Carpal Tunnel Syndrome: Symptoms and What Helps

Carpal tunnel syndrome is pressure on a nerve in the wrist, the median nerve. It causes tingling, numbness and pain in the thumb, index and middle fingers, often worse at night. It usually gets better with a wrist splint at night and less wrist strain. If it lasts or your grip gets weak, see a doctor. This guide is by Dr. Pedro Yelamo Vera, a GP licensed in Spain (Colegiado No. 484814280).

What is the carpal tunnel?

It is a narrow channel on the palm side of the wrist, made by the wrist bones and a ligament. The tendons that bend the fingers pass through it, along with the median nerve. When the channel swells or narrows, the nerve gets squeezed. The NHS describes it simply as pressure on a nerve in your wrist. In Spain it is called síndrome del túnel carpiano.

What are the symptoms of carpal tunnel syndrome?

• Tingling, numbness or pins and needles in the thumb, index, middle and half the ring finger.
• Pain in the hand or wrist that can spread up the forearm.
• Symptoms that are worse at night and wake you up.
• Clumsiness: dropping things, or trouble doing up buttons.
• A weak thumb when you grip or pinch.

It often starts slowly and comes and goes. If your little finger is numb, the problem is probably a different nerve, the ulnar nerve, which runs past the elbow.

What causes carpal tunnel syndrome?

Often there is no single cause. The NHS lists things that raise the risk:

• Work or hobbies that bend the wrist a lot or need a hard grip, such as vibrating tools.
• Pregnancy, from fluid build-up. It often gets better after the birth.
• Diabetes, an underactive thyroid and rheumatoid arthritis.
• Being overweight.
• A past wrist fracture or injury.
• Close family with the same problem.

How is it diagnosed?

A doctor asks about your symptoms and checks your hand: feeling, thumb strength and a few simple tests. One is bending the wrist for a minute (Phalen's test). Another is tapping over the nerve (Tinel's sign). To confirm it and see how bad it is, a nerve test (nerve conduction study, electromiograma in Spain) is done. Sometimes blood sugar and thyroid tests are added.

What helps carpal tunnel syndrome?

• A splint that keeps the wrist straight at night. The NHS says it may take up to six weeks to feel better.
• Doing less of what bends the wrist or needs a hard grip, and taking breaks.
• Painkillers such as paracetamol or ibuprofen help for a short time, but do not treat the cause.
• Gentle hand exercises, though the evidence is limited.

When is an injection or surgery needed?

If a splint is not enough, a steroid injection into the wrist may be offered. It reduces swelling, but symptoms can come back after a few months. If symptoms get worse, or there is weakness or the thumb muscles waste, surgery is considered. The NHS says it usually cures the problem. It is done under local anaesthetic and you go home the same day. Getting back to normal activities can take about a month.

Could it be thumb arthritis?

Thumb-base arthritis (rizartrosis in Spain) is wear of the joint at the base of the thumb. It hurts there when you pinch, turn a key, open a jar or write. It does not usually cause tingling. It is more common in women over 50. A thumb splint, changing how you do tasks, painkillers and sometimes an injection or surgery can help.

What about Dupuytren's contracture?

In Dupuytren's contracture, the tissue in the palm thickens into lumps and cords. Slowly, one or more fingers, mostly the ring and little fingers, bend towards the palm and cannot be straightened. It is usually painless. It is more common in men over 50 and when it runs in the family. It is linked to diabetes, smoking and alcohol. Treatment is offered when the hand will not lie flat on a table or is hard to use.

When to see a doctor

• Tingling or pain is not better after a few weeks of a splint and rest.
• It wakes you most nights.
• Your grip is weak, you drop things, or the muscle at the base of the thumb looks thinner.
• Your fingers bend and will not straighten.
• You have diabetes or are pregnant and these symptoms start.

When to call 112

Call 112 if hand weakness or numbness starts suddenly together with a drooping face, slurred speech or weakness on one side of the body. This can be a stroke. Also go to A&E if your hand turns numb, cold or pale after a blow or a fracture.

Frequently asked questions about carpal tunnel syndrome

Getting a medical assessment

If you are in Spain and have tingling or pain in your hand, you can book a video consultation with Dr. Pedro Yelamo Vera, a physician registered in Spain. You can also read about joint pain and diabetes care. A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

This guide is general information. It does not replace the package leaflet or the advice of your doctor or pharmacist.