Musculoskeletal Health

Question 1

Carpal Tunnel - Specialist referral criteria

Answer 1

When:
✓ diagnosis is unclear.
✓ severe symptoms/ reduced functional ability.
✓ recurrence of symptoms after carpal tunnel surgery.
✓ patient requests referral.
✓ conservative management in primary care failed.
✓ serious condition (e.g neurological disease, inflammatory joint disease) is suspected.
Management:
✓ Corticosteroid injections can be offered in primary care if analgesia and lifestyle modifications (like avoiding tasks that precipitate symptoms), splint have not been effective
✓ In pregnancy, fluid retention is likely cause for symptoms s/s likely to resolve after pregnancy.
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