Carpal Tunnel Syndrome


Overview

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Carpal Tunnel Syndrome Icon    Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is caused by compression of the median nerve as it passes through the carpal tunnel of the hand. Symptoms include numbness, tingling or pain along the distribution of the median nerve with symptoms often more pronounced at night. This commonly encountered condition has a prevalence of 2.7% and is more common in older women.

Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosen I. Prevalence of carpal tunnel syndrome in a general population. JAMA 1999; 282(2):153-158.

Clinical Reviews

Carpal Tunnel Syndrome: Prevention



Prevention strategies for heart disease, lung disease and diabetes to name just a few are obvious and often incorporated into a physician’s practice. It is well recognized in the search for effective treatment the best intervention is usually prevention. Yet prevention strategies for more mundane, less life threatening conditions are commonly overlooked although many of these conditions can result in significant morbidity and impact on quality of life. A recent Canadian study found in workers four years after carpal tunnel surgery that 46% still had moderate to severe pain, 40% had difficulty grasping small objects and only 14% were pain free. Interestingly 36% were unable to return to their previous job, whether modifications had been made or not. A separate study found 26% of workers that had surgery had to move from heavy to lighter work. The incidence of carpal tunnel syndrome (CTS) has been estimated at 2.7% to 3.5%. In certain professions, such as factory workers, the incidence has been estimated to be as high as 11.7 %. Although better reporting, more sensitive testing or litigation rewards may be responsible, a 350% increase in the prevalence of carpal tunnel syndrome has occurred in the past 20 years.

Carpal Tunnel Syndrome: Diagnosis



The diagnosis of carpal tunnel syndrome (CTS) is not nearly as straight forward as one might think. Although long considered the “gold standard” for evaluating CTS, electrodiagnostic studies (EDS) seem to have as many critics as adherents. Based on the available studies, a high quality history and examination appears to be the most cost efficient and accurate path to a proper diagnosis, particularly when conservative treatment remains the first treatment option. Electrodiagnostic studies are of value in a properly selected subgroup of patients where surgical intervention is being considered or diagnosis is uncertain.

Carpal Tunnel Syndrome: Therapy



Carpal tunnel syndrome (CTS) is a common clinical diagnosis associated with significant morbidity. Conservative treatment options, many which demonstrate promising treatment effects, have not been adequately investigated. The following list is comprised of treatments that have been studied at least on a limited basis. If a specific treatment is not on the list, it is because no studies have been performed or located. A significant concern with several of the published articles is “multiple treatment interface”. This occurs when the investigator treats patients with more than one intervention at the same time. An example would be a test group being treated with ultrasound (US) and vitamin B6 at the same time. If improvement is noted one must ask the question “could the B6 alone or ultrasound alone lead to the improvement or was it the combination of B6 and ultrasound?” This research design makes identifying the effective treatment difficult.

Medical Subject Heading (MeSH) Information

MeSH Term: Carpal Tunnel Syndrome

Scope Note: Entrapment of the MEDIAN NERVE in the carpal tunnel, which is formed by the flexor retinaculum and the CARPAL BONES. This syndrome may be associated with repetitive occupational trauma (CUMULATIVE TRAUMA DISORDERS); wrist injuries; AMYLOID NEUROPATHIES; rheumatoid arthritis (see ARTHRITIS, RHEUMATOID); ACROMEGALY; PREGNANCY; and other conditions. Symptoms include burning pain and paresthesias involving the ventral surface of the hand and fingers which may radiate proximally. Impairment of sensation in the distribution of the median nerve and thenar muscle atrophy may occur. (Joynt, Clinical Neurology, 1995, Ch51, p45)

MeSH Synonyms:
  • Carpal Tunnel Syndrome
  • Carpal Tunnel Syndromes
  • Syndrome, Carpal Tunnel
  • Syndromes, Carpal Tunnel
  • Amyotrophy, Thenar, Of Carpal Origin
  • Median Neuropathy, Carpal Tunnel
  • Compression Neuropathy, Carpal Tunnel
  • Entrapment Neuropathy, Carpal Tunnel
Applicable MeSH Subheadings:
  • analysis
  • anatomy and histology
  • blood
  • chemically induced
  • classification
  • complications
  • congenital
  • diagnosis
  • diagnostic imaging
  • drug therapy
  • economics
  • embryology
  • enzymology
  • epidemiology
  • ethnology
  • etiology
  • genetics
  • history
  • immunology
  • metabolism
  • microbiology
  • mortality
  • nursing
  • organization and administration
  • parasitology
  • pathology
  • physiology
  • physiopathology
  • prevention and control
  • psychology
  • radiotherapy
  • rehabilitation
  • statistics and numerical data
  • surgery
  • therapy
  • veterinary
  • virology

Informative Links

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MayoClinic.com Carpal Tunnel Syndrome Information



Mayo Clinic Health Solutions' award-winning consumer Web site offers health information and self-improvement tools. MayoClinic.com's medical experts and editorial professionals bring you access to the knowledge and experience of Mayo Clinic for all your consumer health information needs, from cancer, diabetes and heart disease to nutrition, exercise and pregnancy.
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MedlinePlus: Carpal Tunnel Syndrome



MedlinePlus will direct you to information to help answer health questions. MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations.
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National Institute of Neurological Disorders and Stroke: Carpal Tunnel Syndrome Fact Sheet



The mission of the National Institute of Neurological Disorders and Stroke is to reduce the burden of neurological disease - a burden borne by every age group, by every segment of society, by people all over the world.
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Wikipedia: Carpal Tunnel Syndrome



From Wikipedia, the free encyclopedia

Current Clinical Trials Relating to  Carpal Tunnel Syndrome

ClinicalTrials.gov: Provides patients, family members, and members of the public easy and free access to information on clinical studies for a wide range of diseases and conditions.

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Mild Carpal Tunnel Syndrome


(Status: Completed)

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Botulinum Toxin for Carpal Tunnel Syndrome


(Status: Active, not recruiting)

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Injection Versus Splinting in Carpal Tunnel Syndrome


(Status: Active, not recruiting)

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Ultrasound Analysis of Human Carpal Tunnel System


(Status: Enrolling by invitation)

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Ultrasonographic Assessment of Carpal Tunnel Syndrome


(Status: Enrolling by invitation)

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Bilateral vs Unilateral CTR


(Status: Unknown status)

100 Clinical Trials Returned