Carpal Tunnel Syndrome: Symptoms, Progression & Treatment

Persistent tingling in your fingers? Waking at night with numb hands? Struggling to grip your phone or coffee cup? You might be dealing with Carpal Tunnel Syndrome (CTS) – a common, treatable nerve problem in the hand and wrist.

At CityMed Medical Centre in Auckland’s CBD, our experienced GPs can assess wrist and hand pain, organise appropriate tests, start treatment, and refer you to a specialist if needed. Because we offer comprehensive GP care and minor procedures onsite, your pathway from diagnosis to management is streamlined and convenient if you live or work in the city.

What Is Carpal Tunnel?

The carpal tunnel is a narrow passageway in your wrist, formed by small wrist bones and a strong band of tissue (the transverse carpal ligament).

Running through this tunnel are:

• The median nerve – responsible for sensation in the thumb, index, middle and part of the ring finger, and some thumb movement
• Tendons that bend your fingers and thumb

Carpal Tunnel Syndrome happens when the space inside this tunnel becomes crowded or narrowed, putting pressure on the median nerve. Over time, this pressure leads to symptoms like tingling, numbness, pain, and weakness in the hand.

Common contributors include:

• Repetitive hand and wrist movements (e.g. typing, manual work, tools, machinery)
• Prolonged wrist flexion or extension (bent wrists)
• Swelling in the tunnel from injury, pregnancy, thyroid problems, arthritis or fluid retention
• Anatomically narrow carpal tunnel (sometimes just the way your wrist is built)

Carpal Tunnel Syndrome Symptoms

Knowing the typical carpal tunnel syndrome symptoms can help you recognise when it’s time to get your wrist checked.

1. Tingling and numbness

The most common symptoms are:

• Tingling (“pins and needles”) or numbness
• Usually affecting the thumb, index, middle, and ring fingers (but not the little finger)
• Symptoms may be worse at night or when you wake up
• Shaking your hand may briefly relieve the sensation

Many people describe it as their hand “going to sleep” for no clear reason.

2. Pain in the wrist, palm, or forearm

You may notice:

• Aching or burning pain in the hand or fingers
• Pain that can travel up the forearm
• Discomfort when gripping objects, using tools, typing, or driving

Sometimes, pain is the main symptom, even before obvious numbness.

3. Weakness or clumsiness

As the condition progresses, you might develop:

• Reduced grip strength
• Dropping objects more often
• Difficulty with fine tasks like buttoning clothes, fastening jewellery, or opening jars

Over time, untreated carpal tunnel can lead to wasting of the thumb muscles at the base of the thumb.

4. Symptoms in both hands

Carpal tunnel syndrome can affect one or both wrists. It’s common for people to notice symptoms in their dominant hand first, or in both if they do a lot of repetitive work or computer use.

How Long Does Carpal Tunnel Take to Develop?

The short answer: it varies from person to person.

Gradual onset (most common)

For many people, carpal tunnel:

• Develops slowly over months or years
• Starts with intermittent tingling or numbness, often at night
• Progresses into more constant symptoms that occur during the day

Early on, symptoms might only appear when:

• You’re driving
• Holding a phone or a book
• Typing or using a mouse
• Sleeping with your wrist bent

As the condition progresses, symptoms often become more frequent, more intense and harder to ignore.

Faster onset

In some situations, carpal tunnel can develop more quickly, for example:

• Pregnancy, due to fluid retention and swelling
• Wrist injuries, such as a fracture or sprain
• Sudden increase in repetitive or heavy hand use

Even in these cases, symptoms usually build up over weeks, not days – but they may seem to appear “suddenly” because you only notice them once they start interfering with sleep or daily activities.

