Description Carpal tunnel syndr...
Description
Carpal tunnel syndrome is due to compression of the median nerve in the wrist. The median nerve supplies sensation to the palm side of the thumb, index, and middle fingers and the thumb-side of the 4th finger. This nerve also controls the movement of the thumb. The median nerve travels through a narrow space in the wrist called the carpal tunnel with the transverse carpal ligament forming the roof of the tunnel. Swelling in the tunnel causes compression of the median nerve within this tunnel resulting in the symptoms. Repetitive hand movements may increase the likelihood of developing this disorder. It is more common in women than men, is seen more commonly in people with rheumatoid arthritis and diabetes, and most often occurs after age 30.
Symptoms
Wrist pain, hand pain, numbness of thumb and first three fingers, weakness of grip, symptoms worse at night, wasting of thumb muscles.
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be performed. These two tests are used to help diagnose the condition: 1) Tinel's sign, tapping over the median nerve at the wrist causing tingling or numbness to shoot from the wrist to the hand; and 2) Phalen's test (or Phalen's maneuver), bending the wrist forward all the way for 30-60 seconds resulting in numbness, tingling, or weakness. Nerve conduction studies may be done to confirm the diagnosis and assess the severity of the condition.
Tests:
X-ray
Other Specific Tests: Electromyography (EMG)
Specialists:
Internal Medicine, Hand Surgery, Family Practice
Workup:
A history and physical exam will be performed. These two tests are used to help diagnose the condition: 1) Tinel's sign, tapping over the median nerve at the wrist causing tingling or numbness to shoot from the wrist to the hand; and 2) Phalen's test (or Phalen's maneuver), bending the wrist forward all the way for 30-60 seconds resulting in numbness, tingling, or weakness. Nerve conduction studies may be done to confirm the diagnosis and assess the severity of the condition.
Tests:
X-ray
Other Specific Tests: Electromyography (EMG)
Specialists:
Internal Medicine, Hand Surgery, Family Practice
Treatment
Treatment includes: wrist immobilization, nonsteroidal anti-inflammatory medications(NSAIDs) such as ibuprofen/Motrin or naproxen/Advil),acetaminophen (Tylenol), ergonomic wrist splints, cortisone injections and/or surgery. Surgery can be done using an open technique with a larger incision or through an arthroscope. Both methods cut through the transverse carpal ligament relieving the compression of the nerve.