carpal tunnel syndrome

Question 1

what is carpal tunnel syndrome caused by?

Answer 1

compression of median nerve in the carpal tunnel

Question 2

what is the history of carpal tunnel syndrome?

Answer 2

pain/pins and needles in thumb, index + middle finger
may ascend proximally
shake hand for relief, classically at night

Question 3

what are examination findings of carpal tunnel syndrome?

Answer 3

weakness of thumb abduction (Abductor pollicis brevis)
wasting of thenar eminence
tinels sign- tapping causes paraesthesia
phalen’s sign- flexion of wrist causes symptoms

Question 4

what are the causes of carpal tunnel syndrome?

Answer 4

idiopathic
pregnancy
oedema
lunate fracture
RA

Question 5

what are electrophysiology results of carpal tunnel syndrome?

Answer 5

motor and sensory- prolongation of action potential

Question 6

what is the treatment of carpal tunnel syndrome?

Answer 6

6 week trial of conservative treatments if symptoms mild-mod
- corticosteroid injection
- wrist splints at night esp if transient factors

severe symptoms or persistent symptoms w conservative management
- surgical decompression- flexor retinaculum division