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Carpal Tunnel Syndrome

Frances A. Tepolt, MD and Rahul Kapur, MD Reviewed 06/2019
 


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 and may lead to the avoidance of surgery, particularly in mildly symptomatic p...

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
Page MJ, Massy-Westropp N, O’Connor D, et al. Splinting for carpal tunnel syndrome. Cochrane Database Syst Rev.  2012;(7):CD010003. [View Abstract on OvidMedline]
2
Huisstede BM, Randsd...

ADDITIONAL READING

  • Calandruccio JH, Thompson NB. Carpal tunnel syndrome: making evidence-based treatment decisions. Orthop Clin North Am.  2018;49(2):223–229. [View Abstract on OvidMedline]

  • Graham...

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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