Carpal tunnel syndrome

What carpal tunnel syndrome is

The carpal tunnel is a narrow passage on the palm side of your wrist. Tendons and a nerve called the median nerve run through it. When the tissue in the tunnel swells, it presses on the nerve. This is carpal tunnel syndrome (CTS).

The median nerve gives feeling to your thumb, index finger, middle finger and half of your ring finger. It also works some of the muscles at the base of your thumb. That is why CTS affects these fingers and your grip.

CTS is more common in women, and most common in middle age. Among women, new cases peak between 45 and 54. Over half of people with CTS have it in both hands.

Things that raise your risk include:

Often no single cause is found.

Causes and forms

Doctors don't divide CTS into formal types, but it helps to know which situation you are in, because it affects treatment.

Work-related CTS

Linked to repeated wrist bending, forceful gripping or vibrating tools. Changes at work are a key part of treatment.

CTS in pregnancy

Fluid build-up can squeeze the nerve, usually later in pregnancy. It usually settles after the baby is born, so splints are normally tried rather than surgery.

CTS linked to another condition

Diabetes, an underactive thyroid or arthritis can make CTS more likely. Treating the other condition can help.

Mild CTS

Tingling that comes and goes, often at night. Often improves with splints and changes to activity. It can get better on its own.

Severe CTS

Numbness that doesn't go away, weakness or wasting of the muscles at the base of the thumb. This needs prompt specialist assessment, because the nerve damage can become permanent.

Symptoms and how it progresses

Symptoms usually come on gradually. They include:

Tingling or pins and needles
Numbness in the thumb and first fingers
Aching or pain in the hand, wrist or arm
Symptoms that wake you at night
Shaking your hand to get relief
A weak grip or dropping things
Clumsiness with buttons or small objects
Stiffness in the morning

Early

Comes and goes

Tingling at night or during certain tasks, eased by shaking the hand.
Up to 8 weeks

Trying splints

Splints and activity changes are tried first. Benefit should show within about 6 to 8 weeks.
3 months or more

Not improving

If symptoms are no better after about 3 months of treatment, or are severe or constant, referral to a specialist is advised.
Longer term

Nerve damage

Constant numbness, weakness and thumb muscle wasting. Treatment may still help, but feeling can take longer to return.

Up to 1 in 3 people improve without treatment over 10 to 15 months. Others get gradually worse, so don't ignore it.

When to get urgent help

Call 999 if you have

sudden numbness or weakness in one arm or hand, especially with a drooping face or slurred speech
chest pain that spreads to your arm, neck or jaw
a hand that is suddenly cold, pale or blue and very painful

Call NHS 111 if

numbness or tingling started suddenly after an injury or fall
your wrist is badly swollen or looks out of shape
you have hand symptoms with a high temperature or a hot, red wrist
you have lost all feeling in your hand

See your GP if

your symptoms are getting worse or not going away
home treatment such as a splint hasn't helped
numbness is there all the time
your thumb is weak or the muscle at its base looks flatter

Diagnosis and referral

A GP or physiotherapist can often diagnose CTS from your symptoms and an examination. They may tap over the nerve or bend your wrist to see if it brings on tingling. These quick tests aren't completely reliable on their own.

Other tests you might be offered:

Nerve conduction studies. Small sticky pads and mild electrical pulses measure how well signals pass through the nerve at your wrist. They show how badly the nerve is squeezed and help plan surgery.
Ultrasound scan. Shows whether the nerve is swollen, or if something such as a cyst is pressing on it.
Blood tests, to check for diabetes or thyroid problems.

If splints and other treatments haven't worked, your GP or physiotherapist can refer you to a hand surgeon, orthopaedic service or a community hand clinic.

You may be able to see a physiotherapist directly

In many areas you can refer yourself to NHS musculoskeletal physiotherapy or hand therapy. Many GP surgeries also have a first contact physiotherapist you can book through reception.

Treatments and medicines

Mild to moderate CTS is usually treated without surgery first. Pregnancy-related CTS is normally treated this way too.

Wrist splints

Pharmacy, physiotherapist or hand therapist

A splint keeps your wrist straight, mainly at night, so the nerve isn't squeezed while you sleep. The NHS says it can take up to 6 weeks to start feeling better. A hand therapist can check the fit.

Changing activities

At home and at work

Cut down on tasks that bend your wrist or need a tight grip, and take regular breaks. Changes to your workstation or tools can help a lot.

Simple painkillers

From a pharmacy or supermarket

Paracetamol or ibuprofen may ease aching for a short time. They don't treat the squeezed nerve itself.

Hand exercises

Physiotherapist or hand therapist

Gentle nerve and tendon gliding exercises may help some people, alongside a splint.

Steroid injection

GP, physiotherapist or hand clinic

An injection into the wrist can reduce swelling around the nerve. It often gives good short-term relief. The effect may wear off after weeks or months, and some people need surgery later.

