1. Carpal Tunnel Syndrome

2. Definition: It's a compresion of median nerve in the carpal tunnel is called carpal tunnel syndrome

3. anatomy The median nerve travels from the forearm into your hand through a “tunnel” in your wrist.

4. Epidemiology : Most often 30 -60 years old Five times more common in women Older, overweight, and physically inactive people

5. Etiology 1-primery or Idiopathic 2- secondary A: Local etiology I: Anatomical malformation II: Tumors III: Infections IV: Bone prominence B: Systemic etiology obesity, diabetes mellitus, thyroi dysfunction, R.A C:Computer users !!

6. 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).

8. Clinical Features Pain and paresthesias may radiate to the forearm, elbow, and shoulder. Decreased grip strength may result in loss of dexterity, and thenar muscle atrophy may develop if the syndrome is severe.

9. Atrophy

10. Physical examination Phalen’s maneuver Tinel’s sign weak thumb abduction. two-point discrimination

11. Phalen’s maneuver

12. Tinel’s sign

13. Diagnostic History Physical examination Nerve Conduction Study

14. Treatment CONSERVATIVE TREATMENTS – GENERAL MEASURES – WRIST SPLINTS – ORAL MEDICATIONS – LOCAL INJECTION – Predicting the Outcome of Conservative Treatment SURGERY

16. WRIST SPLINTS

18. LOCAL INJECTION

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