A handy review of carpal tunnel syndrome: From anatomy to diagnosis and treatment

Abstract

Carpal tunnel syndrome (CTS) is the most commonly diagnosed disabling condition of the upper extremities. It is the most commonly known and prevalent type of peripheral entrapment neuropathy that accounts for about 90% of all entrapment neuropathies. This review aims to provide an outline of CTS by considering anatomy, pathophysiology, clinical manifestation, diagnostic modalities and management of this common condition, with an emphasis on the diagnostic imaging evaluation.

Personal risk factors for carpal tunnel syndrome in female visual display unit workers

“…In other words, not only occupational but also personal history influence in probabilistic terms natural history of CTS, both inducing and anticipating its clinical presentation [1,2,16]. As CTS has become one of the most frequent causes of work compensation, both in Europe and in the United States, and due to the large and still increasing number of people working with computers, also a feeble excess of risk means that a high number of workers may then experience upper extremities [4,5]. Occupational (i.e., repetitive and forceful work such as gripping, vibrations) and non-occupational risk factors (i.e., female sex, age, obesity, diabetes, gynaecological surgery, menstrual problems/disorders and exercise levels) have been associated with CTS, suggesting a multifactorial aetiology [6][7][8][9][10][11][12][13][14][15].…”

“…Finally, studies on CTS in occupational medicine and, in particular, in VDU workers often lack an accurate evaluation of personal medical history. As CTS is a very frequent condition in adult females [3][4][5], for both anatomical and physiological reasons [1][2][3][4][5], with a very large array of well-established occupational and non-occupational risk factors [6][7][8][9][10][11][12][13][14][15], it should be interpreted as a "work related musculoskeletal disorder," i.e., an impairment of body structures associated with, rather than simply caused by, cumulative exposure to work and working environment over a long period of time [25]. In other words, not only occupational but also personal history influence in probabilistic terms natural history of CTS, both inducing and anticipating its clinical presentation [1,2,16].…”

“…Second, until recently the definition of the exposure to VDU was difficult and erratic, as the use of computers and computer devices (i.e., mouse and keyboard) may be very heterogeneous and even a cut-off, based on the time spent at the VDU, has been irregularly applied [16][17][18][19][20]. Third, symptoms that are usually associated with CTS, such as numbness, tingling, burning or pain at the first digit and at wrist, are very common in the general population [1][2][3][4][5]. Also physical tests (such as Phalen's, reverse Phalen's, Tinel's and carpal compression test), even when combined, do not guarantee a reliable diagnosis without ultrasound and/or nervous conduction studies [1][2][3]21]: a large number of epidemiological studies on CTS in VDU workers are based on self-referred symptoms and the risk of CTS cumulative use) and hormone replacement therapy (HRT); the latter variables were considered together for the purposes of the present analysis.…”

Hand Volume as a Diagnostic Tool in Carpal Tunnel Syndrome

“…This study also demonstrated that edema varies with the degree of carpal tunnel syndrome; increasing from mild to moderate disease and then decreasing with advanced disease. This association between edema and nerve entrapment has been seen in other conditions including gestational edema, colles' fracture and postmastectomy lymphedema [18,19]. One study may have indirectly quantified edema in CTS.…”

The Effect of IL-4 Gene Polymorphism in Carpal Tunnel Syndrome

“…CTS is defined as "a symptomatic compression neuropathy of the median nerve at the level of the wrist" by the American Academy of Orthopaedic Surgeons (AAOS) [5]. In the general population, CTS has been found to have a prevalence rate of 3.8% and an incidence rate of 1.8/1,000 [6,7] with more frequency in women than in men; the prevalence rate is 9.2% in women and 6% in men. [5].…”