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What is carpal tunnel syndrome?
Carpal tunnel syndrome (CTS) is a compressive neuropathy of the median nerve in the area of the carpal (wrist) tunnel. The tunnel is formed by the carpal bones and the transverse carpal ligament (retinaculum flexorum). Nerve compression occurs due to thickening of the ligament or swelling of the tunnel contents.
CTS is the most common compressive neuropathy, affecting 3-6% of the adult population. Women are affected more often (ratio 3:1). Bilateral involvement occurs in 50-60% of patients.
Causes:
- Prolonged computer work (typing, mouse use)
- Manual labor with repetitive movements
- Pregnancy and hormonal changes
- Diabetes mellitus, hypothyroidism
- Rheumatoid Arthritis
- History of wrist injuries
Severity grades:
- Mild — intermittent numbness, especially at night
- Moderate — constant numbness, reduced sensation, pain
- Severe — thenar muscle atrophy, loss of grip strength, permanent sensory loss
Facts about CTS
- ICD-10: G56.0
- Prevalence: 3-6% adults
- Gender: women 3 times more often
- Bilateral: 50-60% cases
- Surgeries: 500 000+/year in USA
- Recurrence after surgery: 3-25%
Symptoms of carpal tunnel syndrome
Early signs
- Numbness and tingling in fingers I-III at night
- Need to "shake out" the hand for relief
- Sensation of finger swelling in the mornings
- Tingling during computer work
Progression
- Constant finger numbness
- Pain in hand and wrist
- Reduced fingertip sensation
- Clumsiness (dropping objects)
- Thumb weakness
Severe Stage
- Thenar muscle atrophy (at the base of the thumb)
- Loss of pinch and grip strength
- Inability to button a shirt
- Loss of tactile sensation
- Chronic pain
Carpal tunnel syndrome: treatment options and what is known about them
The treatment plan is made by the clinic doctor after an examination and a review of your images. The table shows the options usually discussed for this diagnosis and how well they have been studied.
| Option | What to expect | How well studied |
|---|---|---|
| Braces, splints, insoles | Offload and stabilise, reduce pain under load | Moderate evidence |
| Corticosteroid injection | Quickly reduces inflammation and pain, the effect is often temporary; frequent injections are undesirable | Moderate evidence |
| Exercise therapy and physiotherapy | Reduces pain, strengthens muscles, improves function; the basis of treatment | Limited or conflicting evidence |
| PRP / CGF | Concentrate from your own blood; may reduce pain, growth of new tissue has not been shown | Little data |
| Carpal tunnel release | If conservative treatment does not help or there is an indication | When indicated — the doctor decides |
We send your request to several partner clinics. Some will suggest conservative treatment or injections, others surgery; each clinic quotes its own conditions and price. We help you compare the options.
Regenerative methods: realistic expectations
With nerve compression, mild and moderate symptoms often improve with a night splint or comfortable shoes with insoles, and after a corticosteroid injection. If numbness is constant, muscle weakness appears or nerve conduction findings worsen, waiting is not advisable. Regenerative injections have hardly been studied for these diagnoses.
When surgery is discussed. Surgery (nerve decompression or neuroma removal) is discussed for constant numbness, weakness or if conservative treatment has not helped for 3–6 months.
If an injection helps, the effect usually builds up over 6–12 weeks, and the result is assessed after 2–3 months. No clinic can guarantee a result.
Good to know: diagnosis, self-help, outlook
How to tell carpal tunnel syndrome from similar conditions
In carpal tunnel syndrome the thumb, index, middle and half of the ring finger go numb, especially at night and with the arms raised; shaking the hand relieves symptoms. If the little finger is numb, ulnar nerve compression is more likely; if numbness runs from the neck along the whole arm, a cervical nerve root is suspected. Nerve conduction studies confirm the diagnosis and its severity, and ultrasound shows a swollen nerve.
What you can do yourself
A night splint that keeps the wrist in a neutral position reduces numbness in many patients. Take breaks when working at a computer or with tools and avoid prolonged wrist flexion. If numbness becomes constant or finger weakness appears, do not delay seeing a doctor.
Outlook and timelines
In mild and moderate cases a night splint and a corticosteroid injection often work well, although symptoms may return. With marked compression on nerve studies, constant numbness or wasting of the muscles at the base of the thumb, surgery — release of the ligament — is recommended; it is a short procedure under local anaesthesia, and light work is resumed within a few weeks.
Who it is not suitable for and possible risks
Contraindications
- Active infection — at the injection site or systemic, with fever.
- Active cancer or ongoing chemotherapy.
- Blood clotting disorders or a low platelet count. Anticoagulants are discussed with the physician.
- Pregnancy and breastfeeding — the procedure is usually postponed.
- A corticosteroid injection into the same area in recent weeks.
- A complete tendon or ligament rupture with loss of function — surgical repair is usually needed.
Possible risks
- Pain and swelling at the injection site for 1–3 days.
- Bruising where blood or fat tissue is taken.
- Rarely, infection. The procedure is therefore performed under sterile conditions with ultrasound or X-ray guidance.
- The effect may be absent or smaller than expected.
If any of these apply to you, mention it in your request. The coordinator will check with the clinic physician whether treatment is possible. Contact a coordinator.
Scientific evidence
Studies of regenerative methods show mixed results. Clinic physicians rely on research including the following:
- Catapano M et al. Effectiveness of Platelet-Rich Plasma Injections for Nonsurgical Management of Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Arch Phys Med Rehabil, 2020.
- Sheth U et al. Efficacy of autologous platelet-rich plasma use for orthopaedic indications: a meta-analysis. J Bone Joint Surg Am, 2012.
Next steps: Treatment methods · Treatment cost · How treatment in Germany is organised
Frequently Asked Questions about CTS Treatment
RegenPAS is a patient service centre in Munich, not a clinic. We review your images and symptoms and send a request to several partner clinics at once. Clinics that can accept you send their own conditions and price; prices differ between clinics, and you choose the option that suits you. The coordinator replies within 24 hours, and a clinic physician’s preliminary opinion follows in 1–3 business days. We then arrange the appointment, visa invitation, interpreter, transfers and accommodation. Treatment decisions are made by the clinic physician. Contact a coordinator.
Your MRI (or CT, X-ray) report and the images if you have them, plus a short description of your symptoms and previous treatment. Send them via the form on the website — the assessment is free and without obligation: the coordinator replies within 24 hours, and the clinic physician’s preliminary opinion follows in 1–3 business days.
The cost depends on the method, the diagnostics needed and the clinic itself: prices differ between clinics. We request offers from several clinics and send you their conditions and quotes so you can compare. Price guidance is on the treatment cost page. For an outpatient procedure, 2–3 days in Munich are usually enough: examination, procedure and follow-up visit.
Clinic and method matching — free of charge
Describe your case and attach your MRI report. We will identify clinics that use the relevant methods and forward your request to them. No obligation; we reply within 24 hours.
Send a request