Carpal Tunnel
Syndrome

Diagnosing carpal tunnel syndrome in Singapore involves an assessment of the medical history of the patient, followed by a physical exam to better understand the signs and symptoms presented. More specialised diagnostic tests may include:

• Tinel’s sign: During this test, the doctor will press on or tap the median nerve in the wrist using a reflex hammer. If the patient experiences a tingle or an electric shock-like sensation, this may be an indication of nerve irritation and compression, which is commonly associated with carpal tunnel syndrome.
• Phanel test (wrist-flexion test): The doctor will ask the patient to rest their elbows on a table and allow their wrist to fall forward freely. If the patient feels a tingle or numbness in their fingers within 60 seconds, then it could be indicative of carpal tunnel syndrome.
• Nerve conduction velocity test: This test is one of the most reliable tests used to diagnose carpal tunnel syndrome. It measures how fast electrical signals can travel through the nerves. If it takes more time than normal, it could mean that there is possible nerve damage or compression.
• Two-point discrimination test: This is used to find out if the patient can differentiate between two separate touch points on their skin. The doctor will use a two-point discriminator to touch the skin a few centimetres apart, then move closer together until the patient only feels one point of pressure. This way, the doctor can evaluate the patient’s nerve function and identify potential nerve compression associated with carpal tunnel syndrome.

Depending on the severity of the condition, carpal tunnel treatment in Singapore can range from non-surgical to surgical methods.

Non-Surgical Treatments

Some of the most common non-surgical treatments for carpal tunnel syndrome include:

• Wrist Splinting: Wearing a wrist splint is an effective and short-term treatment that helps to stabilise the wrist in a neutral or slightly extended position, reducing pressure placed on the median nerve. Immobilising the wrist can also protect the area while it heals.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): These can alleviate the pain by reducing the pain and inflammation, but they do not treat the condition in itself.
• Corticosteroid injections: Doctors may inject a corticosteroid into the carpal tunnel in order to reduce pain and inflammation. By reducing the swelling in the connective tissue, there is less pressure placed on the median nerve.

Surgical Treatments

If non-surgical treatments fail to address carpal tunnel syndrome, patients may be recommended to undergo carpal tunnel surgery in Singapore:

• Endoscopic Surgery: A small incision will be created on the hand or wrist, through which the endoscope (comprising of a small light and camera) is inserted. This allows the surgeon to visualise the carpal tunnel clearly and in real-time. Another incision may be made to insert specialised surgical instruments to cut the affected ligament and release pressure from the median nerve.
• Open Surgery: This technique will require the surgeon to create a larger incision on the patient’s palm over the carpal tunnel and cut through the ligament to free the nerve.

• Avoid repetitive hand and wrist motions, or take regular breaks and do some stretches to rest your hands and wrists.
• Put the wrist in a straight or neutral position through the use of an ergonomic set-up and proper posture. Avoid excessive flexion or extension of the wrists.
• Maintaining a healthy weight and engaging in regular physical activity can improve not only your overall health but also the wellbeing of your hands and wrists.