Carpal Tunnel Syndrome
Numbness, tingling and hand pain — and the modern options to treat it
In short: Carpal tunnel syndrome is caused by pressure on the median nerve as it passes through the wrist, producing numbness, tingling, and pain in the thumb, index and middle fingers — often worst at night. It is common, very treatable, and many cases respond well to non-surgical care. Options range from splinting and activity changes to ultrasound-guided treatments such as nerve hydrodissection, with surgery reserved for cases that need it. A diagnostic ultrasound scan can confirm the diagnosis and pinpoint the compression at your first visit.
What is carpal tunnel syndrome?
Carpal tunnel syndrome develops when the median nerve is compressed inside the carpal tunnel, a narrow passage on the palm side of the wrist. The median nerve carries sensation from the thumb, index, middle and part of the ring finger, and powers some of the small muscles at the base of the thumb. When the tunnel becomes crowded — through swelling, thickened tissue or repetitive strain — the nerve is squeezed, and the classic symptoms follow.
It is one of the most common nerve compression conditions, and the good news is that it is well understood and highly treatable, particularly when addressed before the compression becomes long-standing.
What are the symptoms?
The hallmark is numbness and tingling in the thumb, index and middle fingers, often worse at night. Common features include:
- Numbness or tingling in the thumb, index and middle fingers — typically sparing the little finger
- Night-time symptoms that wake you and often ease when you shake the hand out
- Pain or aching in the wrist and hand, sometimes travelling up the forearm
- Weakness or clumsiness — dropping things, or difficulty with fine tasks like buttons and keys
- A feeling of swelling in the fingers even when they look normal
Symptoms often build gradually and may come and go at first. Addressing them early gives the best chance of a full, straightforward recovery.
What causes it, and who is at risk?
Carpal tunnel syndrome usually results from a combination of factors that reduce the space available to the nerve. It is more common in women, during pregnancy, and in people with diabetes or thyroid conditions. Repetitive or forceful hand use, sustained gripping and prolonged wrist positions can all contribute, and it sometimes follows a wrist injury. Often no single cause stands out — which is why treatment focuses on relieving the pressure rather than assigning blame.
How is it diagnosed?
Carpal tunnel syndrome can usually be diagnosed from your history and examination, and ultrasound adds valuable detail at the same visit. A clinical assessment identifies the pattern of symptoms and tests nerve function and thumb strength. Ultrasound then lets us see the median nerve directly — measuring how swollen it is at the point of compression and checking for any specific cause within the tunnel. Where nerve conduction studies would add useful information, particularly in more advanced cases, these can be arranged. Seeing the nerve means treatment is guided by what is actually happening in your wrist.
How is carpal tunnel syndrome treated?
Most people can be helped without surgery, especially when treatment starts early. At Triaxis the options include:
- Wrist splinting — particularly at night, to keep the wrist in a neutral position and take pressure off the nerve
- Activity and workstation adjustments — practical changes that reduce the strain driving the compression
- Ultrasound-guided nerve hydrodissection — using fluid to gently free the nerve from the tissue pressing on it, a well-supported option for carpal tunnel syndrome
- Ultrasound-guided corticosteroid injection — reducing swelling around the nerve to ease symptoms, placed precisely under imaging
- Surgical release — an effective operation for cases that need it, to which we refer promptly when it is the right choice
The right path depends on how long symptoms have been present, how severe the compression is, and your goals — all of which are mapped out clearly at your consultation.
Can I avoid surgery?
Many people with carpal tunnel syndrome can be treated effectively without an operation, particularly when it is caught before nerve damage becomes established. Guided treatments such as nerve hydrodissection address the compression directly and can be repeated, and they keep surgery available as an option should you ever need it. Surgery is genuinely the right answer for some patients — usually those with severe or long-standing compression — and when it is, we say so and refer you without delay. A second opinion with a diagnostic ultrasound scan is a low-risk way to understand every option before deciding.
Why choose Triaxis for carpal tunnel syndrome?
You are assessed, scanned and, where appropriate, treated by a musculoskeletal specialist who performs guided nerve treatments and teaches these techniques internationally. Dr Dinesh Sirisena is the author of the Elsevier textbook Ultrasound-Guided Musculoskeletal Procedures in Sports Medicine (2021) and brings experience from elite sport. You see the nerve for yourself on the screen, understand exactly what is causing your symptoms, and leave with a clear plan across the full range of options — non-surgical and surgical.
Numbness or tingling in your hand?
Book a consultation with Dr Dinesh Sirisena for a diagnostic nerve ultrasound and a clear explanation of every option — from splinting through to hydrodissection and surgical referral where needed.
WhatsApp: +65 8889 3594 Email: hello@triaxisclinic.com
Clinic: Triaxis Sports & Joint Clinic, Farrer Park Hospital, #07-16, Singapore
Frequently asked questions about carpal tunnel syndrome
Which fingers does carpal tunnel affect?
Typically the thumb, index, middle and half of the ring finger — the area supplied by the median nerve. The little finger is usually spared, which helps distinguish it from other nerve problems.
Why are my symptoms worse at night?
Wrists tend to curl during sleep, which narrows the carpal tunnel and increases pressure on the nerve. This is why night splinting, which keeps the wrist straight, is often so effective.
Can carpal tunnel syndrome go away on its own?
Mild, recent cases — for example during pregnancy — sometimes settle with simple measures. Persistent symptoms usually benefit from treatment, and addressing them early gives the best result.
Is nerve hydrodissection an alternative to surgery?
For many patients, yes. Hydrodissection uses fluid to release the nerve without an incision, and the evidence for it in carpal tunnel syndrome is encouraging. Your scan and examination findings guide whether it suits you.
Do I need a nerve conduction study?
Not always. Ultrasound alone frequently confirms the diagnosis and shows the degree of compression. A nerve conduction study is arranged when it would add useful information, typically in more advanced cases.
Will splinting alone fix it?
Night splinting helps many people, particularly in milder or earlier cases. If symptoms persist, it is easily combined with a guided treatment — the approach is built up in steps based on how you respond.
Is carpal tunnel syndrome linked to computer use?
Sustained gripping and awkward wrist positions can contribute, though carpal tunnel syndrome usually has several causes together. Practical workstation adjustments are a useful part of the plan.
How soon can it be treated?
Assessment, ultrasound and, where appropriate, treatment can often happen in a single visit — so you can move from uncertainty to a clear plan quickly.
About the author
Dr Dinesh Sirisena — Consultant, Sports, Exercise & Musculoskeletal Medicine
MRCGP (UK) · FFSEM (UK & Ireland) · Diploma in Musculoskeletal Ultrasound
Author of Ultrasound-Guided Musculoskeletal Procedures in Sports Medicine (Elsevier, 2021). Experience in elite sport including the Olympic Games, SEA Games, and professional football and rugby.
Last medically reviewed: July 2026
