Correlation between Female Sex Hormones and Electrodiagnostic Parameters and Clinical Function in Post-menopausal Women with Idiopathic Carpal Tunnel Syndrome

Abstract

ObjectivesTo investigate the role of sex-hormonal changes in idiopathic carpal tunnel syndrome (CTS) among post-menopausal women through measuring estrogen receptor (ER) expression in their transverse carpal ligament (TCL) and serum estrogen level, as well as determine the correlation between these factors and electrodiagnostic parameters and Boston score.MethodsBiopsy samples of TCL were collected from 12 postmenopausal women who had undergone surgery for severe idiopathic CTS; control specimens were collected from 10 postmenopausal women without CTS who had undergone surgery for the other hand pathologies. To determine the distributions of ER in TCL, histological and immunohistochemical examinations were performed. Serum estrogen level was also measured. Electrodiagnosis and Boston questionnaire were used for CTS severity and determination of the patients' function.ResultsER expression in TCL and serum estrogen level were not significantly different in the case group compared to the control group (P = 0.79 and P = 0.88, respectively). Also, there was no correlation between ER expression or serum estrogen level and electrodiagnostic parameters or Boston score.ConclusionsSex hormones cannot still be considered as the etiology of idiopathic CTS in postmenopausal women. The role of other factors such as wrist ratio and narrower outlet in females compared to the males should be considered along with hormonal changes.

Randomized controlled trial of local progesterone vs corticosteroid injection for carpal tunnel syndrome

“…Carpal tunnel syndrome (CTS) as the most common type of entrapment neuropathy can lead to significant discomfort, activity restriction, or occupational disability . Conservative therapy is usually considered as the first step in the management of mild to moderate CTS . Surgical release of the median nerve at wrist is usually performed in the severe conditions considering the potential side effects of surgical intervention .…”

“…Surgical release of the median nerve at wrist is usually performed in the severe conditions considering the potential side effects of surgical intervention . There are many conservative treatments commonly used in CTS including oral non‐steroidal anti‐inflammatory drugs (NSAIDs), wrist splints, physical agent modalities, and local injections …”

Transthyretin Gene Mutation Associated with Familial Carpal Tunnel Syndrome in Sample of Iraqi Patients

“…In addition, female’s daily activity at home may aggravate the disease. Moreover, female hormonal changes like that during the menstrual cycle and pregnancy had been proven to play a role ( 19 ). Many previous studies had recorded same results ( 20 ).…”

“…This can be explained by the usual unilateral hand activity load by most of the people until complaint started, possibly due to the increased liability to trauma, then the patient starts to use the other hand ending with bilateral disease (Taylor et al, 2017). The authors in ( 19 ) had suggested the presence of inheritable variations in the carpal tunnel size or contents, which would usually manifest themselves bilaterally. This was consistent with the findings of other researcher ( 19 ).…”

“…The authors in ( 19 ) had suggested the presence of inheritable variations in the carpal tunnel size or contents, which would usually manifest themselves bilaterally. This was consistent with the findings of other researcher ( 19 ). Our study revealed that the majority of the patients had mild disease.…”