(^264) Medical-Surgical Nursing Demystified
PROGNOSIS
Some patients respond to conservative treatments including nonsteroidal anti-
inflammatory medications and rest of the affected area. A wrist brace may help to
keep the wrist in a neutral position during this time. If this conservative treat-
ment fails, the patient may need surgery to decompress the carpal tunnel area to
relieve pressure on the nerve as it passes through the wrist into the hand. Long-
term presence of carpal tunnel syndrome can lead to atrophy of muscles in the
palm of the hand. Hand grip strength may be affected. After treatment, carpal tun-
nel syndrome may recur in the future.
HALLMARK SIGNS AND SYMPTOMS
- Tingling, numbness, or burning sensation (paresthesia) in the hand due to
nerve compression - Weakness in the hand due to nerve compression and, eventually, muscle
wasting - Pain in the hand due to nerve compression
- Tapping over the carpal tunnel area will cause tingling, numbness, or pain
through the palm and affected fingers (Tinnel’s sign) - Pain, tingling, and burning sensation in the wrist and hand as a result of the
blood pressure cuff being inflated on the upper arm to the level of the patient’s
systolic blood pressure
INTERPRETING TEST RESULTS
- Electromyography (EMG) or nerve conduction studies will show nerve dys-
function. - Magnetic resonance imaging (MRI) will show swelling of the median nerve
within the carpal tunnel.
TREATMENT
- Splint the wrist for 2 weeks to keep the wrist in a neutral position or slightly
extended and decrease compression on the carpal tunnel area. - Administer NSAID (nonsteroidal anti-inflammatory drugs) to decrease
inflammation: