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Carpal tunnel syndrome

The median nerve passes within the carpal tunnel and runs deep to the flexor retinaculum. If the tendons of the long finger flexors become swollen due to overuse (typist), or oedema (pregnancy), then the median nerve becomes compressed. This results in pain, paresthesia and numbness (tingling and pins and needles) of the lateral three and a half fingers. Tapping over the median nerve in the carpal tunnel (‘Tinel’s maneuver’) results in numbness or pain in the median nerve distribution. Flexion of the wrist for 60 seconds will also elicit pain or numbness. Symptoms include thenar muscle wasting and weakness. Treatment is with surgical compression.

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