Carpal tunnel syndrome is caused by compression of the median nerve by the transverse carpal ligament of the wrist. It causes numbness in the thumb, index finger, middle finger, radial side of the ring finger and palm. These symptoms often cause people to wake at night. Treatment comprises of splinting, steroid injection or surgery via an open incision or a supraretinacular endoscopic technique devised by Mr Ecker. Surgery can be performed as a day case under local anaesthetic.