The Anatomy, Symptoms, and Signs of Carpal Tunnel Syndrome

1997 ◽  
Vol 8 (3) ◽  
pp. 439-457 ◽  
Author(s):  
William J. Hennessey ◽  
Kurt A. Kuhlman
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Tunnel Syndrome ◽  
Symptoms And Signs

Correspondence between clinical presentation and electrophysiological testing for potential carpal tunnel syndrome

2012 ◽  
Vol 38 (5) ◽  
pp. 489-495 ◽  
Author(s):  
H. S. Makanji ◽  
M. Zhao ◽  
C. S. Mudgal ◽  
J. B. Jupiter ◽  
D. Ring
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Presentation ◽  
Pain Catastrophizing ◽  
Future Studies ◽  
Secondary Purpose ◽  
Electrophysiological Testing ◽  
Tunnel Syndrome ◽  
Nerve Dysfunction ◽  
Symptoms And Signs

The diagnosis of carpal tunnel syndrome (CTS) is often applied in the absence of objectively verifiable pathophysiology (i.e. electrophysiologically normal carpal tunnel syndrome). The primary purpose of this study was to determine whether depressive symptoms, heightened illness concern, and pain catastrophizing are associated with an absence of electrophysiological abnormalities. The secondary purpose was to examine the correspondence between the Levine scale, the CTS-6, and electrophysiological abnormalities. Ninety-eight participants completed validated questionnaires assessing psychosocial factors at the initial visit, and surgeons recorded clinical data and their confidence that the diagnosis was carpal tunnel syndrome. Symptoms and signs that are characteristic of carpal tunnel syndrome (e.g. the CTS-6 and Levine scale) significantly, but incompletely coincided with electrophysiological testing. Psychological factors did not help distinguish patients with normal and abnormal objective testing and it remains unclear if symptoms that do not coincide with abnormal tests represent very mild, immeasurable median nerve dysfunction or a different illness altogether. Future studies should address whether outcomes are superior and resource utilization is optimized when surgery is offered based on symptoms and signs (e.g. the CTS-6) or when surgery is offered on the basis of measurable pathophysiology.

Wrist Kinematics and Ultrasound Measures of the Median Nerve During Computer Keyboarding

2011 ◽  
Author(s):  
Kevin K. Toosi ◽  
Michael L. Boninger
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Health Concern ◽  
Mechanical Compression ◽  
Occupational Risk Factors ◽  
Daily Task ◽  
Tunnel Syndrome ◽  
Acute Changes ◽  
Symptoms And Signs

Carpal tunnel syndrome (CTS) is a common, costly problem in the general population and particularly in manual workers [1–3], with as many as 3 million individuals experiencing its symptoms and signs, including pain, tingling, numbness, fatigue and weakness in the hands and fingers [4]. Treatment of CTS is estimated to cost over one billion dollars a year [5]. The most prevalent theory for the pathogenesis of CTS is compression of median nerve in the carpal tunnel [6]. Although this theory is widely accepted, the cause of the compression in the carpal tunnel is not fully understood. Epidemiological research has identified several occupational risk factors associated with the development of CTS in general industry including: force, repetition, awkward/static postures, localized mechanical compression, and vibration [7]. Several studies have found greater prevalence of carpal tunnel syndrome in workers with highly repetitive manual jobs [8]. Keyboarding is a highly repetitive daily task, and its association with musculoskeletal disorders of the upper extremity has been a public health concern since the 1980s [1]. However, there are controversial results regarding the association between computer keyboarding and CTS which indicate that we have an insufficient understanding of an association between keyboarding and upper limb neuropathy. Using ultrasonographic techniques, our laboratory was able to explore acute changes in the median nerve following a one-hour keyboarding task [9].

scholarly journals Evaluation of Local Corticosteroids Injection in Treatment of Carpal Tunnel Syndrome

