Associated transient tenosynovitis of the digital flexor tendons is a common finding. Night symptoms are common. Evaluation includes assessment of static two-point discrimination and motor strength and provocative measures such as Phalen's maneuver and testing for Tinel's sign. Swelling in the region of the distal forearm may also be noted. Unless the symptoms are longstanding, motor weakness and atrophy of the thenar musculature are not seen.
Treatment involves avoiding climbing, and splinting the patient's wrist in a neutral position.
Anti-inflammatory medication may be used in patients who have associated tenosynovitis. Injection of the carpal tunnel should be reserved for those patients who have complied with rest and splinting but continue to have symptoms for longer than 3 months. The majority of climbers respond to this conservative treatment approach, and surgery is rarely indicated. Prevention Pointers Physicians can give patients pointers on ways to prevent injuries with skin protection, exercise, and taping. Thin rubber pads or sleeves applied to the finger or tape wrapped around the finger will help prevent skin and fingertip injuries.