Carpal Tunnel Syndrome
What is it?
Pressure on the median nerve at the wrist resulting in reduced nerve function
Symptoms
Pins and needles and numbness, usually worse on the thumb - side of the hand and often worse at night. There may be associated pain in the hand and arm. The hand may feel weak and clumsy and you may drop things
What causes it?
In most cases, carpal tunnel syndrome occurs spontaneously without an underlying cause. In a few cases, it occurs as a result of other conditions (inflammatory arthritis, hormonal disorders, pregnancy, wrist fractures)
Treatment
Splints - may be helpful for night-time symptoms
Steroid injection - may relieve symptoms but the benefit is often incomplete or temporary
Surgery - Carpal tunnel release. A minor operation under local anaesthetic which takes approximately 15 mins. A small cut is made at the base of the palm and the nerve is released. Stitches are removed after 7-14 days. Average time off work is 3 weeks.
Cubital Tunnel Syndrome
What is it?
Pressure on the ulna nerve at the elbow resulting in reduced nerve function.
Symptoms
Pins and needles and numbness, often worse on the little finger -side of the hand. There is sometimes pain in the hand and arm: the elbow in particular may be sensitive. The hand may feel weak or clumsy.
What causes it?
Compression may be due to a tight ligament, a muscle or altered anatomy (e.g. after a fracture). Often there is no clear cause.
Treatment
Splints - a splint may be worn at night to prevent the elbow bending and reduce symptoms
Surgery - Cubital tunnel decompression (release of the ulnar nerve), performed under general anaesthetic as a day case procedure. A curved incision is made around the back of the elbow and the nerve is released. Dissolving stitches are used and the elbow is bandaged for 2 weeks. Average time off work is 3 weeks.