CARPAL TUNNEL SYNDROME (CTS)

Understanding Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a condition caused by pressure on the median nerve as it passes through a narrow passageway in the wrist called the carpal tunnel. It can cause symptoms such as numbness, tingling, pain and weakness affecting the hand and fingers.

Symptoms can develop gradually and may initially come and go. Some people notice symptoms particularly at night or during activities that involve bending the wrist or gripping objects.

At Alton Pain Clinic, we offer ultrasound-guided cortisone injections for suitable patients with carpal tunnel syndrome. Your clinician can assess your symptoms and discuss whether an injection is an appropriate treatment option for you.

What Is Carpal Tunnel Syndrome?

Carpal tunnel syndrome occurs when the median nerve becomes compressed within the carpal tunnel at the wrist.

The carpal tunnel is a narrow space formed by the wrist bones and a strong ligament. The median nerve passes through this space along with tendons that help move the fingers.

If pressure develops within the carpal tunnel, the median nerve may become irritated or compressed. This can lead to symptoms affecting the hand and fingers.

The median nerve provides sensation to the thumb, index finger, middle finger and part of the ring finger. It also supplies some of the muscles involved in thumb movement.

Carpal tunnel syndrome can vary considerably between people. Some people experience occasional tingling, while others may develop more persistent numbness, pain or weakness.

What Are the Symptoms of Carpal Tunnel Syndrome?

The symptoms of carpal tunnel syndrome can develop gradually and may initially be intermittent.

Common symptoms include:

Numbness in the hand or fingers
Tingling or pins and needles
Aching or pain in the wrist, hand or fingers
Burning or uncomfortable sensations
Symptoms that are worse at night
A weak grip
Difficulty gripping or holding objects
Clumsiness when using the hand
Symptoms that may extend towards the forearm

The symptoms commonly affect the thumb, index and middle fingers and part of the ring finger, although people may describe the sensation as affecting much of the hand.

Carpal Tunnel Symptoms at Night

Night-time symptoms are common with carpal tunnel syndrome. Some people wake with numbness, tingling or discomfort in their hands and may feel the need to move or shake their hand to relieve the sensation.

Symptoms can also occur during the day, particularly during activities where the wrist remains bent or the hand is used for prolonged gripping.

Our Treatment Options

Ultrasound-Guided Carpal Tunnel Injection at Alton Pain Clinic

At Alton Pain Clinic, we provide ultrasound-guided cortisone injections for suitable patients with carpal tunnel syndrome.

Ultrasound allows the clinician to visualise the relevant anatomy during the procedure and guide the injection.

Your clinician will assess your symptoms and discuss whether an ultrasound-guided cortisone injection is appropriate for you.

We do not assume that an injection is suitable for every patient. The recommended approach depends on your symptoms, clinical findings and individual circumstances.

How Does a Cortisone Injection Relieve Carpal Tunnel Pain?

Carpal tunnel syndrome occurs when the median nerve is compressed within the carpal tunnel at the wrist. This can be associated with irritation and swelling around the nerve, contributing to symptoms such as pain, numbness and tingling.

A cortisone injection delivers a corticosteroid medicine into the carpal tunnel. Corticosteroids have anti-inflammatory properties and may help reduce inflammation and swelling around the median nerve.

By reducing this local inflammation and swelling, the injection may decrease pressure around the median nerve, which can help relieve symptoms such as wrist pain, tingling and numbness in some people.

The degree and duration of symptom relief vary between individuals. A cortisone injection does not necessarily address every underlying cause of carpal tunnel syndrome, and symptoms can return.

Potential Benefits of a Cortisone Injection for Carpal Tunnel Syndrome

A cortisone injection may offer several potential benefits for suitable patients:

Pain relief: May help reduce pain associated with carpal tunnel syndrome.
Reduced tingling and numbness: Reducing inflammation around the median nerve may help improve these symptoms in some people.
Reduced local inflammation: Corticosteroids can reduce inflammation and swelling around the affected area.
Non-surgical treatment option: An injection can be considered before or instead of surgery in appropriate cases.
Targeted treatment: The corticosteroid is delivered directly into the carpal tunnel rather than taken as a systemic medication.
Ultrasound guidance: At Alton Pain Clinic, ultrasound can be used to visualise the relevant anatomy and guide the injection.

Your Care Pathway with us

To book an appointment you can call our normal reception line, 0142084487, email direct to info@altonpainclinic.co.uk or click the button given below.
Comprehensive Musculoskeletal examination and testing.
Same day Ultrasound Guided Injection for pain relief.
Discussion of your treatment plan; Treatment Plans can include i.e advanced treatments for ex. Cortisone Injections, Hyaluronic injections and various other options tailored for your specific needs.

