Carpal tunnel syndrome
Background
- Most common focal mononeuropathy
- Results from compression of median nerve at wrist where it traverses the carpal tunnel
- Etiology:
- Repetitive use, DM, amyloidosis, trauma, edema
Clinical Features
- Pain, paresthesia, and numbness in distribution of median nerve
- Palmar aspect of thumb, index, middle, and radial aspect of ring finger
- Tinel sign
- Tapping on palmar aspect of wrist reuslts in electric shock sensation shooting into hand
- Phalen maneuver
- Holding wrists in flexion for 60s evokes or worsens symptoms
Treatment
- Behavioral modification
- Wrist splint w/ wrist in neutral position
- NSAIDs (although not clearly effective)
- Diuretics (if edema is significant contributor to pt's symptoms)
Source
Tintinalli