Has anyone here had a carpal tunnel operation? After a bikepacking event in late 2024 I had some bad nerve issues. Ive had them before, always with drop bars actually, never flats. Anyway, after about 7 months it got a lot better. Typical median nerve compression symptoms. I did a bunch of hand rehab and had a nerve test that implied that I had carpal tunnel syndrome. I got a referral under ACC to have an operation, so had an interview with the Dr this morning. He did some simple tests trying to get some pain out of my hand. There was no pain or numbness, so speculated that I was unlikely to have carpal tunnel syndrome…
Yesterday I did a cross race and had to flip my hands about repeatedly on multiple occasions just to get some feeling back so I could even change gears. I get the same thing on the trails on my MTB, certain trails that are big on braking. He had no real answer to this. His reason for not doing the operation seemed very negative. What if it didnt work? What if there were complications, I would blame them! I asked him what else could be cause my nerve issues and he his answers were pretty vague, diabetes, a bad diet, immune deficiency…
Has anyone experienced a cause of median nerve compression which was not caused by carpal tunnel syndome? I havent been able to find anything online. I understand that numbness in the hand is only where it’s felt, the issue could be in the neck even. He has suggested that I have a cortiscone injection into the wrist area, if this brings relief it will prove that it IS carpal tunnel syndrome. HMU with your median nerve compression stories!
After getting treatment in my left wrist post break and starting to ride again with a brace on that, I developed pain in my right wrist. My Dr thought it might be carpal tunnel but a nerve conduction test proved otherwise. An X-ray on the right wrist suggests that, like my left post break, I’m dealing with arthritis.
None of which eased the pain in my right wrist. I’ve been assiduously exercising my forearms with a wrist strengthener (hand spring thing) and that has helped, but ultimately I had to tweak my bikes’ handlebar/cockpit resolve the issue. I added more back and up sweep to my mtb with a different set of risers, and I got a bike fit on the road bike to address it there.
We took a bit of weight off my hands by dropping the saddle, moving my cleats back and some other shims and bits and pieces, but perhaps the most significant change was rolling my levers in so they’re no longer parallel to the drops - not as radical as you see in the pro peloton, but in that direction. That means my wrist is a little lesss twisted when I’m on the hoods
It helped A LOT, particularly in the hoods - but that led to less moving around trying to stop my right hand falling asleep. No doubt the weight shift contributed too.
I’d suggest a bike fit, or at least try fiddling with your lever rotation.
Thanks Jim. I have zero pain in the wrist, it’s all in the top 2 fingers and thumb, typical median nerve compression symptoms. Yes I am always trying different brake/shifter angles and recently paid for my first proper bike-fit.
Ah, I should have mentioned that, while my wrist hurt, my three non-index fingers also fall asleep/tingle, hence the nerve conduction test. Either way, both those have eased with forearm strength training and positional changes.
I have had surgery on both hands for carpal tunnel syndrome. In my case the cause was most likely mousing although long hours on the bike probably contributed too. No complications and the result was excellent. I have no pian and little numbness, although occasionally my little and second finger get numb (separate nerve pathway), but not riding. Your surgeon sounds very conservative, so perhaps seek another opinion? My bloke was a specialist hand surgeon, so if yours was not perhaps seek one out.
Same Tom, Ive been a digi slave and double mousing since the 90’s. Dang it. That isn’t covered by ACC tho, ( NZs health care). Stupid, they cover me for a weeks riding which caused the flare up, but not years of work abuse! Were you alright when not riding or dud you have issues all the time Tom? Your right, hes not a hand specialist. 2nd opinion isn’t on the cards tho.
Had been having issues for years, riding or not. Usually waking in the morning with numbness which usually cleared in a few minutes, but as with you, when riding it would return. Had my RH done first but about a year later, after some major (unrelated) surgery, woke up with a numb left hand - which scarily didn’t clear! So had the left done then. Not sure of the complexities of the NZ health system but I am in Australia and had insurance, so could choose who I went to. Didn’t go down the Workers Comp path as it is a bit of a nightmare. Good luck, but the diagnosis sound correct and your surgeon seems to be overstating the risks.
I’m a hospital physio in Australia, working in orthopaedics and hands for a good while, but not a fully qualified Hand Therapist. I’ll start by saying a surgeon who chooses not to do surgery a good thing. We don’t want surgeons operating on people where the outcomes and benefits are highly questionable.
From your story I’m hearing that you only get symptoms when riding and not day to day? I might have missed a bit in there so please correct me if I have. If this is the case I can understand the surgeon being reluctant to do an all or nothing operation purely to cater for a strenuous sporting activity. It’s kind of like doing a knee operation to manage knee pain that only comes on after you run 30km; a potentially questionable surgery to manage something you don’t necessarily have to do, and if things go wrong your whole life is affected. Surgeries are risky, we shouldn’t be overly nonchalant about this.
I’m guessing you’re getting a lot of arm pump specifically when you’re riding, so there’s potentially excess pressure building in your arms around your median nerve giving you your symptoms. Would chopping up your carpal tunnel relieve this while you ride? Maybe? Taking some of the other advice here and adjusting your fit to reduce pressure on your hands and potentially improve your wrist position while braking would be a better option, as well as some hand and forearm strength work. I would aim to see a Hand Therapist (in Aus and NZ these can be Physios or Occupational Therapists) to get a better diagnosis and plan. They can probably also better advise you on if surgery would be useful, and would probably recommend a Hand specialist surgeon who may be better able to advise you also.
I’m not sure if i suffer median nerve compression but I definitely get numb fingers while riding. Not always but reasonably often.
I don’t have noticeable pain when not riding.
My left wrist got quite bad 2 years ago so I saw a hand therapy guy and had an ultrasound of my wrist that actually indicated I did not have a carpal tunnel issue. (Ironically, my therapist had surgery for it himself while he was seeing me.)
He got me wearing a wrist brace for a while back then but it actually got better just over time - except now I’m getting similar pain in my right wrist. I’m putting it down to being old.
Thankfully it isn’t crippling yet and hasn’t got a lot worse over the years. I can relieve it simply by taking my hand off the handlebars for a while.
So I’m not sure this is much help except as an example of someone with wrist pain that is apparently not due to carpal tunnel syndrome.
I might have to try riding Jim’s bike to see what his aero hoods feel like…
One of the best improvements I’ve made to my MTB bike is getting Ergon GS1 and GS2 grips. They really help spread the pressure on the hand - and the mini bar ends are great for touring.
Thanks very much for your comments here. I really appreciate them. I did do a big stretch of hand therapy and wore a brace to bed for probably 6 months. My right hand only had a quarter the strength of my left but over a few months of exercises it came back. I guess my symptoms are small compared to Tom’s at least. I could always go for 4 pot brakes on my trail bike ! Its the drop bars that bug me the most tho. I have a large amount of flare, Ritchey Beacons, also very shallow drop. Thanks again.
Firstly, not a doctor so medically I’ve no advice to offer, but I’m a classical musician so have always been very concious of things like numb fingers on rides, and very keen to avoid any hint of CTS and anything like it.
When I’ve had tingling and numb fingers riding the first thing I do is look at my wrists on the bars. 9 times out of 10 I’ll see that my hands have this kindof flare out and its causing a compression at the wrist. Changing grip on the bars to conciously straighten out the wrist, and even rotate slightly the opposite way almost always seems to alleviate the numbness straight away.
I’ve tried different gloves/no gloves/suspension stem/thin bar tape/thick bar tape/different bars/different bikes. The only thing that makes the main difference is ergonomics of the wrist.
