Please note: contains a medical procedure (injection of the carpal tunnel). ![]() It describes the anatomy of the wrist and shows what you can expect from a corticosteroid injection. ![]() The following educational video on the technique of corticosteroid injection in carpal tunnel syndrome was created by NSW Hand Surgeon Dr Stuart Myers for general practitioners. We do not routinely check vitamin D levels in individuals who have carpal tunnel syndrome but if you have vitamin D deficiency (which can be diagnosed with a blood test through your general practitioner) it is not unreasonable to treat this. There is limited evidence (see articles here and here) implicating vitamin D deficiency in carpal tunnel syndrome. The photo on the left shows an example of a thermoplastic splint made to treat carpal tunnel syndrome. This is particularly so for women who develop carpal tunnel syndrome during pregnancy. Splinting, anti-inflammatory medications, injections of corticosteroids and exercises can be successful in mild and moderate cases of carpal tunnel syndrome, especially when the condition has been present for less than 3 months. Certainly if you have carpal tunnel syndrome you may find that certain work activities aggravate your condition. Whether it can be caused by repetitive movements at work is controversial. Carpal tunnel syndrome can be related to pregnancy, diabetes, rheumatoid arthritis, osteoarthritis, broken wrist bones, hypothyroidism, obesity, acromegaly and ( very rarely) tumours. The most common cause is "idiopathic", which means that there's no particular reason for it to have occurred. ![]() CausesĪll of the causes of carpal tunnel syndrome result in the same problem: median nerve compression at the wrist. The presence and severity of the condition can be diagnosed with nerve conduction studies, which may be recommended by your GP or surgeon, especially if your symptoms are not "classical". The condition may be diagnosed on the basis on your symptoms and examination findings. In severe, longstanding cases there may be wasting (shrinkage) of the muscles at the base of the thumb, although this is rare ( see photo above right). The symptoms may also be exacerbated by activities where the wrist is flexed, such as driving. People commonly describe that when they wake up with pain they shake their hands to try to get rid of the pain. They may wake at night with pain in the hands, wrist or up the arm. People often complain that their affected hand feels clumsy and that they have trouble picking up things. The most common symptoms are pain and numbness or tingling of the fingers and hand. It also supplies the muscles at the base of the thumb (the "thenar" muscles). The median nerve supplies sensation to the thumb, index, middle and half of the ring finger, plus most of the palm. It is a tight, inexpansile passageway with a floor and walls made of bone (the 8 carpal bones) and a roof made of a tough tendon (the transverse carpal ligament). The carpal tunnel is located at the base of the hand where the median nerve and nine flexor tendons pass from the forearm to the hand. At Melbourne Hand Surgery we offer both the open and endoscopic surgery techniques to treat this condition. ![]() so.Ĭarpal tunnel syndrome is a common condition that results from compression of the median nerve at the wrist, where the median nerve passes through the "carpal tunnel". If you are eligible to get vaccinated and/or boosted, please do. Rapid Antigen Testing is no longer required for asymptomatic patients prior to hospital admission and surgery. If our surgeons assess that your condition (especially recent injuries) is best managed with hand therapy rather than surgery we may recommend that you see a qualified hand therapist (physiotherapist or occupational therapist) rather than schedule an appointment with our surgeons. We are experiencing high demand for appointments hence require that all patients provide a referral prior to booking an appointment so that we can identify and manage urgent and emergency conditions in a timely manner, and so that our surgeons can assess your suitability for a telehealth appointment and identify any further information or tests that might be required before your consultation. Videoconsultations are conducted via telehealth at our dedicated virtual clinic. We recommend that adults and children over 12 wear face masks when attending our clinic, but no longer provide masks to patients and carers.
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