Carpal Tunnel Syndrome

Question 1

What does CTS involve?

Answer 1

1. Entrapment of the median nerve at the level of the wrist (Carpal canal)

Question 2

What are the symptoms of CTS?

Answer 2

1. Numbness
2. Tingling
3. Pain/aching
4. Worse at night or with aggravating activities
   *may wake at night
5. Drop items frequently
6. Weakness

Question 3

What will be found on the PE?

Answer 3

1. Thenar atrophy
2. Strength decreased
3. Sensation diminished through median nerve distribution
4. Phalanx maneuver
   *back of hands together for a min, patient will have pain
5. Tinel’s sign
   *tap on carpal canal

Question 4

What can make the CTS diagnosis?

Answer 4

1. Made by H&P
2. XRays
   *if CTS is not better with treatment

Question 5

What is the confirmatory test for CTS?

Answer 5

1. EMG/NCS
   *testing the nerves in the muscles
   *can be normal or abnormal

Question 6

What are some adverse outcomes of CTS?

Answer 6

1. Loss of sensation
2. Loss of hand strength
3. Inability to perform fine motor skills

Question 7

What is the treatment of CTS?

Answer 7

1. Splinting and therapy (mild to moderate)
2. ICE, heat, exercises, job modifications
3. NSAIDs
4. CI
5. Surgery
   **do 1,2, 3 first if no improvement then complete 4&5