Carpal tunnel syndrome

doi:10.1136/bmj.39282.623553.AD

BMJ 2007;335:343-346 (18 August), doi:10.1136/bmj.39282.623553.AD

Clinical Review

Carpal tunnel syndrome

Jeremy D P Bland, consultant in clinical neurophysiology

Kent and Canterbury Hospital, Canterbury CT1 3NG

Jeremy.Bland@ekht.nhs.uk

The first 150 words of the full text of this article appear below.

Carpal tunnel syndrome is the commonest causeof nocturnal hand paraesthesias and should be suspected in anypatient with this symptom, whatever age

Initial treatment shouldbe with neutral angle splinting at night; milder cases may betreated with local steroid injection before further investigation

Refermore severe cases—those with thenar weakness, sensorydeficit, and daytime symptoms—for nerve conduction studiesand possible surgery

Either open or endoscopic surgery maybe used depending on availability of local expertise

Carpal tunnel syndrome (CTS) is the commonest peripheral nerveproblem in the United Kingdom and has considerable employmentand healthcare costs. If recognised early it is readily treatable.No established UK guidelines exist for diagnosis and management,but the American Academy of Neurology issued guidelines in 1993,which remain current as no major recent advances have occurred.¹

Carpal tunnel syndrome results from compromise of median nervefunction at the wrist caused by increased . . . [Full text of this article]

For health professionals
For patients

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Nerve studies are not that useful in diagnosis: Peter J Mahaffey
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Rapid Responses:

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Carpal Tunnel? Check the neck!: Dr A Breck McKay
bmj.com, 18 Aug 2007 [Full text]
Carpal tunnel syndrome (CTS) is a clinical syndrome: Sidha Sambandan
bmj.com, 18 Aug 2007 [Full text]
Thoracic Outlet Syndrome Should Be Ruled Out in All Cases Diagnosed as Carpal Tunnel Syndrme: Carlos A Selmonosky.MD
bmj.com, 19 Aug 2007 [Full text]
carpal tunnel syndrome is a clinical diagnosis: peter j mahaffey
bmj.com, 22 Aug 2007 [Full text]
CTS no occupational disease?: P. Paul F.M. Kuijer
bmj.com, 22 Aug 2007 [Full text]
Carpal Tunnel Syndrome in Patients on Dialytic Therapy: Chandra Mauli Jha
bmj.com, 23 Aug 2007 [Full text]
Real life management of CTS in UK General Practice: Stephen Longworth
bmj.com, 28 Aug 2007 [Full text]
Authors reply: Jeremy D P Bland
bmj.com, 28 Aug 2007 [Full text]
Carpal Tunnel Syndrome (CTS): NAZAR R DESSOUKI
bmj.com, 28 Aug 2007 [Full text]
Authors reply (2): Jeremy D P Bland
bmj.com, 30 Aug 2007 [Full text]
Re: Authors reply (1) & (2): Sidha Sambandan
bmj.com, 11 Sep 2007 [Full text]
Author's replly (3): Jeremy D P Bland
bmj.com, 13 Sep 2007 [Full text]
Real life (surgical!)management of CTS in General Practice: John P Rine
bmj.com, 14 Sep 2007 [Full text]
Compression theorem is built on sand riddled with holes.: Ibrahim,M. Khan
bmj.com, 27 Sep 2007 [Full text]