Difference between revisions of "Carpal tunnel syndrome"

(Created page with "==Background== *Most common focal mononeuropathy *Results from compression of median nerve at wrist where it traverses the carpal tunnel *Etiology: **Repetitive use, DM, amyloido...")
 
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*Results from compression of median nerve at wrist where it traverses the carpal tunnel
 
*Results from compression of median nerve at wrist where it traverses the carpal tunnel
 
*Etiology:
 
*Etiology:
**Repetitive use, DM, amyloidosis, trauma, edema
+
**Repetitive wrist flexion/extension, DM, amyloidosis, trauma, edema
  
 
==Clinical Features==
 
==Clinical Features==
 
*Pain, paresthesia, and numbness in distribution of median nerve
 
*Pain, paresthesia, and numbness in distribution of median nerve
 
**Palmar aspect of thumb, index, middle, and radial aspect of ring finger
 
**Palmar aspect of thumb, index, middle, and radial aspect of ring finger
 +
*Awakening at night w/ burning pain and tingling in hand
 
*Tinel sign
 
*Tinel sign
 
**Tapping on palmar aspect of wrist reuslts in electric shock sensation shooting into hand
 
**Tapping on palmar aspect of wrist reuslts in electric shock sensation shooting into hand
 
*Phalen maneuver
 
*Phalen maneuver
**Holding wrists in flexion for 60s evokes or worsens symptoms
+
**Holding wrists in flexion for 60 seconds evokes or worsens symptoms
  
 
==Treatment==
 
==Treatment==

Revision as of 21:29, 26 February 2012

Background

  • Most common focal mononeuropathy
  • Results from compression of median nerve at wrist where it traverses the carpal tunnel
  • Etiology:
    • Repetitive wrist flexion/extension, DM, amyloidosis, trauma, edema

Clinical Features

  • Pain, paresthesia, and numbness in distribution of median nerve
    • Palmar aspect of thumb, index, middle, and radial aspect of ring finger
  • Awakening at night w/ burning pain and tingling in hand
  • Tinel sign
    • Tapping on palmar aspect of wrist reuslts in electric shock sensation shooting into hand
  • Phalen maneuver
    • Holding wrists in flexion for 60 seconds evokes or worsens symptoms

Treatment

  1. Behavioral modification
  2. Wrist splint w/ wrist in neutral position
  3. NSAIDs (although not clearly effective)
  4. Diuretics (if edema is significant contributor to pt's symptoms)

Source

Tintinalli