Just been told I have Carpal Tunnel Syndrome.


Hello, after having pins and needles in my hands on and off for about 6 years, and my Dr just telling me it was probably my blood loss anaemia that caused it, but that's all sorted now, and over the last few weeks my hands and arms have been waking me up at night and some mornings, the pain up my palm and forearm was just terrible, and sometimes it wouldn't go until I had been up and about for half an hour or so. I went to my Drs last week and she said it sounded like CT and pressed my wrist which quickly resulted in pins and needles, and she gave me wrist supports to wear at night and in the day if I need to. I still get pins and needles with the wrist supports on, but haven't had the pain so far in the few nights I've worn them. My Dr said I may need steroid injections into my wrists or surgery in the future. Shouldn't I have been sent off for tests or anything?


As splints are cheap and effectively harmless (the only problems I have seen are that they can be very hot at night and a few patients react to the elastic used) it has always seems reasonable to me to try those out just on the basis of clinical suspicion of the diagnosis without bothering with any formal tests. In my own clinic we think that the objective severity of CTS should be documented before any kind of invasive treatment with steroid injection or surgery but there are people who adopt a policy of injection without testing, and indeed surgeons who will operate purely on the basis of a clinical diagnosis. The overall clinical cost-effectiveness of these various approaches has not been sufficiently studied to arrive at a definitive verdict on which is the best way to proceed. If your symptoms resolve completely after a few weeks with a splint however, and do not recur when you leave the splint off, it is pretty obvious that no further investigation is required. JB

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