Musculoskeletal System >
Carpal Tunnel Syndrome
“Peripheral neuropathy caused by compression of median nerve in carpal tunnel“
Risk Factors
- Manual work ( repetitive overuse- Flex/ext)
- Advanced Age
- Females
- Pregnancy
- Diabetes
- Obesity
- Rheumatoid Arthritis
- Acromegaly
Aetiology
- Idiopathic
Pathophysiology
- Increased pressure in carpal tunnel causes compression
- Impairment of blood flow
Clinical Presentation
- Pain or tingling in arm/hand along median nerve
- Loss of sensation/ numbness
- Paraesthesia
- Chronic cases can lead to muscle wasting of thenar eminence
- Weakened pinch grip
- Symptoms worse at night
Investigations
- Hand and wrist examination
- Provocative tests
- Hand elevation test
- Carpal compression test
- Phalen’s test
- Tinel’s sign
- Confirmation of diagnosis by nerve conduction or electromyogram
Management
- Conservative treatment
- Immobilization and splinting of wrist and NSAIDs
- Corticosteroid injection only if moderate to severe pain
- Surgical
- Severe cases: surgical decompression- release of transverse carpal ligament
Complications
- Atrophy of thenar eminence