Table of Contents CausesClinical features Management Test yourself! Carpal tunnel syndrome is a median nerve entrapment neuropathy caused by compression of the median nerve in the carpal tunnel. Causes IdiopathicPregnancyObesityRheumatoid arthritisLocal extrinsic pressure, e.g. ganglion, lipoma, fracture, haematomaEndocrinologicalDiabetesHypothyroidismAcromegaly Clinical features Intermittent paraesthesia, pain/burning and numbness of thumb, first, middle and radial half of ring fingerLoss of strength and wasting of the thenar eminenceSymptoms often worse at nightPhalen’s test +veTinel’s test +ve Management ConservativeWatch and wait (spontaneous resolution occurs in 25% over 1 year)Wrist splint (especially at night)Corticosteroid injectionNSAIDs may helpSurgical carpal tunnel release: transverse carpal ligament over volar aspect of wrist incised under local anaesthesia) – recurrence rare Test yourself! What is the differential diagnosis of carpal tunnel syndrome? Oops! This section is restricted to members. How is Phalen’s test undertaken? Oops! This section is restricted to members. How is Tinel’s test undertaken? Oops! This section is restricted to members.