musculoskeletal

Check if you have carpal tunnel syndrome (CTS) and do you need an Injection?

Alok Kashyap

April 15, 2024

Carpal Tunnel Syndrome is the pressure on the median nerve in your wrist. The cause can be due to many reasons including repetitive activities such as using vibrating tools, manual labour, desk jobs, and playing an instrument. Some conditions increase the risk such as history of wrist fracture or injury, overweight, arthritis, diabetes, underactive thyroid, and inflammatory arthritis to name a few.  

The symptoms of carpal tunnel syndrome include: 

  • an ache or pain in your fingers, hand, or arm 
  • altered sensation, numbness in hands or fingers. 
  • tingling or pins and needles 
  • a weak thumb or difficulty gripping leading to dropping things.  

These symptoms often start slowly and are usually worse at night. 

Carpal tunnel treatment  

Generally, wrist stretching and wrist splints can help relieve pressure on the nerve. You wear the splint at night while you sleep. Moreover, painkillers can improve pain in the short term but there's little evidence to say they can treat the cause of CTS. 

If the conservative management has failed, steroid injection might be recommended to reduce the swelling, and inflammation around the nerve, easing the symptoms.  

Ultrasound can be used as a One Stop Clinic to confirm the diagnosis, exclude other pathology, or cause for the CTS and help to guide the cortisone injection to the right spot at the same time.  

Steroid injection for carpal tunnel vs surgery 

Evidence suggests that surgery has longer-term benefits compared to injection. On the other hand, steroid injections have less risk, are cheaper and easier to perform. 

It is difficult to tell how long the steroid injection will last as it will vary from individual to individual and depends on the severity of the condition. Sometimes, an injection can ultimately settle symptoms depending on the cause of the condition.