Peripheral Nerve Compression

Carpal Tunnel Syndrome (CTS)

CTS is the most common peripheral nerve compression and is caused by pressure on the median nerve as it passes under a ligament at the base of the wrist

It is typically first noticed in patients around 'middle' age, is slightly more common in women and may affect both hands in 50% of cases.

Typical symptoms may include:
  • Tingling in the hand (worse at night and with elevation of the hands) - relieved by shaking the hand
  • Tingling in the hand in daytime when the arm is elevated (e.g. driving, using the telephone)
  • Numbness in the thumb, index and middle finger¬†
  • Reduced strength of grip

My management of this condition involves taking a detailed history of the symptoms, an examination of your hand and neck and acquistion of special tests called nerve conduction studies and in some cases an MRI scan of your neck

Nerve conduction tests (performed by electrophysiologists) evaluate the speed of nerve impulses across the wrist to determine whether the nerve is likley being compressed

Mild cases of CTS can be managed with anti-inflammatory drugs and wearing a splint however many patients benefit from a procedure called a carpal tunnel decompression. I perform this procedure in the NHS and privately and my preference is to perform surgery (as a day case) using local anaesthetic however in some cases patient will require a short general anaesthetic

Ulnar Nerve Compression

The ulnar nerve may be compressed at many points, however is most commonly 'pinched' around the elbow

Typical symptoms may include:
  • Pain/numbness/tingling in the little and ring finger on the affected side (worse in cold weather)
  • Cramping and weakness in the hand
  • Clumsiness of the fingers
  • An ache in the forearm

My management of this condition involves taking a detailed history of the symptoms, an examination of your hand and neck and acquistion of special tests called nerve conduction studies and in some cases an MRI scan of your neck

Patients benefit from a surgical procedure to decompress the nerve around the elbow.

I perform this procedure in the NHS and privately and my preference is to perform surgery (as a day case) using local anaesthetic however in some cases patient will require a short general anaesthetic