Emergency Care Institute Patient Fact Sheet

Published on 20 Jul 2022 Printed on 10 Aug 2022


Carpal tunnel syndrome

This fact sheet is for people who have presented to the emergency department with this condition.

This fact sheet provides general information. If you have specific concerns, speak to your healthcare professional for further information and advice.

What is carpal tunnel syndrome?

Carpal tunnel syndrome (CTS) is caused by pressure on the median nerve as it travels through a bony tunnel in the wrist.

Typically, your clinician can diagnose CTS from your symptoms and a physical examination. Nerve conduction studies maybe ordered to give an accurate measure of the degree of pressure affecting the nerve.

Symptoms

Patients with CTS will often describe pain, numbness, tingling, weakness or clumsiness to the hand or reduced grip strength. Symptoms are most common at night or early morning.

Causes

Often the reason is unknown. Possible causes include:

  • repeated forceful hand movements
  • inflammation
  • arthritis in your wrist
  • wrist fractures
  • fluid retention, for example, if pregnant.

      Treatment

      A temporary splint is often used to keep your wrist in a comfortable position. Usually, this position is with your wrist straight and your fingers naturally curled. The splint is one of the most effective ways to relieve symptoms, especially when worn overnight.

      Simple regular pain relief, such as paracetamol or ibuprofen, may ease symptoms.

      Steroid injections can provide some short-term relief, but symptoms often return once the steroid has worn off. That can be within a few weeks or a few months. Steroid tablets can also be used but are less effective and tend to have more side effects, such as nausea, insomnia and stomach pains.

      If you have severe or persistent symptom that don’t clear up after trying the simpler options, surgery may be suggested by your doctor. Surgery consists of cutting the ligament that stretches over the top of the roof of the carpal tunnel.

      Strategies to help reduce or prevent CTS include activity modification, posture correction and hand therapy. Hand therapy exercises aimed at gently gliding the median nerve and tendons through the carpal tunnel.

      What to expect

      If you have CTS and develop any of the following symptoms, seek medical help urgently:

      • Weakness of the affected arm
      • Pain that is worsening or very severe
      • Changes in sensation

      Often pregnant woman who experience CTS find symptoms go away after the birth of their child.

      Seeking help

      In a medical emergency call an ambulance – dial triple zero (000). If you have any concerns, see your local doctor or healthcare professional. If this is not possible return to the emergency department or urgent care centre.

      For more information

      Ask your GP or healthcare professional. You can also call healthdirect 24 hours a day on 1800 022 222 or visit healthdirect.gov.au.

      Evidence informedBased on rapid evidence check of grey literature and, where there is no research, based on clinical expert consensus.
      CollaborationDeveloped in collaboration with the Agency for Clinical Innovation (ACI) Emergency Care Institute members and the ACI's Musculoskeletal Network. 
      Currency Due for review: July 2027.
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