Carpal tunnel syndrome. A guide to prompt intervention

Carpal tunnel syndrome is the most common entrapment neuropathy in the United States. The diagnosis should be considered for any patient with hand or wrist pain, weakness, or numbness. Changes in sensory conduction velocities across the wrist appear to be the most sensitive electrophysiologic indicators of the condition. Treatment of mild cases involves avoiding the precipitating activity, wrist splinting, and local steroid injections; surgical decompression is often required for moderate and severe cases. Overall, prognosis relates directly to the severity of the median nerve injury at diagnosis, the clinical cause, and the mode of treatment.