Carpal Tunnel Syndrome
From WikiMSK
Aetiology
- Pregnancy
- Obesity
- Diabetes Mellitus
- Hypothyroidism
- Acute fluid retention
- Connective tissue diseases
- Rheumatoid arthritis
- Local abnormalities/lesions involving the wrist, including previous fractures
Assessment
- Symptoms are often variable but classically include pain or paraesthesia in the median nerve distribution.
- Neurological examination
- Provocative tests
Investigations
Not normally required, but can include nerve conduction studies or diagnostic ultrasound. These modalities cannot exclude the condition.
Treatment
Conservative treatment for mild and intermittent symptoms, or symptoms that are likely to resolve soon such as during pregnancy.
- Activity Modification
- Corticosteroid injection
See Carpal Tunnel Injection article.
- Splinting and Hand Therapy
Hand therapists can teach graded exercises and provide custom thermoplastic or off the shelf splints.
- Surgery (Carpal tunnel release or decompression)
Consider conservative therapy first until severe pain or marked neurological signs. Access to surgery is variable across New Zealand. Surgery may not result in complete recovery of any neurological deficit but may prevent progression.
