Carpal tunnel syndrome is pressure on the median nerve as it passes through a narrow tunnel at the front of the wrist. It causes tingling, numbness and sometimes pain in the thumb, index and middle fingers, often worse at night. Mild to moderate cases often improve with night splints and activity changes, while more severe or persistent cases may need an injection or surgery.
Also known as CTS, median nerve compression, trapped nerve in the wrist
Symptoms
- Tingling or pins and needles in the thumb, index, middle and part of the ring finger
- Numbness or burning that wakes you at night and eases when you shake your hand
- Symptoms brought on by gripping, driving, typing or holding a phone
- Aching in the wrist or forearm
- Clumsiness or dropping things
- In longer-standing cases, weakness and wasting of the muscle at the base of the thumb
Causes and risk factors
- Anything that crowds the carpal tunnel and squeezes the nerve
- Pregnancy, due to fluid retention (often settles after birth)
- Higher body weight, diabetes, underactive thyroid and inflammatory arthritis
- Being female and aged 40 to 60
- Repeated forceful gripping or use of vibrating tools
- Previous wrist fracture or hand arthritis
What the evidence says helps
- A wrist splint worn at night, holding the wrist straight, is a common first step for mild to moderate symptoms. Evidence for splints is limited and mostly low quality, but they are low risk.1
- A steroid injection into the carpal tunnel probably eases symptoms and improves hand function for up to three to six months compared with a placebo, and may slightly reduce the need for surgery within a year. This is given by a GP or specialist.2
- Surgery to release the tunnel probably gives a higher chance of overall improvement in the long term than splinting, although the difference in day-to-day symptoms may be small. Surgery is usually considered for severe, constant or worsening symptoms.3
- Nerve and tendon gliding exercises and hands-on mobilisation have been studied, but the evidence is limited and of very low quality. They may suit people who prefer this approach, alongside other care.4
- One trial found that a single session of education, night splinting and home exercises reduced the number of people going on to surgery while on a waiting list.6
Things you can try at home
- Try a wrist splint at night that keeps your wrist straight, not bent back
- Notice which tasks bring symptoms on and take regular breaks or change your grip
- Avoid sleeping with your wrists curled under you
- Keep generally active; if you are overweight, gradual weight loss may help
- If you are pregnant, mention symptoms to your midwife or GP, as they often settle after birth
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- Call 999 if hand numbness or weakness comes on suddenly with a drooping face, arm weakness on one side or slurred speech, as this could be a stroke
- Go to A&E if numbness and swelling develop quickly after a wrist injury or fracture
- See a GP urgently if numbness is constant, or you notice the muscle at the base of your thumb wasting or your grip weakening
- See a GP urgently if you have tingling in both hands and feet, problems with balance or walking, or neck pain with arm weakness
- Get urgent advice from NHS 111 if your hand or wrist is hot, red and swollen and you feel unwell
How Apollo can help
Our osteopaths and sports therapist can assess your symptoms, check for other sources of tingling such as the neck, and explain what is going on. We give advice on night splinting, activity and workstation changes, and a home exercise programme where appropriate. We do not give injections or perform surgery, so if your symptoms are severe, constant or not improving we will write to your GP to discuss nerve tests or a hand surgery referral. After carpal tunnel release we can support your rehabilitation.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
Can carpal tunnel syndrome go away on its own?
Sometimes, especially when it is linked to pregnancy or a short spell of heavy hand use. Many people with mild symptoms improve with night splints and activity changes. If numbness becomes constant or your grip weakens, see your GP, because long-standing pressure can damage the nerve.
Is a wrist splint worth trying?
For mild to moderate symptoms, a night splint is a simple, low-risk first step and is widely used. The research behind it is limited, so if you have no improvement after several weeks it is worth having your options reviewed.
When should I think about carpal tunnel surgery?
Surgery is usually considered when symptoms are severe, constant, affecting sleep or work, or when there are signs of nerve damage such as thumb weakness. Your GP can refer you for nerve tests and a hand surgery opinion.
References
- Page MJ, et al. (2012). Splinting for carpal tunnel syndrome. Cochrane Database of Systematic Reviews. View source
- Ashworth NL, et al. (2023). Local corticosteroid injection versus placebo for carpal tunnel syndrome. Cochrane Database of Systematic Reviews. View source
- Lusa V, et al. (2024). Surgical versus non-surgical treatment for carpal tunnel syndrome. Cochrane Database of Systematic Reviews. View source
- Page MJ, et al. (2012). Exercise and mobilisation interventions for carpal tunnel syndrome. Cochrane Database of Systematic Reviews. View source
- Atroshi I, et al. (1999). Prevalence of carpal tunnel syndrome in a general population. JAMA. View source
- Lewis KJ, et al. (2020). Group education, night splinting and home exercises reduce conversion to surgery for carpal tunnel syndrome: a multicentre randomised trial. Journal of Physiotherapy. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
