• Common compressive neuropathy

• Risk factors

  • female sex

  • obesity

  • pregnancy

  • hypothyroidism

  • rheumatoid arthritis

  • advanced age

  • chronic renal failure

  • smoking

  • alcoholism

  • repetitive motion activities

  • Diabetes

Symptoms   

• numbness and tingling in radial 3-1/2 digits

• clumsiness

• pain and paresthesias that awaken patient at night

Physical exam:

• thenar atrophy

• Phalen , Durkhan, Tinnel tests

Exams

• imaging : no need

• EMG essential

Treatment

• NSAIDS, night splints, activity modifications

• Corticosteroids injection ( effect may be temporary)

• carpal tunnel release ( open or arthroscopy)