CARPAL TUNNEL SYNDROME

Medical conditions associated with CTS:

• DM
• Pregnancy
• Amyloid
• RA
• Hypothyroidism
• Acromegaly

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.