It is the commonest mononeuropathy.
Classical presentation is pain in hand and arm with paraesthesia in thumb, index and middle fingers. The pain is often worse at night and is relieved by dangling the hand out of bed and shaking it.
'Bedside tests' include:
- Phalen's test = maximal wrist flexion ('praying') for 1 minute recreates symptoms
- Tinel's test = tapping over nerve at wrist recreates symptoms
Associations with carpal tunnel syndrome include:
Management may be conservative, spliting, steroid injections or surgery.
Now on to some diabetic neuropathy...