Carpal Tunnel

Carpal tunnel is often misdiagnosed most people do not realize that they are affected by this nerve disorder. Here is an example of a case study of a 60 year old woman who made complaints of “tingling” around the thumb, index and middle fingers of the right hand. This symptom started randomly four months ago and was not due to any injury or change in her daily activities. She first experienced this symptom one night when intensive pain woke her up, but lately its being bothering her every night. She works as a secretary in a law firm and uses her right hand most of the time.

Upon physical examination of the right hand the bulk of the intrinsic musculature of the hand, including the thenar eminence, were normal. There was no tenderness to palpation in the hand. The neurologic examination shows that the strength of the abductor pollicis brevis muscle were normal and is rated as grade V. Two point discrimination in the distribution of the median nerve were normal. The Phalen test was positive. The Tinel sign was positive – light tapping over the median nerve at the level of the carpal tunnel causes paraesthesiae radiating into the index and middle fingers.

After her diagnosis the woman underwent a steroid injection in to her carpal canal and splinted her hand in a wrist brace to avoid wrist flexion at night. After two weeks of treatment the symptom went away and she went back to work and reduced the usage of her splint.

She returned after a year and states symptoms resumed in about 6 months when she stopped using the splint. After being advised to continue splinting during sleep there were still signs of symptoms. After electro diagnostic examinations she was advised to undergo an open carpal tunnel release because her median nerve was dysfunctional at the level of the carpal tunnel.

At the end of the surgery her transverse carpal ligament was released and all the tingling sensation went away immediately. Even though she was in some amount of pain for 6...