Care and Mobility Considerations

The median nerve is responsible for sensation in most of the palm of the hand, apart from the area under the little finger, and for certain thumb movements – i.e. lifting the thumb vertically away from the palm, (abduction), and moving the thumb across the palm of the hand towards the little finger (opposition).

Loss of function of the median nerve due to carpal tunnel syndrome will give rise to varying degrees of impairment of manual dexterity, particularly activities involving pinch or key grip.

Many individuals with carpal tunnel syndrome will experience mild and intermittent symptoms in the early stages of the condition. The dominant hand is usually affected first, tends to develop the worst symptoms and may be the only hand affected. However, Carpal Tunnel Syndrome can affect both hands. Even though the worst symptoms are normally experienced in the dominant hand, the degree of functional impairment would normally be minimal in the majority of cases. Specifically such individuals would normally be able to dress and undress unaided, and be able to manipulate small objects, such as buttons and zips, although there is a tendency to drop items. Aspects of main meal preparation including peeling and chopping vegetables and lifting pans are unlikely to be significantly impaired.

There would normally be no significant restriction of self-care activities.

A minority of cases will have disability. This tends to occur where the condition is longstanding and treatment has not been sought. In such cases severe muscle wasting at the base of the thumb occurs together with marked loss of sensation of most of the palm of the hand. This causes considerable difficulties with manual dexterity.