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Carpal Tunnel Syndrome

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Symptomatic compression neuropathy of the median nerve

  • Increased pressure within the carpal tunnel leads to compression of the median nerve and characteristic motor-sensory findings.

  • T...

DIAGNOSIS

HISTORY

  • Nocturnal pain, numbness, and tingling of the thumb, index, long, and radial portion of the ring fingers; patients may not localize and alternatively describe the entire hand as being...

TREATMENT

GENERAL MEASURES

  • Splinting the wrist in a neutral position while sleeping may provide significant symptom relief:

    • Limited evidence indicates that night splints are more effective than no tre...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Patients treated nonoperatively (splinting, injections) require follow-up over 4 to 12 weeks to ensure adequate progress.

  • There is only limited, ...

REFERENCES

1
1 Page MJ, Massy-Westropp N, O’Connor D, et al. Splinting for carpal tunnel syndrome. Cochrane Database Syst Rev.  2012;(7):CD010003. {L-End} {L-End} [View Abstract on OvidMedline]
...

ADDITIONAL READING

  • Middleton SD, Anakwe RE. Carpal tunnel syndrome. BMJ.  2014;349:g6437. {L-End} {L-End} [View Abstract on OvidMedline]

  • Page MJ, O’Connor D, Pitt V, et al. Therapeutic ultrasou...

SEE ALSO

  • Arthritis, Rheumatoid (RA); Hypoparathyroidism; Lupus Erythematosus, Systemic (SLE); Scleroderma

  • Algorithms: Carpal Tunnel Syndrome; Pain in Upper Extremity

CODES

ICD10

  • G56.00 Carpal tunnel syndrome, unspecified upper limb

  • G56.01 Carpal tunnel syndrome, right upper limb

  • G56.02 Carpal tunnel syndrome, left upper limb

ICD9

354.0 Carpal tunnel syndrome 

SNOMED

  • 5740...

CLINICAL PEARLS

  • Paresthesias associated with CTS are characteristically confined to the thumb, index, long, and radial 1/2 of the ring fingers of the affected hand.

  • Thenar atrophy is a late finding, in...

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