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Carpal Tunnel Syndrome

Carpal tunnel syndrome is a common disorder characterized by pain, burning , and tingling of the palmar surface of the hand, resulting from compression of the median nerve between the carpal ligament and other structures within the carpal tunnel (entrapment neuropathy). The volume of the contents of the tunnel can be increased by organic lesions such as synovitis of the tendon sheaths or carpal joints.

Carpal tunnel syndrome can also be a feature of many systemic diseases: rheumatoid arthritis.

Clinical Findings

Pain in the distribution of the median nerve, which may be burning and tingling (acroparesthesia), is the initial symptom. Aching pain may radiate proximally into the forearm and occasionally proximally to the shoulder, neck, and chest. Pain is exacerbated by manual activity, particularly by extremes of volar flexion or dorsiflexion.

Treatment is directed toward relief of pressure on the median nerve. When a primary lesion is discovered, specific treatment should be initiated.

Operative division of the volar carpal ligament gives lasting relief.