Don't put up with constant numbness

If numbness is there all the time, or your thumb muscles are getting weaker, ask your GP about a referral. Waiting too long can mean feeling doesn't fully come back, even after surgery.

Surgery and recovery

Surgery is offered if symptoms are severe or constant, if nerve damage is getting worse, or if other treatments haven't worked after about 3 months. It usually cures CTS.

The operation is called carpal tunnel release or decompression. The surgeon cuts the ligament across the top of the tunnel to give the nerve more room. It is done as a day case under local anaesthetic and takes about 20 minutes. It can be open surgery or keyhole.

First few days

Remove any bulky dressing after 2 to 3 days

Keep your hand raised to reduce swelling. Move your fingers gently. Night-time tingling often eases quickly.
Wound healing

Keep the wound clean and dry for 10 to 14 days

Stitches, if they need removing, usually come out at 10 to 14 days. The scar and palm can be tender for some weeks.
Back to normal activities

Around a month

Most people are back to normal daily activities within about a month. Grip strength keeps improving for several months. Feeling can take longer to return if you had CTS for a long time.

Typical return times after carpal tunnel release (UK expert consensus, 2022)
Activity	Usual time
Driving	5 to 14 days
Desk work: typing, mouse, paperwork	4 to 14 days
Repeated heavy hand use, such as hammering or sawing	14 to 35 days
Lifting or holding items over 10 kg	21 to 42 days

Only drive when you can grip the wheel firmly and control the car safely. Your surgeon may give different advice for you.

Self-help and living well

Day to day

Wear your splint at night as advised
Keep your wrist straight when typing, using a phone or sleeping
Use a lighter grip and larger-handled tools
Take short breaks from repeated hand tasks
Warm your hands up in cold weather

Longer term

Keep diabetes or thyroid conditions well controlled
Losing weight, if you are overweight, may help
Do the hand exercises your therapist gives you
Notice which tasks bring on symptoms and change them
Stay active in ways that don't strain your wrists

Tips for getting the best treatment

Help your doctor help you

Note which fingers are affected. CTS usually spares the little finger
Note whether symptoms wake you, and how often
Say if you are dropping things or finding buttons hard
Describe your job and any vibrating tools you use
Give a splint a fair trial of 6 to 8 weeks, then go back if it hasn't helped
If numbness is constant, ask about nerve tests and referral
Before surgery, ask about return-to-work times for your type of job

Carpal tunnel and work

What your employer must do

Employers must assess and reduce the risk of upper limb disorders, under the Management of Health and Safety at Work Regulations. If you use a screen daily for an hour or more at a time, the Display Screen Equipment (DSE) Regulations apply too, including at home. Your employer must carry out a DSE workstation assessment, and look again if you report pain. If you use vibrating tools, the Control of Vibration at Work Regulations also apply.

Your rights under the Equality Act

CTS can count as a disability under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland). This applies if it has more than a minor effect on your daily life and has lasted, or is likely to last, at least 12 months. The law looks at how you would be without treatment such as a splint. If it does, your employer must make reasonable adjustments, such as:

Changing or rotating tasks
More frequent breaks
A phased return after surgery
Light duties while you recover
Time off for appointments and surgery
Specialist equipment

Equipment that can help

Access to Work is a government grant that can pay for specialist equipment and assistive software at work. For advice on your rights, contact Acas or Citizens Advice.

Benefits

If you are off work, for example after surgery, you may get Statutory Sick Pay from your employer for up to 28 weeks.

Carpal tunnel syndrome is a prescribed disease for Industrial Injuries Disablement Benefit. It is covered if it was caused by regular use of hand-held vibrating tools, or by repeated bending of the wrist at work for long periods. You must have been employed, not self-employed.

If CTS makes daily tasks hard over the long term, you may be able to get Personal Independence Payment (PIP), or Adult Disability Payment in Scotland. Turn2us and Citizens Advice can help you check.

How The Beyond Pain Foundation can help

If NHS waits are too long, or the help you need isn't available to you on the NHS, we may be able to fund:

A private consultation with a hand specialist
Nerve conduction studies or an ultrasound scan, where your doctor recommends them
A course of hand therapy or physiotherapy, including made-to-measure splints
A steroid injection from a qualified clinician
Workplace or home equipment, such as a vertical mouse, ergonomic keyboard or voice software

We fund treatment and equipment, not everyday living costs. Prices vary between clinics, so always get a written quote to include with your application.

Apply for funding Check the requirements

Support and sources

Versus Arthritis

Information and helpline

Helpline 0800 5200 520, Monday to Friday, 9am to 6pm. Information on carpal tunnel syndrome and other hand conditions.

versusarthritis.org

British Society for Surgery of the Hand

Hand surgeons' professional body

Clear patient information on carpal tunnel syndrome and its treatment.

bssh.ac.uk

NHS

Health information

Symptoms, treatment and when to get help with carpal tunnel syndrome.

nhs.uk/conditions/carpal-tunnel-syndrome

Sources for this guide

Last reviewed: October 2026.