2021 ◽  
pp. 21-27
Author(s):  
Mostafa Fersan Sallam ◽  
Nabil Omar Gharbo ◽  
Muhammed Abd Elmoneam Quolquela ◽  
Mohammed Osama Ramadan
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Steroid Injection ◽  
Dominant Hand ◽  
University Hospitals ◽  
Significant Clinical Improvement ◽  
Tunnel Syndrome ◽  
Local Steroid Injection ◽  
A Prospective Study ◽  
Symptoms And Signs

Background: Carpal tunnel syndrome is the most common type of peripheral nerve entrapment; it affects females more than males; it may be idiopathic or secondary to other disorders especially diabetes mellitus. Carpal tunnel syndrome mostly affects manual workers and may be bilateral or unilateral and mainly affects the dominant hand. Carpal tunnel syndrome has characteristic symptoms and signs including paresthesia and pain along median nerve distribution, these symptoms are usually accompanied by positive provocative tests. Electrodiagnostic studies remain the cornerstone in the diagnosis of CTS. Carpal tunnel syndrome can be treated conservatively by activities of daily living instructions, splints, medical treatments as neurotropic drugs and NSAIDs and local steroid injection. Also, it can be treated by surgical decompression in severe cases. Aims: The aim of this study was to evaluate local steroid injection in the treatment of CTS. Twenty-one patients with mild and moderate CTS were included in this study. Patients and Methods: This was a prospective study included 21 patients with symptoms and signs of mild to moderate CTS attending the outpatient clinic of orthopedic Department, Tanta University Hospitals in the period between February 2019- January 2020. 1 ml Triamcinolone was used with 2 ml lidocaine. Patient’ hand was rested on towel roll flexed about 30 to 45 degrees and injection was done according to landmarks. Night splint was described for 3 days after injection. Results: In regards to clinical assessment; there was a significant clinical improvement after injection and follow-up period as compared to before injection. In regards to electrophysiological assessment; there was a significant improvement in NCS after injection. Conclusion: Local steroid injection is an effective treatment and recommended as a therapeutic tool in the management of idiopathic mild to moderate CTS.

Carpal Tunnel Syndrome in Black South Africans

1990 ◽  
Vol 15 (1) ◽  
pp. 96-99
Author(s):  
I. E. GOGA
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Rare Case ◽  
Population Group ◽  
Tumoral Calcinosis ◽  
South Africans ◽  
Black South Africans ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
Symptoms And Signs

The incidence and the aetiology of chronic carpal tunnel syndrome in black South Africans was evaluated. This study showed that the incidence of idiopathic carpal tunnel syndrome was very low in this population group and that most patients who presented with symptoms and signs of chronic carpal tunnel syndrome had a specific pathology. A rare case of tumoral calcinosis causing carpal tunnel syndrome is presented. A case of perineural lipofibroma causing carpal tunnel syndrome is also described.

scholarly journals Exploring the Effectiveness of External Use of Bach Flower Remedies on Carpal Tunnel Syndrome

2016 ◽  
Vol 22 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Saira R. Rivas-Suárez ◽  
Jaime Águila-Vázquez ◽  
Bárbara Suárez-Rodríguez ◽  
Lázaro Vázquez-León ◽  
Margarita Casanova-Giral ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Effect Sizes ◽  
Controlled Clinical Trial ◽  
Clinical Exam ◽  
Self Reports ◽  
Tunnel Syndrome ◽  
Symptoms And Signs ◽  
Surgical Option

Background. A randomized, pilot, placebo-controlled clinical trial was conducted with the aim of evaluating the effectiveness of a cream based on Bach flower remedies (BFR) on symptoms and signs of carpal tunnel syndrome. Methods. Forty-three patients with mild to moderate carpal tunnel syndrome during their “waiting” time for surgical option were randomized into 3 parallel groups: Placebo (n = 14), blinded BFR (n = 16), and nonblinded BFR (n = 13). These groups were treated during 21 days with topical placebo or a cream based on BFR. Results. Significant improvements were observed on self-reported symptom severity and pain intensity favorable to BFR groups with large effect sizes (η2partial > 0.40). In addition, all signs observed during the clinical exam showed significant improvements among the groups as well as symptoms of pain, night pain, and tingling, also with large effect sizes (φ > 0.5). Finally, there were significant differences between the blinded and nonblinded BFR groups for signs and pain registered in clinical exam but not in self-reports. Conclusion. The proposed BFR cream could be an effective intervention in the management of mild and moderate carpal tunnel syndrome, reducing the severity symptoms and providing pain relief.

