Carpal Tunnel Syndrome

Question 1

Risk factors for carpal tunnel syndrome

Answer 1

DM, RA, hypothyroidism

wrist trauma, ESRD, obesity, pregnancy acromegaly and menopause

Question 2

Clinical presentation

Answer 2

pain and paresthesias in median nerve distribution 1st 3 1/2 digits and can involve entire hand and radiate proximal to forearm and worse at night and can awaken patient from sleep. can improve with flicking of wrist or warm running water. proving or flexing

weak thumb abduction or opposition or atrophy of the thenar eminence.

Question 3

Treatment of carpal tunnel syndrome

Answer 3

nocturnal wrist splinting
steroid inejctions if split fails
surgery for patients experiencing motor weakness or atrophy of thenar eminence or refractory to above treatments.

Question 4

When are symptoms worse with carpal tunnel syndrome?

Answer 4

at night and can be exacerbated by repetitive sustained hand movements (knitting)