clinical features
Last reviewed 07/2023
Clinical features of carpal tunnel syndrome include:
- numbness or paraesthesia in the hand
- usually, but not always, of the thumb, index, middle, and radial half of the ring finger
- pain in hand, wrist may extend proximally to forearm or to the shoulder region
- symptoms are worst at night which may be relieved by
- hanging the arm over the side of the bed, or by shaking the arm
- flicking the wrist - known as the flick sign
- decreased grip strength
- motor wasting and weakness lead to thenar wasting and weakened abduction of the thumb – seen in severe, chronic carpal tunnel syndrome,
- clumsiness or reduced manual dexterity e.g. – difficulty in carrying out fine tasks such as doing up buttons or become clumsy and drop items
- trophic ulcers at the tips of thumb, index finger, or middle finger
- positive Tinel's test
- positive Phalen's test
- electrical studies may show a slowing of nerve conduction across the wrist
Note:
- sometimes symptoms may occur in all fingers (but not in dorsum or palm of the hand)
- permanent sensory changes and motor signs and symptoms are considered as late manifestations of CTS
Reference: