Any condition that results in numbness and tingling in the hand and arm caused by a pinched median nerve in the wrist leads to carpel tunnel syndrome. Irritation of the median nerve in this manner causes tingling and numbness of the thumb, index, and the middle fingers.
Symptoms: people mainly experience hand numbness, sensation of pins and needles in hand, hand pain at night, hand weakness/clumsiness (loss of gripping power) or wrist weakness.
1. Phalen sign- tingling in the median nerve distribution is induced by full flexion (or full extension for reverse phalen) of the wrists for up to 60 seconds (this test has 80% specificity).
2. The carpal compression test- this test involves applying firm pressure directly over the carpal tunnel, usually with the thumbs, for up to 30 seconds to reproduce symptoms (this test has specificity of 96%).
All special tests are performed by the physical therapist.
Diagnosis: carpel tunnel syndrome is suspectedly based on symptoms, supported by physical examination signs, and confirmed by nerve conduction testing.
Treatment: mild symptoms usually can be treated with home care.
1. Stop activities that cause numbness and pain. Rest your wrist longer between activities.
2. Ice your wrist for 10 to 15 minutes 1 or 2 times a day along with physiotherapy treatment.
3. Nonsteroidal anti-inflammatory drugs (nsaids) to relieve pain and reduce swelling.
4. Wear a wrist splint at night. This takes pressure off your median nerve.
The sooner you start treatment, the better your chances of stopping symptoms and preventing long-term damage to the nerve.