Carpal Tunnel Syndrome

1. Carpal Tunnel Syndrome

2. Definition: It's a compresion of median nerve in the carpal tunnel is called carpal tunnel syndrome

3. anatomy The median nerve travels from the forearm into your hand through a “tunnel” in your wrist.

4. Epidemiology : Most often 30 -60 years old Five times more common in women Older, overweight, and physically inactive people

5. Etiology 1-primery or Idiopathic 2- secondary A: Local etiology I: Anatomical malformation II: Tumors III: Infections IV: Bone prominence B: Systemic etiology obesity, diabetes mellitus, thyroidysfunction, R.A C:Computer users !!

6. Clinical Features • Pain • Numbness • Tingling • Symptoms are usually worse at night and can awaken patients from sleep. • To relieve the symptoms, patients often “flick” their wrist as if shaking down a thermometer (flick sign).

8. Clinical Features • Pain and paresthesias may radiate to the forearm, elbow, and shoulder. • Decreased grip strength may result in loss of dexterity, and thenar muscle atrophy may develop if the syndrome is severe.

9. Atrophy

10. Physical examination • Phalen’s maneuver • Tinel’s sign • weak thumb abduction. • two-point discrimination

11. Phalen’s maneuver

12. Tinel’s sign

13. Diagnostic • History • Physical examination • Nerve Conduction Study

14. Treatment • CONSERVATIVE TREATMENTS • GENERAL MEASURES • WRIST SPLINTS • ORAL MEDICATIONS • LOCAL INJECTION • Predicting the Outcome of Conservative Treatment • SURGERY

16. WRIST SPLINTS

17. WRIST SPLINTS

18. LOCAL INJECTION

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