Carpal Tunnel Syndrome (CTS)

Numbness, tingling, and night pain in the hand — caused by a compressed median nerve

Conditions Treated

Neck Pain
Trigeminal Neuralgia
Back Pain
Knee pain
Buttock Pain
Shoulder Pain
Pain Due To Vascular Diseases
Hip Pain
Cancer Pain And Palliative Care

Overview

Carpal Tunnel Syndrome is the most common peripheral nerve entrapment neuropathy, caused by compression of the median nerve as it passes through the carpal tunnel at the wrist. It affects up to 10% of the population, with a higher prevalence in women, diabetics, and those who perform repetitive wrist flexion-extension tasks. Symptoms range from intermittent nocturnal tingling to persistent numbness and thenar weakness. Early intervention prevents permanent nerve damage.


Symptoms & Causes

Common Symptoms

  1. Tingling and numbness in thumb, index, middle, and radial half of ring finger
  2. Night pain waking the patient — classic hallmark
  3. Symptoms relieved by shaking the hand (the 'flick sign')
  4. Weakness in grip and thumb pinch (advanced cases)
  5. Thenar muscle wasting (severe / chronic CTS)
  6. Positive Phalen's test (wrist flexion for 60 seconds reproduces symptoms)
  7. Tinel's sign positive over the carpal tunnel
Common Causes

  1. Repetitive wrist flexion-extension work — keyboard use, assembly
  2. Diabetes mellitus (neuropathy lowers threshold)
  3. Pregnancy (fluid retention causes tunnel swelling)
  4. Hypothyroidism and acromegaly
  5. Rheumatoid arthritis — synovial proliferation
  6. Wrist fractures causing anatomical narrowing
  7. Obesity and sedentary lifestyle

Conservative & First-Line Treatment

  • Neutral-position wrist splinting especially at night
  • Activity modification and ergonomic keyboard/mouse setup
  • NSAIDs and B-complex vitamins (B6, B12)
  • Stretching exercises for median nerve and wrist flexors
  • Control of underlying conditions (diabetes, hypothyroidism)

How Vedant Pain Management Clinic Can Help

Our interventional pain specialists offer the following evidence-based procedures, all performed with real-time ultrasound guidance for precision and safety:

  • Ultrasound-guided corticosteroid injection into the carpal tunnel — effective for mild-to-moderate CTS, especially in pregnancy
  • Ultrasound-guided median nerve hydrodissection — separating the nerve from surrounding fibrotic tissue using fluid, restoring nerve glide
  • Nerve Conduction Study (NCS) correlation to grade severity
  • Diagnostic high-resolution ultrasound to measure median nerve cross-sectional area (> 10 mm² confirms CTS) and identify causes such as tenosynovitis or ganglion
  • PRP perineural injection for subacute nerve compression
  • Guidance on when surgical decompression is warranted vs interventional treatment

Newer Diagnostic Concepts & Advances

Ultrasound-guided median nerve hydrodissection — injecting fluid around the median nerve to restore nerve mobility and reduce fibrotic adhesions — has emerged as a highly effective minimally invasive alternative to surgery for mild-moderate CTS. Multiple RCTs now support its use, and Vedant Pain Clinic offers this advanced technique.

Frequently Asked Questions

No. Mild-to-moderate CTS responds well to non-surgical management including splinting, steroid injections, and the newer technique of ultrasound-guided hydrodissection. Surgery is reserved for severe cases with thenar wasting or those unresponsive to conservative treatment.

Pregnancy-related CTS often resolves postpartum. For severe symptoms, ultrasound-guided carpal tunnel injection with a low-dose local anaesthetic and/or corticosteroid is considered safe in pregnancy. We individualise the plan based on your trimester and severity.

Ultrasound allows the needle to be placed precisely within the carpal tunnel, adjacent to the median nerve without touching it, and confirms the injectate spreading around the nerve. This maximises efficacy and eliminates the risk of inadvertent intraneural injection.

Hydrodissection uses a fluid (normal saline or dilute local anaesthetic) injected under ultrasound guidance to physically separate the median nerve from surrounding tight tissue or adhesions. This restores nerve gliding, reduces compression, and often produces sustained relief — studies show effects lasting 6–12 months.

Yes — bilateral CTS occurs in 40–60% of patients. Each hand is evaluated independently and treatment can be staged. Systemic contributing factors (diabetes, hypothyroidism, fluid retention) should be addressed for both hands.
Meet Our Specialist

Dr. Mohit Gupta

Interventional Pain Physician & Pain Specialist

Dr. Mohit Gupta is a highly experienced Interventional Pain Physician dedicated to helping patients overcome chronic pain and regain a better quality of life. He combines advanced, minimally invasive pain management techniques with compassionate, personalized care.

10+ Years Experience
Advanced Pain Therapies
Patient-First Care
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Dr Mohit Gupta