The carpal tunnel is located at your wrist. The flexor tendons to your fingers as well as the median nerve pass through this space. The median nerve can become compressed as it passes through the carpal tunnel, and this in turn can lead to numbness or a feeling of "pins and needles" in your thumb, index and middle fingers as well as waking at night with a numb hand. Carpal Tunnel Syndrome (CTS) as it is called can lead to difficulty driving, sleeping and doing manual tasks as the wrist may ache and the fingers involved can become numb. Eventually some of the small muscles in the hand that power the thumb can weaken, leading to difficulties manipulating small objects.

Treatment can be surgical or non-surgical. Non-surgical management involves the use of splints, or injections into the carpal tunnel. These will often only provide temporary relief. Surgical management is directed at "decompressing" the carpal tunnel to take the pressure off the median nerve. This can be done as an "open" or as a "keyhole" procedure.

Open - a cut is made in the palm at the level of the wrist and the ligament that forms the roof of the carpal tunnel is divided to release pressure on the nerve

Endoscopic or "keyhole" - a small cut  (~1cm) is made just proximal to the wrist and a small TV camera/scope combination is passed into the carpal tunnel and the ligament is divided from below using a small blade.

Recovery of the nerve and relief of symptoms is usually rapid if the damage to the nerve is not too severe.

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