are the result.

Symptoms of Carpal Tunnel Syndrome

If you have any of the following symptoms of Carpal Tunnel Syndrome, it's a good idea to make an appointment. Early intervention often means treatment is more effective.

  • Weakness in your hand.
  • You suffer pain at night.
  • Diminished grip strength.
  • You have pain that radiates into your arm or shoulder.
  • Your little finger and half of your ring finger are not affected by pain or weakness.
  • You have stabbing pain in your wrist.
  • You experience numbness or pins and needles in your wrist or hand.
  • Tingling sensation in all the fingers except little finger. 

Causes of Carpal Tunnel Syndrome

While sometimes the cause of Carpal Tunnel Syndrome remains a mystery, the following conditions are common causes:

  • Pregnancy can cause fluid retention which leads to swelling.
  • Arthritis often causes swelling and inflammation.
  • Wrist fracture, when a fragment of bone irritates surrounding tissue.
  • Overuse of the hand or wrist, especially when using awkward or repetitive movements. Common examples of this include typing, smart phone use, gaming, e-sports, etc.
  • Some people were born with a smaller carpal tunnel, making them more prone to the condition.
  • Sprains.
  • Hormonal imbalance, and other medical conditions such as hypothyroidism, rheumatoid arthritis, diabetes, obesity, gout, overactive pituitary gland.
    Presence of a cyst or tumour in the canal.
Non-Surgical Treatments For Carpal Tunnel Syndrome

In most cases, non-surgical treatments will be recommended before considering surgery. 

These can include:

  • Wearing a splint at night to help with the pain.

  • Resting your hand and wrist if the injury is caused by overuse.

  • Physiotherapy treatments.

  • Corticosteroid injections to reduce the swelling.

  • Diuretic medication which reduces fluid in your body by excreting it as urine.

  • Treating underlying medical conditions.

  • Immobilisation of the hand and wrist with a splint or wrist brace for 4-6 weeks.

  • Ice packs to avoid swelling.

  • Avoid activities that tend to worsen the symptoms.

  • Medications such as non-steroidal anti-inflammatory drugs, diuretics.

  • Strengthening and stretching exercises once symptoms diminish.

  • If conservative treatment options fail to resolve the condition your surgeon may recommend a surgical procedure.

Carpal Tunnel Surgery and Recovery

When surgery is the best option, ASULC will perform a relatively simple operation.  It involves cutting the transverse carpal ligament over the top of the carpal tunnel, which relieves pressure on the median nerve below.  As your body heals the injury to the ligament, scar tissue forms which should prevent the buildup of pressure on the nerve.

The surgeons at Adelaide Shoulder and Upper Limb Clinic prefer to manage carpal tunnel syndrome using a minimally-invasive, key-hole endoscopic surgical technique (when indicated).  An open technique can also be used and involves a slightly larger incision and clear visualisation of the structures inside the carpal tunnel.