Carpal Tunnel Syndrome
Pins and needles in the hand can be frightening, especially when it wakes you at night. In some patients this is a simple nerve compression at the wrist, but in others it points to inflammation or an underlying rheumatology condition. I would like to help you work out which it is.
What carpal tunnel syndrome is
Carpal tunnel syndrome happens when the median nerve is squeezed as it passes through a narrow space at the wrist. Swelling around tendons, wrist arthritis, pregnancy, thyroid disease, diabetes or repetitive hand use can all contribute. The symptoms are often typical, but the cause is not always obvious without a careful look.
Symptoms to look out for
Tingling or numbness in the thumb, index and middle fingers
Symptoms worse at night or on waking, sometimes shaking the hand out to relieve it
Hand pain or aching that can travel up the arm
A weak grip or dropping small objects
Wasting of the muscle at the base of the thumb in longer-standing cases
Swelling or stiffness in the wrist joint itself
Why this matters to a rheumatologist
A rheumatology review is useful when wrist swelling, inflammatory arthritis, tenosynovitis or an autoimmune condition may be contributing to nerve compression. Rheumatoid arthritis, gout and other inflammatory conditions can all present first as carpal tunnel symptoms, and it is important not to miss this.
Signs I would like you to seek care for
For emergency symptoms please seek urgent or emergency care first rather than waiting for a WhatsApp reply.
Persistent numbness or weakness in the hand
Symptoms affecting your sleep or daily tasks
Visible wrist swelling or other swollen joints
Loss of thumb strength or muscle bulk at the base of the thumb
Symptoms in both hands, especially with joint pain elsewhere
What a specialist review looks like
In clinic I examine the wrist and hand, test sensation and grip, and look carefully for joint or tendon swelling. Where the picture is not clear or symptoms are severe, I arrange nerve conduction studies, ultrasound of the wrist or targeted blood tests. If an underlying inflammatory or systemic cause is found, I treat that alongside the nerve compression.
Questions my patients often ask me
Speak with me
If numbness, tingling or weakness in your hand is disturbing your sleep or daily life, especially with joint swelling or stiffness, please seek specialist care. I would like to help you find the cause.
Other conditions I treat
This page is for general education only and does not replace medical advice. Please consult a qualified healthcare professional for diagnosis and treatment.