Carpal tunnel syndrome - when the hand falls asleep at night

Typical: Tingling in fingers and palms

Tingling and a feeling of numbness are typical signs of carpal tunnel syndrome. One symptom is also nocturnal numbness in the thumb, index and middle finger or even the ring finger - where the middle arm nerve runs. The little finger remains unaffected. Occasionally, the entire hand is affected or hand pain or pain occurs in the forearm. Very rarely, this pain radiates to the shoulder.

When cycling or driving a car, or even when using the telephone, the sensation in fingers 1 to 3 is also disturbed during the day. However, this mainly occurs at night or in the morning because sleeping people tend to bend their hand. If the hand is shaken out, the symptoms usually subside. Motor restrictions in thumb movement usually only occur late in the course of the disease.

Do you have signs of carpal tunnel syndrome? Then don't delay too long before having an examination. If your hand keeps falling asleep and also hurts, you should contact our specialists.

Clinical and neurological investigations for suspected CTS

The first step is a detailed discussion with a precise description of the symptoms. Neurologists and neurologists then carry out a comprehensive clinical examination and test how mobile and sensitive your fingers and wrist are.

At Bethesda Hospital, various steps are taken to clarify your condition. In addition to the clinical examination, the specialists can also examine your wrist electrophysiologically. This measures how quickly nerves transmit a stimulus, allowing conclusions to be drawn about carpal tunnel syndrome. Another suitable diagnostic method is neurosonography, i.e. an ultrasound examination. The ultrasound image shows the nerve and the exact location of the narrow area (compression) in the carpal tunnel. This makes it easier for the doctor to decide on the right treatment.

What helps against carpal tunnel syndrome?

Conservative treatment for pain relief

The good news is that the majority of CTS can be treated conservatively. Surgery is therefore rarely necessary. If sufferers only have mild to moderate symptoms, this is the best way to alleviate the pain. Only if the symptoms are severe and persist for a long time should surgery be considered.

Those affected are initially given a splint for the night. This prevents the wrist from bending during sleep and makes it possible to sleep through the night without pain. A bandage often helps during the day. This protects the nerve, but the hand can still be moved in everyday life.

There are also many exercises for stretching and strengthening the wrist that can help prevent carpal tunnel syndrome. The posture of the hand - especially during everyday activities such as typing, telephoning or cycling - is also crucial.

In the short term, cortisone treatment can also help with carpal tunnel syndrome. Cortisone is either taken in tablet form or injected directly into the joint. However, this is purely symptom relief for acute pain relief and not a long-term solution to the problem of CTS.

Surgery for carpal tunnel syndrome

If all conservative methods are unsuccessful or if the damage to the median nerve is moderate or severe, the only option is surgery. In such cases, surgery should be performed to prevent permanent damage to the median nerve. During the operation, the surgeon cuts the carpal ligament to create space for the nerve. This relieves the pain and the syndrome disappears in the long term.

The operation can be performed openly or minimally invasively, i.e. with only the smallest of skin incisions ("keyhole surgery"). Minimally invasive surgery is one of our specialities at Bethesda Hospital and is offered by our in-house doctors with a wealth of experience.

Carpal tunnel syndrome is more likely to affect women

CTS usually occurs in people between the ages of 40 and 60 and is much more common in women. They are affected three to four times as often as men. For every 1000 people, more than three are affected by carpal tunnel syndrome.

CTS is the most common compression-related disease in the peripheral nervous system, i.e. outside the brain and spinal cord.