The most common nerve compression of the hand — numbness, tingling, and night pain in the fingers. Highly treatable with endoscopic keyhole release.
What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through the carpal tunnel — a narrow passage at the wrist formed by bone and ligament. It affects approximately 3–6% of adults and is more common in women, people aged 40–60, and those with diabetes, hypothyroidism, or rheumatoid arthritis.
The median nerve supplies sensation to the thumb, index, middle, and part of the ring finger, and controls the thenar muscles at the base of the thumb. Muscle wasting may develop in advanced, untreated cases.
Symptoms
Symptoms
Numbness and tingling in the thumb, index, middle, and ring finger
Waking at night needing to shake or hang the hand
Burning or aching pain in the wrist or forearm
Weakness when gripping or dropping objects
Loss of fine motor dexterity
Thenar muscle wasting in advanced cases
How it is diagnosed
Clinical examination and Phalen's/Tinel's tests
Nerve conduction studies (NCS) to confirm and grade severity
Ultrasound to assess nerve cross-sectional area
EMG for associated nerve or muscle pathology
Non-surgical Treatment
Non-surgical options
Night wrist splinting — effective for mild, intermittent symptoms
Activity modification to reduce repetitive wrist flexion
Corticosteroid injection — provides temporary relief in 50–70%
Ergonomic review of keyboard and workstation setup
When to consider surgery
Surgery is considered when symptoms are persistent, moderate to severe, or when nerve conduction studies show significant compression. Endoscopic (keyhole) or open release divides the transverse carpal ligament to decompress the median nerve as day surgery under local anaesthetic.
Day surgeryLocal anaestheticEndoscopic or openHigh success rate
Recovery Expectations
Typical recoveryEndoscopic release: light activities 2–3 days, return to office work 1–2 weeks, full recovery 4–6 weeks. Open release: 6–8 weeks. Night symptoms often improve immediately after surgery.
When to see a Hand Surgeon
Seek specialist assessment if:Persistent night pain or numbness waking you from sleep. Symptoms not improving after 4–6 weeks of splinting. Any weakness or wasting of the thumb muscles. Nerve conduction studies showing moderate or severe compression.
Frequently asked questions
Common questions about carpal tunnel syndrome, answered by Dr David Ma.
Most patients return to light activities within 1–2 weeks. Full recovery takes 4–6 weeks (endoscopic) or 6–8 weeks (open). Night symptoms typically improve within days of surgery.
Both divide the transverse carpal ligament with equivalent long-term outcomes. Endoscopic uses a 1cm wrist incision and camera — no palm scar and faster return to activity. Open release uses a small palm incision with an excellent track record.
Mild or intermittent symptoms often respond to night splinting and activity modification. Cortisone injection provides temporary relief in many patients. Surgery is more reliably curative for moderate to severe compression.
Yes. Both techniques are routinely performed under local anaesthetic as day surgery, without general anaesthesia.
A GP referral is recommended for Medicare rebates but not required to book.
Dr David Ma performs carpal tunnel release at accredited Sydney facilities.
Consultations at Chatswood (North Shore — Lane Cove, Willoughby, Artarmon, St Leonards, Gordon)
and Strathfield (Inner West — Burwood, Homebush, Rhodes, Concord, Auburn, Newington).
Call (02) 8112 8569 or email admin@drdavidma.com.
