A handy review of carpal tunnel syndrome: From anatomy to diagnosis and treatment (original) (raw)
Related papers
Carpal tunnel syndrome: a review of the recent literature
The open orthopaedics journal, 2012
Carpal Tunnel Syndrome (CTS) remains a puzzling and disabling condition present in 3.8% of the general population. CTS is the most well-known and frequent form of median nerve entrapment, and accounts for 90% of all entrapment neuropathies. This review aims to provide an overview of this common condition, with an emphasis on the pathophysiology involved in CTS. The clinical presentation and risk factors associated with CTS are discussed in this paper. Also, the various methods of diagnosis are explored; including nerve conduction studies, ultrasound, and magnetic resonance imaging.
Carpal tunnel syndrome - anatomical and clinical correlations
Folia medica Cracoviensia, 2013
Carpal tunnel syndrome (CTS) is the most common and widely known of the entrapment neuropathies in which the body's peripheral nerves are compressed. Common symptoms of CTS involve the hand and result from compression of the median nerve within the carpal tunnel. In general, CTS develops when the tissues around the median nerve irritate or compress on the nerve along its course through the carpal tunnel, however often it is very difficult to determine cause of CTS. Proper treatment (conservative or surgical) usually can relieve the symptoms and restore normal use of the wrist and hand.
In carpal tunnel syndrome (CTS), the median nerve is compressed at the level of the carpal tunnel in the wrist. This entrapment manifests as unpleasant symptoms, such as burning, tingling, or numbness in the palm that extends to the fingers. As the disease progresses, afflicted individuals also report decreased grip strength accompanied by hand weakness and restricted movement. The first half of this review elaborates on CTS pathology by providing readers with a comprehensive understanding of the etiology, relevant anatomy, and disease mechanism. CTS is considered the most common entrapment neuropathy, affecting around 3-6% of the adult population. Further, CTS prevalence has seen a dramatic increase in the last few decades paralleling the growth of everyday technology usage. Despite how common it is to have CTS, it can be quite challenging for physicians to make a definite diagnosis due to differentials that present with overlapping symptoms. Even more difficult can be deciding on a course of treatment that is the most effective and considerate of patient needs. Thus arises the need for clear clinical direction, and hence we end with a discussion around such guidelines that serve as a starting point toward effective diagnoses and patient treatment.
Carpal Tunnel Syndrome (Diagnosis and Management)
JPHV (Journal of Pain, Vertigo and Headache), 2021
Carpal Tunnel Syndrome (CTS) is a neuropathy disease that affects the median nerve with an incidence of around 90%. Carpal Tunnel Syndrome appears in 3.8% of the general population, with the highest prevalence occurring in women. There are several risk factors associated with CTS, namely medical and non-medical factors. The mechanism of carpal tunnel syndrome until now is still very complex and is not known with certainty, but compression and traction factors in the median nerve are thought to be the most common cause of CTS. Carpal Tunnel Syndrome can manifest clinically with subjective signs such as paresthesia, proprioceptive changes, and paresis, as well as objective signs, such as changes in motor sensitivity and function, positive Tinel and Phallen tests, and thenar muscle atrophy. The diagnosis of Carpal Tunnel Syndrome is based on the classic symptoms of pain, numbness, tingling, and/or burning sensation in the distribution of the median nerve in the hand, as well as the abn...
Carpal Tunnel Syndrome: A Review of Literature
Cureus, 2020
Carpal tunnel syndrome (CTS) is a common medical condition that remains one of the most frequently reported forms of median nerve compression. CTS occurs when the median nerve is squeezed or compressed as it travels through the wrist. The syndrome is characterized by pain in the hand, numbness, and tingling in the distribution of the median nerve. Risk factors for CTS include obesity, monotonous wrist activity, pregnancy, genetic heredity, and rheumatoid inflammation. The diagnosis of CTS is conducted through medical assessments and electrophysiological testing, although idiopathic CTS is the most typical method of diagnosis for patients suffering from these symptoms. The pathophysiology of CTS involves a combination of mechanical trauma, increased pressure, and ischemic damage to the median nerve within the carpal tunnel. The diagnosis of CTS patients requires the respective medical professional to develop a case history associated with the characteristic signs of CTS. In addition, the doctor may question whether the patients use vibratory objects for their tasks, the parts of the arm where the sensations are felt, or if the patient may already have predisposing factors for CTS incidence. During the diagnosis of CTS, it is essential to note that other conditions may also provide similar symptoms to CTS, thus requiring vigorous diagnosis to assert the medical condition of the patients. Doctors use both non-surgical and surgical treatments when addressing CTS. Non-surgical treatments include wrist splinting, change of working position, medications, and the use of alternative non-vibrating equipment at work. On the other hand, surgical methods include open release and endoscopic surgeries. This review of literature has provided an overview of CTS with an emphasis on anatomy, epidemiology, risk factors, pathophysiology, stages of CTS, diagnosis, and management options.
