CARPAL TUNNEL SYNDROME


 

Medical conditions associated with CTS:

Clinical aspects: median nerve compression causes

  1. Painful paresthesias in thumb, index, & middle fingers, often worse @ night, relieved by whaking wrist
  2. Weakness of thumb abduction
  3. Occasionally, pain radiating proximally from hand into forearm & upper arm; shouldn?t go above shoulder.
  4. ?Clumsiness? of fingers

Dx:

  1. Phalen?s maneuver: forced wrist flexion for 1 minute reproduces or worsens sx
  2. Tinel?s sign: tap over carpal tunnel; get worsening of sx
  3. If necc., electrodiagnostic tests (EMG & nn. conduction studies)

 

Tx:

  1. Stop the inciting activity
  2. Wear a splint @ night holding wrist in sl. extension
  3. NSAIDs
  4. Time
  5. Sometimes, local inj. of steroids can help
  6. If all else fails, carpal tunnel release helps 80% of pts.