Impairment both motor or sensor function of median nerves then traverses through carpal tunnel called Carpal Tunnel Syndrome (CTS).
The syndrome itself characterized by tingling sensation, pain, and weakness in the median nerve distribution of the hand.

Based on the America Academy of Orthopaedic Surgeons, determine precise sign of Carpal Tunnel Syndrome should be take in clinical examination. This is to prevent misdiagnosed.
Some diagnostic test can be used as following;
- Phalen’s manouver test (for 2 minutes, the patient maintain full wrist and finger extension.)
- Tourniquet compression, a non invasive method in nerve grafs that enhance nerver regeneration
- Direct compression.
- Electromyography (EMG), a technique of electromyograph instrument that will evaluate and record electrical activity produced by skeletal muscles.
- MRI (not wide available and many contra indication such as older aneurysm clips, cardiac pacemakers, ferromagnetic ocular fragments, new stents or aortic valves)
- Plain radiotheraph (doesn’t reveal ligamentous or soft tissue abnormalities)
- Helical CT (doesn’t reveal ligamentous abnormalities to any degress)
- Ultrasonography (depending of skillness and interpretation from equipment operator of carpal tunnel)

From above diagnosing procedures, EMG given tight accuracy between 85%-90% to detect CTS compare with phalen test that have wide range of sensitivity around 33%-88%.
All these procedure used to detect signs of median nerve entrapment.

However the symptoms of Carpal Tunnel Syndrome as following;
- numbness
- a burning and tingling sensation (paresthesia)
- wasting of thenar muscles (for chronic disease)
- weakness of palmer abduction (difficulty bringing the thumb away from the hand for chronic disease)

Causes of Carpal Tunnel Syndrome as following;
- A disease from decreasing activity of thyroid gland (Myxoedema)
- A swelling caused by excess fluid trapped in the tissues (Edema)
- Diabetes mellitus
- Idiopathic
- A disease marked by enlargement of the bones of the extremities, face, and jaw that caused by overactivity the pituitary gland (Acromegaly)
- An abnormal growth of tissue or tumor (Neoplasm)
- Trauma
- Rheumatoid Arthritis
- Abnormal amyloid proteins that deposited in tissues and/or organs (Amyloidosis)
- Pregnancy

Treatment of Carpal Tunnel Syndrome with surgery should be taken as last options and prescription antibiotics often used as pre-operative before surgery.
Mean while some treatments can be used as following;
- local steroid injection (for mild symptoms of CTS)
- oral steroids
- ultrasound
- carpal tunnel release
- heat therapy
- surgery (for mild and acute)
- other treatments, such as drugs categorized NSAID, natural supplements, vitamins (B complex), workstation redesign, ergonomic tool modification, acupuncture, and yoga.

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