Carpal tunnel syndrome

Alternative names:

median nerve dysfunction

Symptoms:

• weakness in 1 or both hands
• numbness or tingling in the thumb and next 2 or 3 fingers of 1 or both hands
• numbness or tingling of the palm of the hand
• joint pain (wrist pain) in 1 or both hands can occur
• impaired fine finger movements in 1 or both hands
• weak grip, difficulty bringing the thumb across the palm to meet the other fingers (thumb opposition)

Signs and tests:

Physical examination shows decreased sensation in the palm, thumb, index finger, middle finger, and thumb-side (radial surface) of the ring finger. The hand grip is weak. Tapping over the median nerve at the wrist causes numbness (Tinel's sign). Bending the wrist forward all the way (full flexion--called Phalen's test) or bending the wrist back also causes numbness.

Electromyography and nerve conduction velocity may be performed, showing decreased conduction across the wrist. Wrist X-rays may also be recommended.