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Carpal Tunnel Syndrome

Frances A. Tepolt, MD, CAQSM and Rahul Kapur, MD Reviewed 06/2020
 


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

  • Strong evidence supports immobilization (brace/splint/orthosis) and the use of local steroid (methylprednisolone) injection in improving patient-reported outcomes.

  • Strong evid...

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
Chesteron LS, Blagojevic-Bucknall M, Burton C, et al. The clinical and cost-effectiveness of corticosteroid injection versus night splints for carpal tunnel syndrome (INSTINCTS trial): an ...

ADDITIONAL READING

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

  • Graham B, Peljovich AE, Afra R, et al...

CODES

ICD10

  • G56.0 Carpal tunnel syndrome

  • G56.01 Carpal tunnel syndrome, right upper limb

  • G56.02 Carpal tunnel syndrome, left upper limb

  • G56.00 Carpal tunnel syndrome, unspecified upper limb

  • G56.03 Carpal t...

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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