CARPAL TUNNEL SYNDROME
Dr. M.Jaffar PT
DPT(NCS,KMU),
MS-NMPT* (RIU)
CARPAL TUNNEL SYNDROME
Carpal tunnel syndrome is a condition that causes
numbness, tingling and other symptoms in the
hand and arm.
 Carpal tunnel syndrome is caused by a compressed
nerve in the carpal tunnel, a narrow passageway
on the palm side of your wrist.
 The anatomy of your wrist, health problems and
possibly repetitive hand motions can contribute to
carpal tunnel syndrome.

NORMAL ANATOMY
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Carpal Tunnel
Boundaries:
Flexor Retinaculum
superiorly
Carpal bones
inferiorly
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Carpal Tunnel
Contents:
Tendon of flexor
pollicis longus
4 tendons of flexor
digitorum profundas
4 tendons of flexor
digitorum superfacilis
Medial nerve
CARPAL
TUNNEL
SYNDROME:
THE MOST
COMMON FOCAL
PERIPHERAL
NEUROPATHY,
RESULT FROM THE
COMPRESSION OF
MEDIAN NERVE AT
THE WRIST
CLINICAL FEATURES
Pain
 Numbness
 Tingling
 Symptoms are usually worse at night and can
awaken patients from sleep
 To relieve the symptoms, patients often flick
their wrist as if shaking down a thermometer
(flick sign)
 Weak grip
 Weakness and atrophy of thumb muscles if
untreated

CAUSES AND CONTRIBUTING FACTORS
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Aberrant anatomy
Infections
Inflammatory conditions
Increased canal volume
Sex
Obesity
Kidney Failure
DIAGNOSIS
History
 Physical examination
 Nerve conduction
study

PHYSICAL EXAMINATION
Phalen’s maneuver
 Tinel’s sign
 weak thumb abduction.

TREATMENT
Conservative treatments
 Surgery

CONSERVATIVE TREATMENT
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Wrist splints
Exercises
Oral medications
Local injections
Ultra sound therapy
SURGERY

Should be considered in patients with symptoms
that do not respond to conservative measures and
in patients with severe nerve entrapment as
evidenced by nerve conduction studies, thenar
atrophy, or motor weakness.