Weakness in the Hand of a Woman During Pregnancy

2017 ◽  
Author(s):  
Janet Waters
Keyword(s):  
Carpal Tunnel Syndrome ◽  
General Population ◽  
Pregnant Women ◽  
Carpal Tunnel ◽  
The United States ◽  
Physiological Changes ◽  
Steroid Injections ◽  
Tunnel Syndrome ◽  
Symptoms And Signs ◽  
In Pregnancy

Carpal tunnel syndrome is the most common neuropathy experienced by pregnant women. It has an incidence of 3.4% in the general population in the United States. It occurs more frequently in pregnant women than in the general population, with an incidence of 17%. It is the most common mononeuropathy in pregnant women. This chapter covers the symptoms and signs that allow a clinician to make the diagnosis of carpal tunnel syndrome. Neuroanatomy and physiological changes that predispose pregnant women to this disorder are described. Management and prognosis of carpal tunnel syndrome in pregnancy are discussed: conservative management with wrist splints worn at night is effective in over 80% of patients. Local steroid injections can provide relief in patients with severe symptoms.

scholarly journals Combined Sensory Index Test versus Diagnostic Ultrasonography in Early Detection of Carpal Tunnel Syndrome

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M M M A Mustafa ◽  
N Nassar ◽  
I Amen ◽  
H Abdelmohsen
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Early Detection ◽  
Carpal Tunnel ◽  
Control Group ◽  
Index Test ◽  
Control Groups ◽  
Tunnel Syndrome ◽  
Diagnostic Ultrasonography ◽  
And Control ◽  
Symptoms And Signs

Abstract Objectives to evaluate combined sensory index test (CSI) versus diagnostic ultrasonography in early detection of carpal tunnel syndrome. Patients and Methods case control cross sectional study was performed on twenty patients with symptoms and signs suggestive of carpal tunnel syndrome with duration 1 to 4 months and twenty apparently healthy volunteers included as a control group. All patients and controls were assessed and underwent ultrasound of the wrist and electrophysiological testing. Data from patients and control groups were compared to determine the diagnostic relations in patients with CTS. Results This study include 20 Patient with ages ranged from 25 to 45 with mean±SD (36.8±6.1) years with symptoms and signs suggestive of carpal tunnel syndrome with duration 1 to 4 months. The control group ages ranged from 25 to 45 with mean±SD (57.63±6.41) years. Our results revealed that CSI ranged from (0.7-1.9ms) with mean ± SD (1.36± 0.366) in CTS group and ranged from (0.2-0.8ms) with mean ±SD (0.59± 0.187) in control group (P < 0.001), cutoff point was > 0.8ms with sensitivity 85%, specificity 100% and accuracy 97.5%. Our diagnostic ultrasound results revealed that Inlet Outlet Ratio of CSA of median nerve ranged from (1-1.6) with mean ± SD (1.26 ± 0.226) in CTS group and from (0.7-1.1) with mean ± SD (0.92 ± 0.134) in control group (P < 0.001) with sensitivity was 80%, specificity 70% and accuracy 85%. By combination of both electrodiagnostic test (CSI) and diagnostic ultrasound (IOR) in early detection of CTS, our results revealed highly statistically significant difference between patient and control groups (P < 0.001) with sensitivity 100%, specificity 70%, and accuracy 85%. Conclusion Combined sensory index (CSI) is indicated in suspected cases of CTS with positive symptoms and negative signs. US is not an alternative diagnostic tool to electrodiagnostic tests but they are complementary.

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