Carpal Tunnel Injection

Procedure

Injection of a mixture of local anaesthetics and steroids around the ‘Median nerve’ at the level of the wrist (see arrow above). After cleaning of the area, this procedure takes less than 1 minute.


Indication

Mild or moderate Carpal Tunnel Syndrome. It should not be done in severe Carpal tunnel syndrome with established numbness or muscle wasting. In these case patients should undergo carpal tunnel decompression.


Risks

Acute: Bleeding, Infection, neurological deficit including numbness of the thumb, index and middle finger and weakness of the thumb. No improvement of symptoms in particular in cases where there is established nerve damage.


Hospital stay

Day case, can also be done in outpatient clinic


Anaesthesia

local anaesthesia


Recovery

The hand/wrist might feel a bit sore for a few hours and the thumb, index and middle finger might become numb after a few minutes for a few hours.


Outcome

In patients with mild or moderate carpal tunnel syndrome this can be a very effective way of treatment. In my personal experience, many patients can avoid surgery or have significant improvement for months or years.


Commonly asked questions

Why can the effect be long-lasting if the drugs usually wear off within hours or a few days?

There is no plausible answer but as with many injections (Spine or other joints) the mixture of local Anaesthetics and steroids seem to settle the inflammation and produce an effect for a much longer time than they actually work.

Can I have injections of both hands?

Yes. Unlike in surgical decompression there is no scar and the discomfort is limited to a few hours.