Why early assessment matters

The longer the median nerve is compressed:

• The higher the risk of persistent numbness
• The more likely you are to develop muscle weakness and wasting

Seeing a GP early at CityMed means:

• Identifying the cause of your symptoms
• Starting non-surgical treatment sooner
• Organising further tests and specialist referral if needed, before permanent nerve damage occurs

Carpal Tunnel Syndrome Treatment Options

The best treatment depends on:

• How severe your symptoms are
• How long have you had them
• Your work, lifestyle, and other health conditions

At CityMed in Auckland’s CBD, our GPs will take a careful history, examine your wrist and hand, and may arrange tests or refer you to a hand specialist if necessary.

Here are common treatment approaches:

1. Self-care and activity changes

For mild or early symptoms, simple changes can help:

• Reduce or modify repetitive activities that aggravate your symptoms
• Take regular breaks from typing or tool use
• Adjust your workstation ergonomics (keyboard, mouse, chair, and wrist position)
• Avoid sleeping with your wrists bent; some people benefit from a night wrist splint

Your GP can give individualised advice based on your work and lifestyle.

2. Wrist splints

A neutral-position wrist splint, especially worn at night, can:

• Keep the wrist straight
• Reduce pressure on the median nerve
• Help you sleep better
• Improve symptoms over several weeks

Your CityMed doctor can advise on whether splinting is suitable for you, and help organise one if needed.

3. Medications & injections

Depending on your situation, your GP may consider:

• Anti-inflammatory medications (not suitable for everyone) to help with pain and swelling
• Steroid injections into the carpal tunnel to reduce inflammation around the nerve

Steroid injections can provide temporary or sometimes longer-term relief, especially in mild to moderate cases, and with purposes to accurately diagnose the carpal tunnel syndrome. However, they may not be a permanent solution.

4. Physiotherapy and hand therapy

CityMed works closely with physiotherapists and hand therapists, who can:

• Teach nerve gliding exercises
• Work on strength, flexibility, and posture
• Help with workplace or activity modifications

Your GP can refer you if this would benefit your particular case.

5. Surgery (carpal tunnel release)

If symptoms are:

• Severe
• Long-standing
• Not improving with conservative treatment

then carpal tunnel release surgery may be recommended to prevent permanent nerve damage and muscle wasting. This procedure involves cutting the tight ligament forming the roof of the tunnel to relieve pressure on the median nerve.

The surgery is done in Citymed, typically under local anaesthetic as a day procedure.

At CityMed, our GPs:

• Assess your symptoms and overall health
• Offer various treatment options, including the carpal tunnel release surgery if needed
• Provide pre- and post-operative care, including pain management and ongoing monitoring

When Should You See a Doctor for Carpal Tunnel?

Book an appointment with a GP at CityMed if you:

• Have persistent tingling, numbness or pain in your hand or wrist
• Are you waking at night with numb or painful hands
• Notice weakness, dropping objects, or difficulty with fine hand tasks
• Have symptoms in both hands or they are getting worse
• Have other health issues like diabetes, thyroid disease or arthritis

Seek urgent medical attention if:

• You suddenly lose significant strength or sensation in your hand
• Pain and swelling are severe or associated with recent trauma

Carpal Tunnel Care at CityMed in Auckland CBD

At CityMed Medical Centre, conveniently located on Albert Street in Auckland’s CBD, our team of experienced GPs provides:

• Thorough assessment of wrist and hand pain
• Individualised advice on lifestyle and workplace changes
• Initial treatment options such as splinting, medication and physio referrals
• Coordination of diagnostic tests and referral to hand specialists if needed
• Ongoing follow-up and support before and after any specialist treatment

Whether your symptoms are just starting or have been bothering you for a long time, early assessment can help protect your nerve function and get you back to comfortable, confident use of your hands.

Ready to Talk About Your Wrist and Hand Symptoms?

If you’re worried about carpal tunnel syndrome, don’t ignore the signs. Visit CityMed in Auckland CBD and discuss with our experienced doctors about your symptoms, get a clear diagnosis, and put a plan in place to protect your hands and wrists for the long term.