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Primary care management of carpal tunnel syndrome

Pulvertaft Hand Centre, Derbyshire Royal Infirmary, Derby

Correspondence to:
Correspondence to:
Professor F D Burke, Pulvertaft Hand Centre, Derbyshire Royal Infirmary, London Road, Derby DE1 2QY, UK;
frank.burke{at}virgin.net

Carpal tunnel syndrome of mild to moderate severity can often be effectively treated in a primary care environment. Workplace task modification and wrist splints can reduce or defer referral to hospital for surgical decompression. Nerve and tendon gliding exercises may also be of benefit. Steroid injections to the mouth of the carpal tunnel are particularly useful for symptomatic women in the third trimester of pregnancy. However inadvertent neural injection may cause disabling chronic pain. Referral to a minority of practitioners trained in the technique would ensure sufficient patient numbers to maintain skill levels.

Keywords: carpal tunnel syndrome; median nerve compression; conservative management; primary care

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