Carpal Tunnel Syndrome Summary

HPI: Ms. Smith presents to the office with bilateral shoulder stiffness and lateral elbow pain in right arm. The patient has been suffering shoulder stiffness for over 2 years. The symptom developed gradually after she started using her computer more at her work place; she had to hold her telephone between her shoulder and head while typing information on computer. The pain in right elbow stated about 8 months ago with gradual onset. The patient does not recall any trauma to the shoulder and elbow. She has been diagnosed as tennis

Patient is a 57-year-old male fuel tank driver who sustained cumulative trauma on 2/7/2004 due to repetitive movement caused by delivering fuel. As per QME dated 1/25/14, the patient has numbness in the fingers and the patient is diagnoses that he has carpal tunnel syndrome. The left wrist had undergone carpal tunnel surgery; however, he gets numbness from the wrist up into his forearm and numbness in the fingertips. It was also noted that on 12/5/13, the patient complains of shoulder pain bilaterally at 7/10. It is constant and goes into noth arms, along with weakness with numbness in the hands, decreased ability to perform activities of daily living, and impared grip. The pain in the bilateral shoulders is constant and aching with intermittent

DOI: 6/12/2014. Patient is a 59-year-old right-handed male machine operator who sustained work-related injuries to his right arm, shoulder and neck when his right hand got caught in a mixer. As per office notes dated 9/6/16, the patient returns complains of continued neck pain with burning hot pain extending into the forearm down to the hand along the C6 and C7 distribution with numbness and tingling in the hand. The patient has undergone multiple medications, physical therapy, TEN both in physical therapy and home use. It was also noted that the pateint denies having cognitive behavioral therapy. The provider notes, that it would be appropriate as based on the history including postoperative right forearm fracture repair and forearm open reduction and internal fixation of the right distal radius that an additional surgery to the right arm and continue physical therapy, yet continues to have swelling

Based on the progress report dated 10/07/16, the patient presents for evaluation of carpal tunnel syndrome on the right shoulder.

Based on the medical report dated 12/22/16, the patient was last seen on 10/13/16, and was recommended to have continued therapy. He has not had therapy secondary to insurance issues over the last month or so. He presents with ongoing right elbow pain status post cubital tunnel release and medial epicondylitis debridement, worsening with motion and activity, lifting, reaching, bending, upper extremity dressing, household

DOI: 3/19/2015. Patient is a 63-year-old right hand dominant male janitor who sustained injury while he was mopping when he began having right shoulder pain. Per OMNI, he was initially diagnosed with right shoulder impingement syndrome, neck strain and right shoulder strain.

On Primary Treating Physician’s Progress Report (PR-2) dated 08/11/2017, the patient presented with unchanged symptoms. His left-hand pain was rated at 8/10. and was described as constant and sharp. The pain was aggravated with certain movements and gripping. The

Carpal tunnel syndrome is a common condition that affects the hand and wrist. It happens when too much pressure is put on the median nerve. The median nerve runs through a structure at the wrist called the carpal tunnel, which is where the syndrome gets its name. Sometimes the carpal tunnel (which is made up of the carpal bones and the transverse ligament) will narrow, due to swelling, and that is how the median nerve gets squeezed. This condition is usually progressive (it will continue to get worse over time) and the symptoms involve numbness and pain in the wrist and hand. Sometimes the pain will also spread up into the arm (Sartore).

Moreover, Tinel’s sign is positive bilaterally and Jamar grip strength is measured to be 10/10/10 bilaterally. Diagnoses include continuous trauma; cervical strain with radicular complaints; bilateral shoulder rotator cuff tendinitis with rotator cuff tear, status post left shoulder arthroscopy with rotator cuff repair; and bilateral wrist strain with carpal tunnel syndrome and degenerative arthritis of the index/long distal interphalangeal joint, triggering of the bilateral

DE Quervain’s Tenosynovitis. The rationale for choosing this condition as a differential diagnosis as the other is likely is based on the decreased sensation and the inability to grasp objects tightly. Evidence: De quervain’s tenosynovitis disease, also called gamer's thumb or mother's thumb, is a common pathological condition of the wrist. Even though the exact etiology is unknown, the cause of de quervain's disease is thought to be due to thickening of the synovial sheath containing the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) tendons. This disease can cause irritation of the muscles, pain and swelling over the radial side of the wrist in patients along with an increased difficulty in gripping objects. Signs and symptoms of de quervain’s tenosynovitis include mild pain, limited ROM, swelling, and decreased sensation and locking with thumb motion (Patel, Tadisina, & Gonzalez,

Carpal tunnel syndrome is a common condition treated by orthopedists. The carpal tunnel is a narrow structure inside of your wrist which houses flexor tendons and the median nerve, both of which are protected by a type of tissue called synovium. When the synovium swells, pressure is put on the nerve, resulting in numbness in the palm side of the thumb and long fingers. Many factors can cause the synovium to swell and crowd the median nerve including heredity, hormonal fluctuations, hand usage, age, and medical conditions such as rheumatoid arthritis and diabetes. There are several symptoms that indicate carpal tunnel syndrome. These are often experienced when holding a steering wheel while driving or at

Doctors with collect data pertaining to a patient’s medical history and also perform a physical examination. The examination will include the upper extremities and the discomfort level of the patient while completing everyday activities. The physician will examine the arm carefully looking for swelling, discoloration, or warmth. Every finger will be evaluated for sensation and the muscles surrounding the arm will be tested for strength. X-Rays will be used to also test for underlying disease’s such as arthritis and fractures which will ensure the diagnosis of CTS. The Tinel Test is a test performed to test the median nerve in the wrist. The exam will consist of applying pressure to the nerve and if tingling is felt by the patient he or she is positive for

On 01/03/2018, the claimant presented for a follow-up for the right wrist. She complained of pain and weakness in her right wrist/hand. The associated symptoms include joint pain, joint stiffness, weakness, pain, and decreased strength. Objective findings showed healed pin sites. There was less swelling, deformity, tenderness, and limited range of motion. She had a full range of motion in the fingers with popping in the wrist. She lacked full supination and pronation. Physical therapy was

\DOI: 3/11/2016. Patient is a 52-year old male supervisor who sustained a work related injury to his right elbow and tore his muscle when he tries to grab a falling 'A' frame. As per medical report dated 5/3/16, patient suffered biceps tendon tear. It was noted that the patient had surgery performed on 3/25 and he is in the process of going through physical therapy. He continues to have limitations in range of motion of the elbow. He also has developed fluid and edema over the right elbow into the olecranon bursa. He has an extension lag of about 15 degrees. He can flex his elbow, but not fully. There is about 5-6 inches between his fingertips and his shoulder. He also cannot perform full supination and pronation. It is in the moderate range at this time.

As per medical report dated 5/17/16, the patient is right handed male and presents for evaluation of the right elbow. The patient has been treated with a strap, PT, and NSAIDs. The symptoms have not improved. He presents for ongoing management. Current the patient complains of pain