Reviewed by The Wellness Team. Last reviewed October 2026.
If your hand tingles, goes numb or wakes you at night, carpal tunnel syndrome is one of the most common explanations. It affects around 1 in 20 people at some point, and it is very treatable. Here is how to recognise it, how it is diagnosed and which treatments actually work.
What is carpal tunnel syndrome
Carpal tunnel syndrome is pressure on the median nerve where it passes through a narrow passage in the wrist called the carpal tunnel. The median nerve carries feeling to the thumb, index and middle fingers, so compression produces a recognisable pattern of symptoms in those fingers.
Symptoms of carpal tunnel syndrome
- Numbness, tingling or pins and needles in the thumb, index and middle fingers
- Symptoms that are worse at night or first thing in the morning, often waking you
- An urge to shake or flick the hand to relieve the feeling
- Pain that can travel from the wrist up the forearm
- A weaker grip, dropping things, or struggling with buttons, keys and jars
Symptoms usually build gradually over weeks or months and may affect one or both hands.
Who gets it and why
Carpal tunnel syndrome is more common in women and most often appears between 40 and 60. Pregnancy, diabetes, an underactive thyroid, rheumatoid arthritis, obesity and previous wrist injury all raise the risk, as does work or hobbies involving repeated or forceful hand use. In many people no single cause is found.
How carpal tunnel syndrome is diagnosed
Diagnosis starts with the pattern of symptoms and a short examination of the hand and wrist. Simple bedside tests, including Phalen's manoeuvre and Tinel's sign, can support the diagnosis. When the picture is unclear, or if surgery is being considered, nerve conduction studies measure how severely the nerve is compressed and guide the next step.
Treatment that works
NICE guidance supports a stepwise approach:
- Night splinting. A wrist splint worn in bed keeps the wrist neutral and offloads the nerve. It is the first treatment for most people and often settles mild symptoms within a few weeks.
- Activity changes. Easing off aggravating tasks, adjusting keyboard and tool positions, and taking regular breaks reduce pressure on the nerve.
- Steroid injection. A corticosteroid injection into the carpal tunnel relieves symptoms for many people and can be repeated. It is also a useful diagnostic pointer when the response is good.
- Surgery. For severe or persistent symptoms, carpal tunnel release is a short, well established day case procedure with high success rates.
Treating an underlying cause, such as an underactive thyroid, can improve symptoms too, which is why a proper assessment matters before settling for splints alone.
When to see a GP
Book a review if symptoms persist beyond a few weeks, keep waking you, or interfere with work or daily tasks. Seek prompt assessment if numbness has become constant, the thumb muscles look smaller, or grip is clearly weakening, because prolonged severe compression can cause lasting nerve damage.
What an online GP can do today
A GP can confirm the likely diagnosis from your symptoms, check for underlying causes, advise on splints and activity, and arrange referral for nerve conduction studies, injection or surgery where needed. A fit note can be issued where symptoms affect your ability to work.
Appointments cost £59 by phone, £150 by video and £220 in person at 10 Portman Square, Marylebone. The price is confirmed before you book, and same day appointments are usually available. Message us on WhatsApp at https://wa.me/447961280835 to book.
Sources: NICE Clinical Knowledge Summaries, Carpal tunnel syndrome; British Society for Surgery of the Hand patient guidance.
Reviewed by The Wellness Team