What Causes Carpal Tunnel Syndrome?

Carpal tunnel syndrome develops when pressure is placed on the median nerve within the carpal tunnel.

There is not always one identifiable cause. A combination of factors can contribute to increased pressure or reduced space around the nerve.

Possible contributing factors include:

Wrist injury or trauma
Arthritis or inflammation around the wrist
Diabetes and some other metabolic conditions
Pregnancy and associated fluid retention
Repetitive or forceful hand and wrist activities
Repeated wrist bending
Use of vibrating tools
Certain hormonal or thyroid conditions
Cysts or other structures occupying space within the carpal tunnel

Having one of these factors does not necessarily mean that someone will develop carpal tunnel syndrome, and CTS can occur without an obvious cause

Diagnosis

During your evaluation, your clinician will discuss your overall health and medical history and inquire about your symptoms. They will conduct a thorough examination of your hand and wrist, including several physical tests. These may involve:

Testing Tinel’s Sign: Your clinician will press down or tap along the median nerve on the palm side of your wrist to check for any tingling sensations that radiate into your fingers.
Wrist Flexion Test: They will bend your wrists and hold them in a flexed position to assess for numbness or tingling sensations in your hands.
Sensitivity Test: Using a specialized instrument, your clinician will lightly touch your fingertips and hands while your eyes are closed to evaluate sensitivity.
Assessing Muscle Strength: They will check for weakness in the muscles around the base of your thumb, which are controlled by the median nerve.
Checking for Muscle Atrophy: In severe cases, your clinician may look for shrinkage (atrophy) in these muscles, which can indicate prolonged nerve compression.
Ultrasound: High-frequency sound waves create images of bone and tissue. Your clinician may use ultrasound to examine the median nerve in your wrist for signs of compression.
This comprehensive examination helps your clinician diagnose carpal tunnel syndrome and determine the most appropriate course of treatment.

What disorders can be mistaken for Carpal Tunnel Syndrome?

If this does not sound like your pain, there are a number of other conditions that might cause it, including:

Wrist osteoarthritis, a type of osteoarthritis that affects the joints in the wrist.
Tenosynovitis of DeQuervain
Thumb osteoarthritis, a type of osteoarthritis that affects the joints of the thumb.
Scapholunate ligament injury due to a rip in the triangular fibrocartilage complex (TFCC).

Carpal tunnel syndrome vs. wrist osteoarthritis (OA):

The primary difference is that carpal tunnel syndrome is a nerve compression that causes pins and needles and hand weakness, but osteoarthritis of the wrist affects the joint and does not cause similar nerve-related symptoms. Wrist Carpal tunnel syndrome is not linked with severe stiffness and edoema at the wrist joint, unlike osteoarthritis, which causes thickening and swelling of the wrist joint with pain and stiffness.

Choosing Alton Pain Clinic for Carpal Tunnel Syndrome

A cortisone injection may help reduce inflammation and pressure around the median nerve, potentially easing pain, numbness and tingling associated with carpal tunnel syndrome. At Alton Pain Clinic, ultrasound guidance is used to help deliver the injection accurately. Your clinician can assess your symptoms and discuss whether this treatment is suitable for you.

Frequently Asked Questions (FAQ's)

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a condition in which the median nerve becomes compressed as it passes through the carpal tunnel in the wrist. It can cause numbness, tingling, pain and weakness in the hand.

What are the first signs of carpal tunnel syndrome?

Early symptoms can include intermittent numbness, tingling or pins and needles affecting the thumb, index, middle and part of the ring finger. Symptoms may initially be more noticeable at night.

Can carpal tunnel syndrome cause wrist pain?

Yes. Carpal tunnel syndrome can cause aching or pain in the wrist, hand and fingers. Some people may also experience symptoms extending towards the forearm.

Can carpal tunnel syndrome cause numbness in the fingers?

Yes. Numbness and tingling are common symptoms of carpal tunnel syndrome, particularly in areas supplied by the median nerve.

Is carpal tunnel syndrome worse at night?

Symptoms are often worse at night. Some people wake with numbness or tingling and may move or shake their hand to relieve the sensation.

Can a cortisone injection help carpal tunnel syndrome?

A cortisone injection may help reduce symptoms in some people with carpal tunnel syndrome. However, the response varies and symptom relief may be temporary.

What is an ultrasound-guided carpal tunnel injection?

An ultrasound-guided carpal tunnel injection uses ultrasound imaging to help the clinician visualise the anatomy around the carpal tunnel and guide the injection.