Carpal Tunnel Syndrome

Referral and Treatment Criteria applies – see RaTC - Carpal tunnel syndrome release

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Background

Carpal tunnel syndrome (CTS) is a common condition that causes tingling, numbness and sometimes pain in the hand and fingers. It occurs when one of the major nerves to the hand – the median nerve – is squeezed or compressed as it travels through the wrist.

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Policy

NHS England guidance recommends that mild cases of carpal tunnel syndrome with intermittent symptoms causing little or no interference with sleep or activities require no treatment

Cases with intermittent symptoms which interfere with activities or sleep should first be treated with:

  • corticosteroid injection(s) provided by an appropriately trained healthcare practitioner, or
  • night splints

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Surgical treatment of carpal tunnel syndrome should be considered if one of the following criteria are met:

  • The symptoms significantly interfere with daily activities and sleep and have not settled to a manageable level with either one local corticosteroid injection and/or nocturnal splinting for a minimum of 8 weeks; or
  • There is either:
    • a permanent reduction in sensation in the median nerve distribution; or
    • muscle wasting or weakness of thenar abduction

 

Nerve conduction studies if available are suggested for consideration before surgery to predict positive surgical outcome or where the diagnosis is

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Refer also to the policy on Smoking status of patients prior to non-urgent surgery

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Individual Funding Request form

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For any queries please contact IFR Team on : 01732 375214 | ifr.southeast@nhs.net

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