Carpal tunnel syndrome is a common condition caused by compression of a nerve in the wrist and hand. It occurs when the median nerve is compressed in the area of the wrist joint. This nerve passes through a narrow canal at the base of the palm, called the carpal tunnel. If swelling, inflammation or mechanical pressure develops in this area, tingling, numbness, pain and weakness in the hand may occur.
Carpal tunnel syndrome most often develops gradually. At first, the symptoms may be temporary and appear only at night or after prolonged strain; however, if diagnosis and treatment are not carried out in time, they may become persistent and affect daily activities, work and sleep quality.
What are the symptoms of carpal tunnel syndrome?
The symptoms of carpal tunnel syndrome usually affect the palm, fingers and sometimes also the forearm. The most common signs include:
tingling or a “pins and needles” sensation in the fingers;
numbness in the thumb, index finger, middle finger and part of the ring finger;
pain in the palm, wrist or forearm;
weakness in the hand and difficulty gripping objects;
objects slipping or falling from the hand;
worsening of symptoms at night or in the morning;
discomfort during prolonged work with a computer, phone, tools or repetitive movements.
Important to know: the little finger is usually not affected, as it is supplied by another nerve. If numbness also clearly affects the little finger, a doctor’s consultation is necessary to assess other possible causes.
Who is at greater risk of developing carpal tunnel syndrome?
Anyone can develop carpal tunnel syndrome, but the risk is higher in people who regularly put strain on their hands and wrists in everyday life. Risk factors include:
repetitive movements of the palm and fingers at work or during hobbies;
prolonged work with a computer, mouse, keyboard or tools;
working with vibrating tools;
pregnancy;
excess body weight;
diabetes mellitus;
rheumatoid arthritis or other joint diseases;
previous wrist injuries;
family history or hereditary predisposition;
thyroid disorders.
Carpal tunnel syndrome is more common in women and people over the age of 40, but it can also develop in younger people, especially if their work or daily habits cause prolonged strain on the wrist joint.
How is carpal tunnel syndrome diagnosed?
The diagnosis is made by a doctor by assessing the patient’s complaints, hand function, sensation and muscle strength, as well as by performing an ultrasound examination.
At the “Diagnostikas centrs” branch of “Veselības centrs 4”, examinations are available using a specially adapted “17LH7 Hockey Stick” probe.
If necessary, additional examinations may be prescribed, such as nerve conduction studies or electromyography, to assess the degree of median nerve damage and exclude other conditions.
Timely diagnosis is essential, as prolonged nerve compression can lead to persistent numbness, muscle weakness and impaired hand function.
How is carpal tunnel syndrome treated?
Treatment of carpal tunnel syndrome depends on the severity and duration of symptoms, as well as the degree of nerve damage. In milder cases, conservative treatment may be possible, while in more severe cases surgery may be required.
Non-surgical treatment
Initially, the doctor may recommend:
a wrist orthosis or splint, especially at night;
reducing strain and improving ergonomics;
regular breaks when working with a computer or tools;
anti-inflammatory therapy as prescribed by the doctor;
physiotherapy and special exercises;
a corticosteroid injection in the carpal tunnel area.
In cases of mild or moderate symptoms, conservative treatment can be effective, especially if the syndrome is detected early.
Minimally invasive treatment — ultrasound-guided carpal tunnel release
If symptoms progress or conservative treatment is not sufficiently effective, ultrasound-guided carpal tunnel release may be used. The aim of the procedure is to reduce pressure on the median nerve by releasing the carpal tunnel.
What is ultrasound-guided carpal tunnel release?
Ultrasound-guided carpal tunnel release is a minimally invasive procedure for the treatment of carpal tunnel syndrome. During the procedure, the doctor uses ultrasonography, or ultrasound, to see the anatomical structures of the wrist in real time — the median nerve, tendons, blood vessels and transverse ligament. The aim of the procedure is to reduce pressure on the median nerve by releasing or cutting the transverse carpal ligament.
Unlike traditional open surgery, this method is usually performed through a very small access point or puncture site, using a special instrument and ultrasound guidance. Ultrasound allows the doctor to guide the instrument more precisely and reduce trauma to the surrounding tissues.
How is the procedure performed?
The procedure is usually performed under local anaesthesia. Using an ultrasound probe, the doctor assesses the carpal tunnel area, identifies a safe access point and monitors the movement of the instrument during the procedure. The transverse ligament that creates pressure on the median nerve is then released.
As the procedure is minimally invasive, it causes less soft tissue damage, less postoperative discomfort and allows a faster return to daily activities than more extensive open surgery. However, recovery time may vary from patient to patient.
Who may this method be suitable for?
Ultrasound-guided carpal tunnel release may be suitable for patients with confirmed carpal tunnel syndrome, especially in cases where:
tingling, numbness or pain persists despite conservative treatment;
symptoms interfere with sleep, work or daily activities;
examinations show compression of the median nerve;
surgical nerve release is required, but a minimally invasive approach is possible.
Before the procedure, the doctor assesses the symptoms, hand function and examination results. Neurography, electromyography or ultrasound is often used to determine the degree of nerve damage and to make sure there are no other causes, such as a ganglion, tumour, pronounced tendon inflammation or anatomical variations.
What are the advantages?
The advantages of ultrasound-guided carpal tunnel release compared with traditional open surgery include:
a smaller incision or puncture site;
the procedure is performed under local anaesthesia;
less soft tissue damage;
precise ultrasound control of anatomical structures;
potentially fewer incision-related complaints;
potentially faster recovery.
Important: this method is not suitable for every patient. The type of treatment is determined by a specialist after an individual assessment.
Is ultrasound-guided carpal tunnel release an operation?
Yes, in essence, it is a surgical release of the carpal tunnel, but it is performed in a minimally invasive way and under ultrasound guidance. It may also be called ultrasound-guided carpal tunnel decompression or an ultrasound-guided carpal tunnel release procedure.
The ultrasound-guided approach allows important anatomical structures to be visualised during the procedure, while local anaesthesia enables treatment without general anaesthesia. Nowadays, carpal tunnel treatment is often performed on an outpatient basis or as a day surgery procedure.
Surgical treatment
If symptoms are severe, persistent or conservative treatment does not help, the doctor may recommend carpal tunnel release surgery. The aim of the operation is to reduce pressure on the median nerve by cutting the ligament that compresses the nerve in the carpal tunnel. This treatment often helps reduce pain and tingling and improves hand function.
When should you see a doctor?
It is advisable to consult a specialist if tingling, numbness or pain in the palm recurs, interferes with sleep, weakens grip strength or makes everyday work difficult. The sooner the cause of the symptoms is identified, the greater the chance of preventing permanent nerve damage.
If you suspect carpal tunnel syndrome, book a consultation with a specialist in Riga. Timely diagnosis and appropriate treatment can help reduce symptoms and restore hand function.
Frequently asked questions
What symptoms are typical of carpal tunnel syndrome?
Typical symptoms include tingling, numbness, pain and sometimes weakness in the palm and fingers, especially in the area supplied by the median nerve. Symptoms often worsen at night.
How is carpal tunnel release performed under local anaesthesia?
The procedure is usually performed under local anaesthesia. Using an ultrasound probe, the doctor assesses the carpal tunnel area, identifies a safe access point and monitors the movement of the instrument during the procedure. The transverse ligament that creates pressure on the median nerve is then released.
Is a hospital stay required after the procedure?
For many patients, this procedure is performed on an outpatient basis or as a day surgery procedure, and it is possible to go home on the same day.
