Abstract
Introduction: Paresthesia (numbness, tingling, “pins and needles” sensation) and pain in the hand comprise a typical set of symptoms of carpal tunnel syndrome. Most authors consider a typical occurrence of these features within the palmar surface of digits I–IV, innervated by a compressed median nerve. Observations of patients by various authors show that some patients feel pares-thesia in all digits of the affected hand and within the forearm. The objective of this study was investigation of the distribution of paresthesia in patients diagnosed with carpal tunnel syndrome, and verification of the hypothesis that this occur-rence in areas beyond the innervation by the median nerve is an atypical manifestation of the syndrome.
Materials and methods: Questionnaires and notes filled out during baseline examination of 276 patients admitted to authors’ institution for carpal tunnel release over a period of 1 year were reviewed. The group consisted of 211 women (76%) and 65 men (24%) at a mean age of 59 years.
Results: Two hundred seventy-four patients (99%) reported feeling paresthesia within the involved extremity, and 2 did not, but complained of pain and reduced sensation. Most patients – 140 (51%) – felt paresthesia on the palmar surface of all 5 digits, including the little finger. Seventy-eight persons (28%) reported a “typical” distribution of paresthesia within digits I–IV and 31 (11%) in digits I–III. As many as 152 patients (55%) felt paresthesia in the little finger, most of them being cases with numbness and tingling present in all 5 digits. The feeling of paresthesia in the midhand, close to the involved digits was reported by 158 patients (57%).
Conclusion: We found that the distribution of symptoms in carpal tunnel syndrome does not closely match the anatomy of the median nerve and this presentation should no longer be considered atypical.