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Ask the expert: How to deal with carpal tunnel syndrome

Ask the expert: How to deal with carpal tunnel syndrome

Tips on spotting and treating carpal tunnel syndrome from Mr Ali Noorani, an orthopaedic surgeon and medical director of the Orthopaedic Specialists Group

How did you become an expert in carpal tunnel syndrome? 

Ali Noorani, expert in carpal tunnel syndrome

Mr Ali Noorani is an orthopaedic surgeon specialising in upper limb surgery, and medical director of the Orthopaedic Specialists Group

It’s a very common problem and was one of the first things I was trained in as a junior doctor. Most people don’t need surgery but it’s a very simple and satisfying procedure.

About 90 per cent of people who have the operation say their pain, numbness, pins and needles, aches, and waking up at night disappear overnight.  

What is carpal tunnel syndrome? 

It’s where one nerve in the hand, the median nerve, gets squished in your wrist. This happens in the carpal tunnel, a natural tunnel made of bone with a ligament on top forming the roof. This carries the nerves and tendons.

"Carpal tunnel syndrome is where the median nerve gets squished in your wrist"

Sometimes the tunnel gets narrow and the first thing that suffers is the median nerve. 

What causes it? 

Carpal tunnel syndrome caused by laptop use

Carpal tunnel syndrome can be caused by jobs and hobbies involving computer work

There are many causes. It can happen in pregnancy because of fluid but normally settles down afterwards. The most common reason is that the ligament on top of the tunnel becomes thick and pushes down on the contents.

Certain groups get it often—those with certain illnesses such as arthritis and diabetes, people who are overweight, and those with hobbies or jobs where they repeatedly make the same movements, perhaps because of vibrating tools or computer work. 

How can people minimise it? 

Occupational therapists can help change desk position and posture.

"What works well are simple splints that keep the hands and wrists straight"

Carpal tunnel syndrome is often bad at night because we bend our wrists as we sleep. What works well are simple splints that keep the hands and wrists straight.  

What treatments are available? 

Wrist splint for carpal tunnel syndrome

Carpal tunnel syndrome can sometimes be treated with wrist splints

If lifestyle or occupational changes or splints don’t work, steroid injections are sometimes enough for mild to moderate carpal tunnel syndrome.

For moderate to severe carpal tunnel, we might offer surgery entailing a small incision in the wrist and dividing the ligament on top. It then reheals looser and takes the pressure off the nerve. 

For more information, visit www.os.clinic 

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