Ultrasound-Guided Cortisone Injections for Carpal Tunnel Syndrome

 

Carpal Tunnel Syndrome (CTS) is a common condition that affects the hand and wrist, often interfering with everyday activities such as typing, driving, or carrying objects. It occurs when the median nerve, which passes through a small channel in the wrist called the carpal tunnel, becomes compressed. This compression can lead to discomfort, tingling, or weakness in the hand.

At Alton Pain Clinic, we provide advanced approaches to help manage pain and discomfort associated with Carpal Tunnel Syndrome. One such option is the use of ultrasound-guided cortisone injections. By using real-time ultrasound imaging, our clinicians ensure that the injection is delivered with precision to the intended site. 

Anatomy of the Carpal Tunnel

The carpal tunnel is a narrow passageway in the wrist formed by the carpal bones at the base and sides, and a fibrous band of tissue known as the transverse carpal ligament at the top.

Contained within this tunnel are:

• The median nerve — providing sensation to the thumb, index, middle, and part of the ring finger, as well as controlling some thumb muscles.
• Tendons of the flexor muscles — which help bend the fingers and thumb.

Because this space is confined, any swelling or thickening of tissues can put pressure on the median nerve, leading to the characteristic features of Carpal Tunnel Syndrome.

Pathology of Carpal Tunnel Syndrome

Carpal Tunnel Syndrome develops when increased pressure within the tunnel compresses the median nerve. This compression may occur due to:

• Thickening of tendons from overuse.
• Swelling of surrounding soft tissues.
• Structural changes in the carpal bones or ligaments.

The restricted space means even small changes can irritate the median nerve, resulting in discomfort and functional difficulties.

Causes and Risk Factors

Several factors may contribute to the development of Carpal Tunnel Syndrome, including:

• Repetitive hand movements — typing, assembly line work, or prolonged tool use.
• Medical conditions — such as arthritis, thyroid dysfunction, or diabetes.
• Hormonal changes — for example, during pregnancy or menopause.
• Trauma — wrist fractures or sprains altering the shape of the tunnel.
• Genetic predisposition — individuals with naturally narrower carpal tunnels.

Symptoms

Carpal Tunnel Syndrome often develops gradually, with symptoms including:

• Tingling or numbness in the thumb, index, middle, and part of the ring finger.
• Weakness in hand grip, making it difficult to hold objects.
• Pain that may extend from the wrist into the forearm.
• Night-time symptoms, often waking individuals from sleep.

These symptoms may worsen with activities involving repetitive wrist motion.

Diagnosis

Diagnosis typically involves a combination of:

• Clinical history — describing the pattern, duration, and severity of symptoms.
• Physical examination — including tests such as Tinel’s sign (tapping over the nerve) and Phalen’s test (wrist flexion).
• Electrodiagnostic studies — measuring nerve conduction and muscle response.
• Ultrasound imaging — to assess the median nerve and surrounding structures.

Management of Carpal Tunnel Syndrome

Management can be conservative or interventional, depending on severity and impact on daily activities.

Conservative approaches may include:

• Activity modification and ergonomic adjustments.

Interventional options include:

• Cortisone injections to address inflammation within the tunnel.

Ultrasound-Guided Cortisone Injections

At Alton Pain Clinic, cortisone injections for Carpal Tunnel Syndrome are performed under ultrasound guidance.

• Ultrasound imaging provides a clear, real-time view of the wrist’s anatomy.
• Precision ensures the injection is directed exactly where needed, targeting the median nerve region while avoiding surrounding structures.
• Minimally invasive and carried out in an outpatient setting.

This technique supports a focused approach to managing Carpal Tunnel Syndrome, especially for individuals who may not have responded to initial conservative measures.

Mechanism of Action of Cortisone

Cortisone belongs to a class of medications known as corticosteroids. Its role in Carpal Tunnel Syndrome involves:

• Anti-inflammatory effects — reducing swelling of tissues around the median nerve.
• Decreasing irritation — by lowering pressure within the carpal tunnel.
• Restoring function — through reduced discomfort, allowing better hand use.

By calming the inflammatory process, cortisone helps the median nerve function more effectively in the confined space of the tunnel.

Why Choose Alton Pain Clinic

Alton Pain Clinic is committed to providing advanced, tailored treatments for conditions such as Carpal Tunnel Syndrome. Choosing our clinic for ultrasound-guided cortisone injections means:

• Experienced clinicians with expertise in musculoskeletal conditions.
• Use of real-time ultrasound for accuracy and safety.
• Patient-centred care delivered in a supportive and professional setting.
• Efficient appointments designed to suit individual needs.

Conclusion

Carpal Tunnel Syndrome is a condition that can interfere with both work and daily life. Understanding its anatomy, causes, and management options is essential for effective care. Ultrasound-guided cortisone injections represent a precise, minimally invasive way of targeting discomfort associated with this condition.

At Alton Pain Clinic, we combine advanced imaging with skilled clinical practice to deliver treatments tailored to each patient’s needs. This careful and accurate approach makes ultrasound-guided cortisone injections a valued option in the management of Carpal Tunnel Syndrome.