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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Clinical features of carpal tunnel syndrome include:

  • numbness or paraesthesia in the hand
    • usually, but not always, of the thumb, index, middle, and radial half of the ring finger
  • pain in hand, wrist may extend proximally to forearm or to the shoulder region
  • symptoms are worst at night which may be relieved by
    • hanging the arm over the side of the bed, or by shaking the arm
    • flicking the wrist - known as the flick sign
  • decreased grip strength
  • motor wasting and weakness lead to thenar wasting and weakened abduction of the thumb – seen in severe, chronic carpal tunnel syndrome,
  • clumsiness or reduced manual dexterity e.g. – difficulty in carrying out fine tasks such as doing up buttons or become clumsy and drop items
  • trophic ulcers at the tips of thumb, index finger, or middle finger
  • positive Tinel's test
  • positive Phalen's test
  • electrical studies may show a slowing of nerve conduction across the wrist

Note:

  • sometimes symptoms may occur in all fingers (but not in dorsum or palm of the hand)
  • permanent sensory changes and motor signs and symptoms are considered as late manifestations of CTS

Reference:

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