Carpal tunnel syndrome: Diagnosis and surgical treatment
Health, 2012
Carpal tunnel syndrome (CTS) is a compressive idiopathic neuropathy, most commonly affecting the median nerve in the upper extremity. CTS have high prevalence, with up to 70% of cases in women aged between 45 and 60 years. Typical manifestations ...
Carpal tunnel syndrome – Part I (anatomy, physiology, etiology and diagnosis)
Revista Brasileira de Ortopedia (English Edition), 2014
r e v b r a s o r t o p . 2 0 1 4;4 9(5):429-436 w w w . r b o . o r g . b r Carpal tunnel syndrome/physiopathology Carpal tunnel syndrome/etiology Carpal tunnel syndrome/diagnosis Median nerve a b s t r a c t Carpal tunnel syndrome (CTS) is defined by compression of the median nerve in the wrist. It is the commonest of the compressive syndromes and its most frequent cause is idiopathic.
Carpal Tunnel Syndrome and Other Entrapment Neuropathies
Oman medical journal, 2017
Entrapment neuropathy is the result of pressure on a peripheral nerve as it passes through a narrow canal that is bounded by stiff tissues. In spite of their ubiquitous nature, they are underdiagnosed, underreported, and sometimes not properly managed, especially in developing countries. Entrapment neuropathies are of various types, but the most common type is carpal tunnel syndrome. Mechanisms involved in the pathophysiology of entrapment neuropathies include mechanical compression and nerve ischemia. A clear understanding of the various types and the underlying mechanisms of entrapment neuropathies are invaluable in the decision-making process involved in the management of every patient with the condition.
Carpal tunnel syndrome: A review
Clinical Rheumatology, 1997
Carpal tunnel syndrome (CTS) is a common problem in daily rheumatologic practice. A study of the National Institute for Occupational Safety and Health estimated a prevalence of 1.55% in the USA population based on self-report from 44,233 households in 1988 (1). Stevens et al report an incidence of 105 per 100,000 (age adjusted rates were 52 for men and 149 for women) for the period 1961 through 1980 examining the medical records in Rochester, Minnesota. The incidence increased to 125 per 100,000 during the 1976 to1980 quinquennium (2). CTS is caused by compression of median nerve (MN) at the level of the wrist as it passes through the carpal tunnel (CT) (fig. 1). Patients complain of painful tingling and numbness in the MN innervated fingers (thumb, index finger, medium finger, and half of the ring finger). Often the pain irradiates up the arm. The symptoms are more intense during the night and on the awakening (3). The patients usually try to find relief by shaking the hand in the air: this is usually referred as flick test and is considered the most valid and reliable clinical sign of CTS (4). Motor complaints include weak grip and a history of dropping objects. Physical findings include sensory loss in the index finger and middle finger, weakness of abductor pollicis brevis, flexor pollicis brevis, and opponens pollicis. In advanced cases wasting of the muscles of the thenar eminence can be found (4). The sensory loss can be better explored by vibrometry than with the pin prick test or the two-point discrimination test. Vibrometry can be used cost-effectively as a screening test for CTS, but is less sensitive than nerve conduction studies (NCS) especialty in the early stages of CTS (5-7). In CTS the sensory loss spares the thenar eminence which is innervated by the palmar cutaneous branch of the MN. Indeed, this branch emerges before the MN enters the CT. If the sensory loss involves the thenar eminence a compression proximal to the CT should be suspected. Exploration of motor impairment may be done by evaluating the abductor pollicis brevis muscle which, among the thenar