Carpal tunnel syndrome

Question 1

What is carpal tunnel syndrome?

Answer 1

Peripheral neuropathy caused by chronic or acute compression of the median nerve by the transverse carpal ligament

Question 2

What are some causes of carpal tunnel syndrome?

Answer 2

Previous fracture of the distal radius
Traumatic dislocation of the lunate
Manual work
Rheumatoid arthritis 
Pregnancy 
Obesity
Osteoarthritis

Question 3

What are the clinical features of carpal tunnel syndrome?

Answer 3

(Sensory symptoms of palmar surface of the thumb, index, and middle finger; and radial half of the ring finger) Burning sensation/paresthesia
Loss of sensation/numbness
(Symptoms worse at night)
(Weakened pinch and grip)
(Sometimes thenar atrophy)
(Tinel’s sign) tapping causes paraesthesia
(Phalen’s sign) flexion of wrist causes symptoms
(Durken’s test) Compression of median nerve to recreate symptoms

Question 4

How is carpal tunnel syndrome diagnosed?

Answer 4

(Electrophysiological tests)i.e. Nerve conduction studies

Question 5

What is the treatment for carpal tunnel syndrome?

Answer 5

(Mild - moderate) Conservative treatment: Immobilization of the wrist; Corticosteroid injection; Short-term oral glucocorticoid therapy; Short-term treatment with NSAIDs
(Moderate to severe) Open or endoscopic release of the transverse carpal ligament