Carpal tunnel syndrome: modern diagnostic and management techniques

Carpal tunnel syndrome is a common disorder characterised by the classical symptoms of numbness and paraesthesiae along the distribution of the median nerve. Thenar muscle weakness is a late manifestation of advanced disease. Tinel's and Phalen's signs are helpful in suggesting the diagnosis. The sy mptoms and signs arise from entrapment of the median nerve. Electrophysiolo gical tests are helpful in conforming the diagnosis od atypical cases. Ergo nomic manoeuvers and steroid injections may alleviate symptoms in mild case s. Surgery is reserved for severe cases and those who do not respond to con servative therapy. open carpal tunnel release is the classical surgery with usually excellent results. Endoscopic carpal tunnel release surgery was in troduced to decrease the morbidity of open surgery. This latter technique a lso has its complications and is still being refined.