Carpal Tunnel Syndrome is the compression of the median nerve travelling through the carpal tunnel. Carpal.The carpal tunnel is an anatomical compartment located at the base of the wrist. Nine flexor tendons and the median nerve pass through the carpal tunnel that is surrounded on three sides by the carpal bones that form an arch.Compression of the median nerve as it runs deep to the transverse carpal ligament causes atrophy of the thenar eminence, weakness of the flexor pollicis brevis, opponens pollicis, abductor pollicis brevis, as well as sensory loss in the distribution of the median nerve distal to the transverse carpal ligament.
Clinical assessment by history taking and physical examination can support a diagnosis of CTS.But diagnosis of carpal tunnel syndrome is confirmed by electrophysiological testing.
* Phalen's maneuver is performed by flexing the wrist gently as far as possible, then holding this position and awaiting symptoms.A positive test is one that results in numbness in the median nerve distribution when holding the wrist in acute flexion position within 60 seconds. • Phalen’s sign is defined as pain and/or paresthesias in the median-innervated fingers with one minute of wrist flexion.
*Tinel's is performed by lightly tapping the skin over the flexor retinaculum to elicit a sensation of tingling or "pins and needles" in the nerve distribution.• Tinel’s sign (pain and/or paresthesias of the median-innervated fingers with percussion over the median nerve) is less sensitive, but slightly more specific than Phalen’s sign.
To aid in the prevention of Carpal Tunnel Syndrome, stretching exercises of the wrist, hand, and fingers have been used to combat against the pain and numbness caused by repetitive actions. Other than using recommended stretches and exercises, useful treatments for CTS include use of night splints, corticosteroid injections and ultimately surgery.