Carpal tunnel syndrome

Carpal tunnel syndrome, what is it?

The carpal tunnel is located underneath the wrist crease overlying the wrist joint. The carpal tunnel is a protective tunnel of bone and has a ligament overlying the anatomical structures (Fig. 1). The transverse ligament is a thick ligament very much like a cable tie and keeps all the structures in place.

Carpal tunnel syndrome

Fig 1

Causes of carpal tunnel syndrome

There is still a lot unknown about carpal tunnel syndrome. We know that there are several factors that play a role in developing carpal tunnel syndrome.

Physical repetitive activity could be a factor. There are other factors such as diabetes, hormonal changes such as during pregnancy and an underactive thyroid. These can all be contributing factors. A direct injury to the wrist can also cause damage to the median nerve the wrist joint. This in turn can also cause problems with the median nerve.

Carpal tunnel syndrome

Many critical structures are tightly packed together within a small tunnel. The carpal tunnel syndrome can be caused by the tunnel becoming strained which can affect the structures running in the carpal tunnel. Nerve tissue is sensitive to small changes in pressure. This can cause nerve irritation and cause symptoms of carpal tunnel syndrome. The main symptoms are pain and numbness in the distribution of the median nerve (see Fig. 2). Compression of the nerve can also cause significant weakness of the musculature if more advanced.

If left untreated compression of the median nerve can cause lasting nerve damage. This can lead to permanent weakness and numbness and pain in the hand. It is therefore important to diagnose this problem early on and to treat it promptly.

Carpal tunnel syndrome

Fig 2

Treatment of carpal tunnel syndrome

The correct treatment of carpal tunnel syndrome depends on the accuracy of the diagnosis. The most important way to evaluate the carpal tunnel is simply by doing a thorough physical assessment. The Sonoscope ultrasound guided injection clinic has experts with many years of experience. They have successfully managed many hundreds of people with carpal tunnel syndrome. The use of diagnostic ultrasound provides another level of information and often confirms the diagnosis made by physical examination.
If left untreated compression of the median nerve can cause lasting nerve damage. This can lead to permanent weakness and numbness and pain in the hand. It is therefore important to diagnose this problem early on and to treat it promptly.

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    What makes Sonoscope so unique?

    We provide a quick physical examination followed by an immediate review with carpal tunnel ultrasound and injection.  The ultrasound guided injection will follow immediately after without any wait and that sets this clinic apart from many others.

    All inclusive fee's

    The whole package of clinical examination ultrasound diagnostics and injection is all included in the fee.  There are no hidden extras, and all of this is done within one single session. Please click here to see our fees.

    For busy people this “one stop shop” clinic will deliver the diagnosis and treatment immediately. This will allow people to return their work quickly.

    What happens during an ultrasound guided steroid injection for carpal tunnel syndrome?

    Ultrasound guided carpal tunnel injection technique 

    1. You are seated with the hand resting on a treatment plinth or table. Your wrist crease faces up to the ceiling.
    2. Your skin is disinfected with a skin friendly disinfectant.
    3. The Injection practitioner has the ultrasound probe with the gel on the wrist crease
    4. He then carefully steers the needle in the path of the ultrasound probe so the needle point can be monitored. This is important both for safety and to ensure accuracy. The steroid is then released.
    5. Following the injection, the injection site is cleaned, and the injection site is covered with a small plaster.

    Meet Rob - Our Specialist Physiotherapist/ Sonographer

    Rob is a specialist Extended Scope Physiotherapist with more than 20 years experience in managing complex musculoskeletal conditions.

    He uses diagnostic ultrasound as an extension of his clinical skills.  He is an interventional sonographer in a busy radiology department of a central London Foundation Trust Hospital .

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    Find out more about Rob


    +44787 0304523


    With 2 practices Sonoscope can help identify and treat your pain in either location.  Click on the buttons below to find out about each practice location and service.

    Hertford Clinic Information

    3a The Maltings, Railway Place Hertford, Hertfordshire, SG13 7BS

    London Clinic Information

    Sonoworld diagnostic services Ltd, 29 Weymouth Street, London, W1G 7DB