Data gathering
- Red flags – wasting of hand muscles, leg weakness
- Others – diabetes, thyroid, occupation
- Examine – muscle wasting, thumb abduction, Phalen’s, Tinel’s
Clinical management
- Investigations
- Bloods – FBC, U+E, TFTs, HbA1c
- Explanation
- due to pressure on a nerve in the wrist – this nerve supplies sensation to the thumb, first and middle finger and some thumb movements
- Treatment
- Lifestyle – weight loss, avoid over use
- Wrist splint
- Medications – analgesia
- Analgesia
- Follow-up / Safety net
- Refer – steroid injection, surgery
NB: refer if thenar wasting, may be myelopathy