Carpal Tunnel Syndrome

The median nerve supplies sensation to the thumb, index, middle and half the ring finger. It also facilitates some movements of the thumb. The median nerve travels down the arm and into the digits through a space at the wrist called the carpal tunnel. Sometimes the nerve can be compressed in the carpal tunnel and this condition is known as carpal tunnel syndrome.

Clinical features
Carpal tunnel syndrome is associated with pain and tingling affecting the fingers supplied by the median nerve. The tingling typically occurs at night and is alleviated by shaking the hand. Movement of the thumb may be affected and the tingling can sometimes also involve the little finger and forearm.

Diagnosis
Neurophysiology testing is used to confirm the diagnosis. This measures the speed at which electrical impulses travel down the nerve which are delayed in carpal tunnel syndrome.

Treatment
-Avoid repetitive movements
-Wrist splint (usually at night or at work)
-Steroid injection into the carpal tunnel
-Pain killers
-Surgery

Other conditions