Carpal Tunnel Syndrome

Christina Caranica

Jane Han

Physical examination includes assessing for numbness and tingling in the fingers, loss of grip, pain over the ventral aspect of the wrist with possible radiation to the palm and fingers, tight or swollen feeling in the hand, and/or temperature changes. Tinel’s sign is assessed by percussing lightly over the median nerve.  A positive test reports tingling, numbness, or pain at the site. Phalen’s sign test requires that the patient holds out their hands in front of him/her and flexes the wrist followed by dropping the hands down for 60 seconds.  Report of tingling, numbness or pain indicates a positive test.

Limitations related to mobility include pain, numbness, paresthesia, and weakness along the median nerve affecting the thumb, index, and middle finger.  Commonly seen is night pain and clenching upon awakening.

Patient teaching includes: minimizing excessive wrist movements (wringing, gripping and squeezing); using a wrist splint to rest the nerves and help the wrist maintain a neutral position; taking quick breaks and performing hand exercises that rotate and stretch the palm and fingers; and asking the doctor if surgery is an option-surgery can help relieve pressure, and prevent permanent nerve and muscle damage.