Dealing with carpal tunnel syndrome? It can cause pain, numbness, tingling, and other sensory changes in the hand—and for some people it can become debilitating. It often disrupts sleep, affects grip strength, and makes everyday activities (typing, driving, holding a phone, using tools) uncomfortable.
What is carpal tunnel syndrome?
Carpal tunnel syndrome happens when the median nerve becomes compressed at the wrist. The nerve passes through a narrow space called the carpal tunnel, alongside tendons that help move the fingers. When pressure builds in this area, the nerve becomes irritated, leading to symptoms in the hand and fingers.
Common symptoms to look out for Carpal tunnel symptoms often affect the thumb, index finger, middle finger, and part of the ring finger.
People commonly notice:
- Pain in the wrist or hand, sometimes travelling up the forearm
- Numbness or tingling in the fingers
- Sensory changes such as reduced feeling or “deadness” in the fingertips
- Symptoms that are worse at night, sometimes waking you from sleep
- Relief when shaking the hand or changing wrist position
- Weakness, clumsiness, or dropping objects in more advanced cases
If numbness becomes constant or you notice weakness, it’s worth getting assessed promptly.
First step: night-time splinting
Night-time splinting is a great first step for many patients. A wrist splint keeps the wrist in a neutral position while you sleep, which reduces pressure on the median nerve. This is particularly effective when symptoms are mainly at night or first thing in the morning.
Simple tips that improve results:
- Wear the splint consistently at night for a few weeks
- Keep the wrist straight (not bent forwards or backwards)
- Avoid overly tight straps that can worsen discomfort
For mild to moderate symptoms, splinting alone can make a meaningful difference.
If splinting isn’t enough: steroid injection around the nerve
If symptoms persist despite splinting, a steroid injection around the nerve can provide relief. The aim is to reduce inflammation and pressure in the carpal tunnel. For many patients, injections are a quick and effective option—sometimes improving symptoms within days.
An injection may be particularly useful when:
- Symptoms are disturbing sleep or affecting daily activities
- You want to avoid or delay surgery
- You need symptom control while addressing contributing factors (work posture, swelling, medical conditions)
It’s important to be realistic: some patients get long-lasting relief, while others experience temporary improvement and may need further treatment.
Why ultrasound-guided injection is the most accurate method?
Doing the injection under ultrasound guidance is the most accurate method and helps minimise complications. Ultrasound allows the clinician to see the median nerve, the surrounding tendons, and the needle position in real time. That improved accuracy helps ensure the medication is placed precisely where it’s needed and reduces the risk of irritating sensitive structures.
If you’re considering an injection, ultrasound guidance is a strong marker of quality and safety.
When surgery may be needed (carpal tunnel release)
In some cases, surgery—called carpal tunnel release—may be recommended. This is usually considered when symptoms are severe, progressive, or recurring despite non-surgical treatment. The procedure works by releasing the ligament that forms the roof of the carpal tunnel, creating more space and reducing pressure on the nerve.
Surgery may be considered sooner if you have:
- Constant numbness (not only at night)
- Weakness or reduced pinch/grip strength
- Dropping objects or clumsiness
- Muscle wasting at the base of the thumb
- Symptoms that return quickly after splinting or injections
Bottom line
Night-time splinting is a sensible first step. If that isn’t enough, an ultrasound-guided steroid injection is often a quick and effective option for many patients, with accurate placement and reduced risk of complications. When symptoms are advanced or persistent, carpal tunnel release surgery can provide a more definitive solution.