Carpal tunnel syndrome is a condition where one of the large nerves that passes through the wrist (the median nerve) becomes compressed.  

What symptoms does it cause?

It usually presents with pain and sensory symptoms in the hand, symptoms which can often be mistaken for a trapped nerve higher up in the arm or the neck.  The sort of sensory symptoms that occur are numbness and/or pins and needles.  The sensory distribution of the median nerve is the thumb, index and middle fingers and this is the area where symptoms are usually experienced.

Why does it develop?

Carpal tunnel syndrome can often occur without any obvious precipitating factors.  However, conditions which can lead to its development include pregnancy and various hormonal disorders including thyroid hormone and growth hormone excess. It is often a condition which can run in families.  Factors local to the wrist such as arthritis within the joint of the wrist or injuries to this area, or repetitive strain can also lead to its development. 

How is it diagnosed?

If symptoms are classical, the diagnosis can be made purely on clinical grounds.  However, nerve conduction studies can be very helpful in making this diagnosis. 

What are the treatment options?

Treatment for this condition does vary.  Sometimes the underlying cause of the carpal tunnel syndrome can be treated or is self-limiting, in which case symptoms can often resolve spontaneously.  Simple measures such as wrist splints can also prove very helpful. 

However, if symptoms are severe or persistent, surgery can be considered.  The operation involves dividing the overlying tough fibrous band which covers the median nerve as it passes through the wrist (the flexor retinaculum).  This is a relatively minor straightforward operation, usually done under local anaesthetic and as a day case procedure. 

Surgery will mean that your hand will be painful and difficult to use for a few weeks following it.  However, in the vast majority of patients who have this operation, it is a very effective cure for their symptoms.