Carpal tunnel syndrome

Due to compression of the median nerve as it passes under the flexor retinaculum.

Associations

Diabetes Mellitus

Hypothyroidism.

Obesity

Pregnancy.

Repeat this activity.

Inflammatory arthropathic such as Rheumatoid arthritis

Pain in the radial 31⁄2 digits of the hand ± numbness, pins, and needles

Thenar wasting.

Symptoms are worse at night.

Symptoms are improved by shaking the wrist.

Examination

Phalen’s test—hyperflexion of the wrist for 1min triggers symptoms

Tinel’s test—tapping over the carpal tunnel causes paraesthesia

Investigations

U/S Wrist

Nerve conduction studies if the diagnosis is in doubt

Management

Night splints

Rest

Cortisone injection in the wrist

Decompression surgery

Referral for physiotherapy or hand therapy