Carpal tunnel syndrome

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Carpal tunnel surgical procedure

Carpal tunnel syndrome

Compression of the median nerve

Surface anatomy - normal wrist

Median nerve dysfunction

• Weakness in one or both hands
• Numbness or tingling in the thumb and next two or three fingers of one or both hands
• Numbness or tingling of the palm of the hand
• Pain in wrist or hand in one or both hands
• Pain extending to the elbow
• Problems with fine finger movements (coordination) in one or both hands
• Weak grip or difficulty carrying bags (a common complaint)
• Wasting away of the muscle under the thumb (in advanced or long-term cases)

During a physical examination, the doctor may identify numbness in the palm, thumb, index finger, middle finger, and thumb-side of the ring finger. Hand grip may be weak.

Tapping over the median nerve at the wrist may cause pain to shoot from the wrist to the hand (Tinel's sign). Bending the wrist forward all the way (Phalen's test) for 60 seconds will usually result in numbness, tingling, or weakness.

Electromyography and nerve conduction velocity may be performed, showing decreased conduction across the wrist. Wrist x-rays should be obtained to ensure that other problems (such as wrist arthritis) are not the cause of the patient's pain.

Review Date: 09/26/2006
Reviewed By: Andrew L. Chen, M.D., M.S., Orthopedist, The Alpine Clinic, Littleton, NH. Review provided by VeriMed Healthcare Network.