Carpal Tunnel Syndrome CTS CPG

Question 1

Examination

Outcome measure B

Answer 1

Use : CTQ-SSS (carpal Tunnel Questionnaire Symptom severity scal) or DASH

Question 2

Examination

Physical impairment measure A

Answer 2

Should NOT use lateral pinch strength as an outcome

Question 3

Diagnosis/Classification

Monofilament A

Answer 3

Use: Semmes Weinstein monofilament testing
- Middle finger with 2.83 or 3.22 as threshold normal for light touch sensation and static 2 point discrimination
- Mod to severe CTS: use radial finger with 3.22 monofilament

Question 4

Diagnosis/ Classifacation

Special test B

Answer 4

Use: Phalen test, carpal tunnel compression test or Katz hand diagram

Question 5

Diagnosis/ Classification

Criteria : 3 = positive

Answer 5

• Age 45+
• Shaking hands relieves symptoms
  -Sensory loss in thumb
• Wrist ration index >.67
• CTQ-SSS score of >1.9

Question 6

Intervention

Orthoses B

Answer 6

Recommend: Neutral positioned wrist orthosis to be worn at night

Question 7

Intervention

Biophysical Agent B

Answer 7

Should NOT use low level laser or iontophoresis
Should NOT use thermal ultrasound