Recognize the manifestations of carpal tunnel syndrome.

Explanation:

Pain, tingling and numbness in the median nerve distribution (lateral 3 and a half fingers) but may go up as high as the shoulder.

Worst after sleep because of abnormal positioning as one sleeps. Tinel's(tingling on tapping over course of median nerve at the wrist) and Phalen's(tingling on keeping the wrist hyper-flexed for a minute or two) signs may be elicited.

Diagnosis is clinical but Nerve Conduction Study confirms the diagnosis.

First line therapy is wrist splints during sleep.

If not effective then try hydrocortisone injection under carpal tunnel

If Motor signs are present at any time- confirm diagnosis and operate for release of carpal tunnel.(minor surgery).