MSK: Carpal Tunnel Syndrome: Free MSRA Podcast

✋Deep Dive: CarpalTunnel Syndrome — Pins, Needles & PressureEverfelt that annoying tingling or aching in your fingers, especially at night? 💤 Welcome to CarpalTunnel Syndrome (CTS) — one of themost common nerve entrapment conditions in general practice and a high-yieldMSRA favourite.In this revisionepisode, we give you a clear, concise, and exam-focused overview of CTS —pulling everything you need to know from trusted notes. 🎯What Is Carpal TunnelSyndrome?• CTS = compressionof the median nerve at the wrist• Occurs within the carpal tunnel (formed by carpal bones +transverse carpal ligament)• Leads to pain, numbness, tingling,and hand weakness• Most affects thumb, index, middle fingers 🧠Causes & RiskFactors• Repetitive wristuse (typing, tools)• Pregnancy, menopause → fluid retention• Conditions: Diabetes, RA, hypothyroidism• Obesity• More common inwomen, middle-aged adults• Familyhistory/genetic predisposition📌Mnemonic: “PRESS”PregnancyRheumatoid/RAEndocrine (diabetes, hypothyroid)Strain (repetitive use)Structural narrowing (trauma) 🩺Clinical Features• Tingling,numbness, burning in median nerve distribution•Worse at night – often wakes patient (🧠 “Night Shakes”)• May radiate toforearm• Dropping objects,weak grip• Late: Thenar muscle wasting 🧪Diagnosis• Clinical exam: - Tinel’s sign = tap wrist → tingling - Phalen’s sign = wrist flexion/reverse prayer →symptoms• Nerve conduction studies (NCS) – slowed signal• EMG – tests muscle activity• Ultrasound/MRI – assess for thickened ligament,ganglion, mass📌Tinel’s tap.Phalen’s prayer. 🧬DifferentialDiagnosis• Cervical radiculopathy (C6/C7)• Pronator syndrome (forearm pain, less nightwaking)• Anterior interosseous syndrome (motor only –can't pinch)• Thoracic outlet syndrome• Peripheral neuropathy• Tendonitis, tenniselbow, fibrositis📌Mnemonic: “CAP TAP”Cervical radiculopathyAnterior interosseousPronator syndromeThoracic outletArthritisPeripheral neuropathy 📊Epidemiology• Affects 5–10% of UK adults• More common in women• Peak age: 40–60• Can occur inyounger patients with risk factors 💊Management🔹Conservative• Night wrist splints – 🧠“Splint at night,all right”• Activitymodification• NSAIDs for pain• Steroid injection – both diagnostic &therapeutic - ~70% benefit at 1month🔹Surgical• Carpal tunnel release – cuts transverseligament• Done open orendoscopic• Return to work:~12–19 days• 🧠 “Glide to avoid the ride” = nerve gliding to delay surgery🔹Other therapies• Physiotherapy (nerve gliding, strengthening)• Therapeutic ultrasound• Acupuncture (limited evidence) 📉Prognosis &Complications👍 Good prognosis if diagnosed early⚠️ Risks if untreated:• Thenar atrophy• Weak grip, poordexterity• Permanent nerve damage• Chronic painEarly interventionis critical to avoid irreversiblecomplications. 📚Useful MSRA Resources📝 Revision Notes:https://www.passthemsra.com/topic/carpal-tunnel-syndrome-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/carpal-tunnel-syndrome-flashcards/❓ Accordion Q&A Notes:https://www.passthemsra.com/topic/carpal-tunnel-syndrome-accordion-qa-notes/⚡ Rapid Fire Quiz:https://www.passthemsra.com/topic/carpal-tunnel-syndrome-rapid-quiz/🧪 Practice Quiz Page:https://www.passthemsra.com/quizzes/carpal-tunnel-syndrome/ 🌐More Free MSRA Help• https://www.passthemsra.com– structured revision + mock exams• https://www.freemsra.com– free summaries, & guides #MSRA#CarpalTunnelSyndrome #MSRARevisionNotes #MedianNerve #MSRAFlashcards #MSRAQuiz#MSRAQandANotes #PassTheMSRA #FreeMSRA #NerveEntrapment #MSKMSRA #NightShakes#GlideToAvoidTheRide