| Quick answer Tingling or numbness in the thumb, index, middle and ring fingers that wakes you at night is a classic sign of carpal tunnel syndrome, caused by pressure on the median nerve at the wrist. Mild cases often improve with a wrist splint worn at night and changes to activity. If symptoms persist, a steroid injection or a short operation under local anaesthetic can help. See a doctor if you notice weakness, constant numbness or wasting at the base of your thumb. |
Why do carpal tunnel symptoms get worse at night?
The median nerve passes through a narrow space at the wrist called the carpal tunnel. Many people sleep with their wrists bent, which narrows that space and squeezes the nerve. As a result, symptoms such as tingling, burning and numbness often wake people in the early hours. Many find that shaking or flicking the hand brings relief, which is itself a recognised clue.
What are the symptoms of carpal tunnel syndrome?
• Pain, tingling or numbness in the thumb, index, middle and ring fingers
• Symptoms that are worse at night or first thing in the morning
• Symptoms triggered by driving, typing or holding a phone
• A weak grip, or dropping things
• Relief when you shake your hand
The little finger is normally spared. If it is affected too, another cause is worth considering.
Could it be something else?
| Possible cause | Typical clues | What helps to check |
| Carpal tunnel syndrome | Thumb to ring finger, worse at night, shaking helps | Clinical assessment, sometimes nerve conduction studies |
| Nerve irritation in the neck | Neck pain, symptoms down the arm, little finger affected | Examination of the neck and arm, imaging if needed |
| Ulnar nerve (elbow) | Little and ring fingers, worse leaning on the elbow | Examination, nerve studies |
| Diabetes, thyroid or B12 problems | Both hands or feet affected, other symptoms | Blood tests such as Diabetes, Thyroid Health and Vitamins & Minerals |
| Arthritis of the thumb or wrist | Joint pain, stiffness, swelling | Examination, ultrasound |
Carpal tunnel syndrome is more common in pregnancy, and with diabetes, an underactive thyroid and inflammatory arthritis. If you have several of these factors, mention them to your doctor.
What can I try at home?
1. Wear a wrist splint at night that keeps the wrist straight. This is the first-line self-care step recommended by the NHS and is often the most helpful.
2. Avoid sleeping with your wrists curled under your pillow or body.
3. Take regular breaks from typing, phone use or repetitive gripping, and keep your wrists in a neutral position.
4. Check your set-up. Adjust keyboard, mouse and driving posture so your wrist is not bent for long periods.
5. Give it a few weeks. If you see no improvement, get assessed rather than waiting.
When should I see a doctor?
• Symptoms have lasted more than a few weeks despite self-care
• Your grip is weakening, or you keep dropping things
• Numbness has become constant rather than coming and going
• The muscle at the base of your thumb looks thinner
Carpal tunnel syndrome that is left untreated can eventually cause permanent nerve damage, so early assessment is worthwhile. Call 999 if you develop sudden numbness or weakness on one side of your body, face drooping, or slurred speech, as these can be signs of a stroke and are not carpal tunnel.
What are the treatment options?
Non-surgical treatment
For mild or early symptoms, night splints and activity changes may be enough. Acorn also offers an ultrasound-guided steroid injection into the carpal tunnel, which the clinic lists from £350 and which can settle symptoms in many cases without an operation.
Carpal tunnel release surgery
When symptoms are moderate to severe or have not responded to other treatment, surgery to release the ligament that is pressing on the nerve is the standard approach. At Acorn, carpal tunnel surgery is performed by Consultant Hand Surgeon Mr Angus Maclean under local anaesthetic, so you stay awake and go home the same day. The clinic describes the procedure as taking 15 to 30 minutes.
What does recovery look like?
| When | What Acorn says to expect |
| Days 2 to 3 | Many office-based patients return to desk work. Night-time tingling is often already easing. |
| Week 1 | Most patients are driving short distances and using the hand for light tasks. |
| Days 10 to 14 | Stitches are removed at a short follow-up visit. |
| Weeks 4 to 6 | Manual workers typically return to full duties. A final review follows. |
| 3 months | Grip strength is usually fully recovered. |
Recovery varies from person to person, and your surgeon will give advice that fits your job and the hand treated.
How do I book an assessment at Acorn?
You can self-refer without a GP letter by booking a pre-operative consultation online or calling 029 2199 9300. Bring any previous nerve conduction results. At the consultation the surgeon confirms whether surgery is right for you, and recommends non-surgical options if they are a better fit. Acorn lists the consultation fee on the carpal tunnel page, and prices and insurance details can be checked on the prices and insurance pages. Related hand problems such as trigger finger are covered under hand surgery. Clinics are in Penarth and Cowbridge, and surgical services are for adults aged 18 and over.
Frequently asked questions
Why do my hands go numb at night?
Numb or tingling hands at night are commonly caused by carpal tunnel syndrome, where the median nerve is squeezed at the wrist. Sleeping with bent wrists can make this worse. Other causes include neck problems, diabetes and thyroid conditions.
Will carpal tunnel go away on its own?
Mild symptoms, especially those linked to pregnancy, sometimes settle. Persistent symptoms often need treatment, and untreated carpal tunnel can cause lasting nerve damage, so get it assessed if it does not improve.
Does a wrist splint help carpal tunnel?
Yes, a splint worn at night to keep the wrist straight is a common first step and helps many people with mild or early symptoms.
Is carpal tunnel surgery painful?
The operation is performed under local anaesthetic, so the area is numbed. Acorn says mild discomfort afterwards is usually managed with simple painkillers such as paracetamol.
Do I need a GP referral for carpal tunnel surgery at Acorn?
No. You can self-refer directly online or by phone. Bring any nerve conduction study results if you have them.
How long does it take to recover from carpal tunnel surgery?
Acorn describes returning to desk work within a few days, driving within about a week, and full grip strength at around three months. Manual workers typically need four to six weeks before full duties.