Common causes and risk factors

• Often no single cause

• Pregnancy or fluid retention

• Diabetes or thyroid disease

• Wrist arthritis or previous fracture

Symptoms and signs

• Night-time tingling or numbness

• Shaking the hand for relief

• Dropping objects or reduced dexterity

• Thumb weakness in advanced cases

How is it diagnosed?

The symptom pattern and examination are often enough to make the diagnosis. Nerve-conduction tests may be used when the diagnosis is uncertain, symptoms are severe or surgery is being considered.

Treatment options

A neutral-position night splint is often tried for mild or moderate symptoms. A steroid injection can provide temporary relief. Surgery releases the ligament over the tunnel and is considered for persistent symptoms, constant numbness, weakness or severe nerve-test changes.

When should I see a specialist?

Arrange an assessment if you have:

• Constant numbness or thumb weakness

• Muscle wasting at the base of the thumb

• Symptoms that persist despite splinting

• Sleep, work or driving significantly affected