Pain Management Procedures
Carpal Tunnel Injection
Carpal Tunnel Injection
What is it?
The carpal tunnel is a narrow passage at the wrist containing the median nerve and finger-flexor tendons. Pressure on the median nerve can cause numbness, tingling, burning, or pain in the thumb, index, middle, and part of the ring finger. A carpal tunnel injection places corticosteroid around the nerve to reduce swelling and pressure.
When may it be recommended?
It may be considered for mild to moderate carpal tunnel syndrome, often together with nighttime splinting and activity changes. It can also provide diagnostic information. Persistent weakness, muscle wasting, severe nerve-test abnormalities, or symptoms that quickly return may lead to a surgical evaluation rather than repeated injections.
What happens?
The wrist is positioned palm up. Ultrasound may be used to identify the median nerve, tendons, and blood vessels. After cleaning and numbing the skin, a small needle is advanced into the tunnel beside - not into - the nerve, and medication is injected.
What should I expect?
The hand may feel numb or heavy for several hours. Protect it from heat, cuts, and forceful gripping until sensation returns. Relief can last weeks or months, but the injection does not permanently enlarge the tunnel.
Important risks
Risks include bleeding, infection, temporary pain, skin changes, tendon injury, and accidental injection into or injury of the median or ulnar nerve. Report new or worsening weakness, severe electric pain, or persistent loss of sensation promptly.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.