Carpal tunnel syndrome (CTS) typically presents with pain, altered sensation and reduced function of the hand and wrist. There are a number of potential causes and factors which can bring about this condition. In clinic we see a wide range of patients affected by this problem, from office workers, construction workers and mums with young babies.
Ultimately the symptoms that patients experience relate to compression or irritation of the median nerve as it passes through the carpal tunnel. This is an anatomical space at the base of the hand which the median nerve passes through along with a number of tendons. The space is bound by ligaments and therefore anything that may cause increase in pressure within this space or compression of the hand and wrist can lead to symptoms.
Carpal Tunnel Syndrome treatment
The first line treatment for carpal tunnel syndrome should be to initially look at potential causative factors. This may involve your posture, your workstation ergonomics and also considering any activities which may result in compression through the forearm or wrist. Wrist splints can also be useful and often times will be recommended by your GP to be worn during aggravating activities and at night where the wrist and hands often fall into a flexed position which may further put pressure on the carpal tunnel. Simple wrist stretches can also sometimes give relief.
Ultrasound-guided injections can be very effective for the treatment of carpal tunnel syndrome if the above conservative management strategies do not help. First we would perform a thorough assessment and also ultrasound scan evaluation of the median nerve which may highlight if there is any thickening or structural issues. Based upon our clinical assessment and ultrasound we can then discuss with the patient if an ultrasound guided steroid injection is likely to be helpful.
When steroid injections are helpful for CTS they can be safely repeated up to three times per year and can be an effective way of managing this condition for many people along with stretches, posture correction and use of a wrist splint.
Before any steroid injections we always screen for any potential contra-indications and advise of all the potential risks and side affects.
Please note that we do not offer injections for patients during pregnancy as the potential risks are unknown. We do offer to patients who are breastfeeding as the British breastfeeding Association has confirms that low dose steroid injections do not present a risk to the breastfeeding baby.