Dr Bryan Betty: Carpal Tunnel Syndrome

Carpal Tunnel Syndrome – a surprisingly common issue that starts to affect the wrist and hand causing pain and discomfort.   

What is Carpal Tunnel and how common is it?  

• A nerve compression issue – one of the most common.   
• Pressure on the 'median' nerve as it passes through the wrist  
• It causes numbness, tingling, pain, and hand weakness.  
• Affects around 3–6% of adults, and is more common in women.  

How do you recognise it? What are risk factors?  

• Gradually notice tingling or numbness in the thumb, index, middle, and ring finger on the palm side.   
• Symptoms are often worse at night, waking people up, or after repetitive use  
• It can cause weakened grip, resulting in dropping objects, and pain using the steering wheel while driving.  
• Those at risk: people who do repetitive work, pregnant people, those with diabetes, obesity, arthritis, or thyroid disease.  
• It’s most common in women aged 40–60.  

How is it diagnosed?  

• Your doctor will take a history and do an examination.  
• They will refer you for nerve test to confirm the diagnosis.  
• An early diagnosis helps prevent permanent damage.  

What is the treatment?  

• In mild cases, night splints to keep stop the wrist 'flexing' (bending over) while asleep and reducing activity.  
• Manage underlying conditions which aggravate the condition such as thyroid issues, diabetes.  
• Steroid injections can sometimes help.  
• However, people are often referred to surgeon for a simple procedure to cut the ligament in the wrist that compresses the nerve.  
• Most people recover well with excellent long-term results.   

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Episode Transcript

Speaker 1 (00:07):
You're listening to the Saturday Morning with Jack Tam podcast
from Newstalk ZEDB.

Speaker 2 (00:13):
Fourteen to eleven on Newstalk ZEDB, and maybe have come
across this in your own life, if not, someone close
to you gradually kind of noticing tingling or numbness in
the thumb. Carple tunnel syndrome actually affects surprising numbers of
New Zealanders, and our resident GP doctor Brian Betty is
with us this morning to explain what it is, how

(00:34):
it affects us, and what we can do about it.

Speaker 3 (00:36):
Morning Brian, Oh, morning, jacking us to be here.

Speaker 2 (00:39):
Yeah, nice to be chatting. So talk us through carple tunnel.
What actually is it and how common is it?

Speaker 3 (00:45):
Yeah? Look, so it's this condition where one of the
nerves that runs down the arm runs through a small
little bone ligament tunnel in the wrist and it gets
it sort of en largest and gets pressure on that
nerve and that starts to cause symptoms in the hands.
So it's this pressure effect and this leads to this
numbalss tingling pain that people sort of describe in the
hand and fingers. Now look at it, one of the

(01:06):
most common nerve compression conditions we see with about six
percent of adults over a lifetime will actually experience it,
and in streamly enough, it's more common in woman than men,
so women between the ages of forty and sixty are
slightly more at risk of it occurring. It often develops
very gradually, and people start to notice the symptoms at night.

(01:28):
Often that's the thing that they see.

Speaker 2 (01:30):
Yeah, that's interesting that the nighttime rather than when it's
kind of you know, when the wrist is in maybe
high use, that people actually notice it. So how do
you recognize it as carpal tunnel.

Speaker 3 (01:41):
Yeah, so, look, it's this tingling and numbness that you
see in the hand, and in particular it's the thumb,
index finger, middle finger, and ring finger on the palm
side of the hand. And people come and saying, look,
I woke up at night and my hand was really
tingly and numb and I had to shake it out
to sort of get it going again. And actually you
do actually get it with repetitive movements, So people who

(02:03):
have repetitive jobs and do repetitive things can actually develop
it as well. Now people may actually start to notice
they start to drop things that've got reduced grip in
the hand and there's difficulty with fine, fine fine tasks
like buttoning up a close or something like that. Now
we know that women get it more than men. We

(02:23):
know that pregnancy is a risk factor diabetes, thyroid conditions,
and people who actually have jobs with repetitive hand movements,
they are often at risk of this occurring.

Speaker 2 (02:33):
And do you have to have some sort of test
to actually confirm it? Yeah, you do.

Speaker 3 (02:37):
Look, if you're getting those type of symptoms, see your GP,
see your doctor, and they'll take a pretty good history
and often do a physical examination. So we often bend
the risk over or we tap on the risk to
see if we reproduce the symptoms. Because if you bend
the risk over, you put pressure on the nerve and
often you'll start to see the tingling or the numbness occur. Now,
if we think it is, will refer you off for

(02:59):
what's called nerve conduction studies. Now these look at the
speed of the nerve through the risk and if it's reduced,
we know that it's compression of the nerve going on,
and that tells us that it's carpal tunnel syndrome.

Speaker 2 (03:10):
Yeah, interesting, and what do you do about it?

Speaker 3 (03:13):
Look? If it's a very mild case, often just wearing
splints at night, because one of the things that happens
at night is your your wrist tends to bend over
and that puts increased pressure on the medium nerve and
it produces a symptom. So we give you a splint
to just straighten the wrist at night, and often that
resolves the symptoms. However, slightly more severe than that, sometimes

(03:34):
a steroid injection will give temporary relief. But often what
we do need to do is sends you off to
see an orthopedic surgeon and they do a small procedure
where they cut a small ligament in the wrist and
that just relieves the pressure and often the symptoms just
resolve once you do that, and it's pretty well a
permanent fix once it happens.

Speaker 2 (03:54):
Yeah, it must give people a lot of relief, especially
if it's keeping them up at night. It must be
so difficult.

Speaker 3 (04:00):
Oh yeah, look it does. They sort of say, oh,
this is great, you know, sort of it was really
starting to interfere with daily activities and sleeping at night.
And yeah, no, it is a really really good procedure.

Speaker 2 (04:11):
A very good Hey, thanks Brian, have a great matodoky
weekend and we'll catch again very soon. Doctor Brian Betty
with us. We're in the garden in a couple of minutes.
The things you need to do right now to prepare
your garden bed for asparagus season. Right now, it's ten
to eleven on Newstalks EDB.

Speaker 1 (04:27):
For more from Saturday Morning with Jack Tame, Listen live
to Newstalks EDB from nine am Saturday, or follow the
podcast on iHeartRadio.