Primary care management of carpal tunnel syndrome

Burke, F. D.; Ellis, Jo; McKenna, Helen; Bradley, Mary

doi:10.1136/pmj.79.934.433

Cited by 60 publications

(63 citation statements)

References 31 publications

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“…In the USA, 460,000 surgical interventions for CTS are performed annually with medical costs exceeding $2 billion dollars each year. 6 As it is not uncommon that CTS gradually worsens if left unchecked 7 and as complication rates following surgery are considerable, 8,9 it is vital to develop and evaluate effective conservative treatment approaches.…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal excursion and strain in the median nerve during novel nerve gliding exercises for carpal tunnel syndrome

Coppieters

Alshami

2007

Journal Orthopaedic Research

133

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Nerve and tendon gliding exercises are advocated in the conservative and postoperative management of carpal tunnel syndrome (CTS). However, traditionally advocated exercises elongate the nerve bedding substantially, which may induce a potentially deleterious strain in the median nerve with the risk of symptom exacerbation in some patients and reduced benefits from nerve gliding. This study aimed to evaluate various nerve gliding exercises, including novel techniques that aim to slide the nerve through the carpal tunnel while minimizing strain (“sliding techniques”). With these sliding techniques, it is assumed that an increase in nerve strain due to nerve bed elongation at one joint (e.g., wrist extension) is simultaneously counterbalanced by a decrease in nerve bed length at an adjacent joint (e.g., elbow flexion). Excursion and strain in the median nerve at the wrist were measured with a digital calliper and miniature strain gauge in six human cadavers during six mobilization techniques. The sliding technique resulted in an excursion of 12.4 mm, which was 30% larger than any other technique (p ≤ 0.0002). Strain also differed between techniques (p ≤ 0.00001), with minimal peak values for the sliding technique. Nerve gliding associated with wrist movements can be considerably increased and nerve strain substantially reduced by simultaneously moving neighboring joints. These novel nerve sliding techniques are biologically plausible exercises for CTS that deserve further clinical evaluation. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:972–980, 2007

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Section: Introductionmentioning

confidence: 99%

“…2,7,10,11 Also in postoperative care, early mobilization and nerve and tendon gliding exercises have been recommended. pressure inside the perineurium, and decrease of carpal tunnel pressure.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal excursion and strain in the median nerve during novel nerve gliding exercises for carpal tunnel syndrome

Coppieters

Alshami

2007

Journal Orthopaedic Research

133

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“…Tendon and nerve gliding exercises are reportedly effective in the prevention and improvement of adhesions affecting the gliding of nerves and tendons in the hand (Cook, Szabo, Birkholz & King, 1995;Burke, Ellis, Mckenna, Bradley & Dubin, 2003;Butler, 2000). These exercises are recommended as exercise therapy as part of conservative or invasive therapy in patients with CTS (Nathan, Meadows & Keniston, 1993;Cook et al, 1995).…”

Section: Discussionmentioning

confidence: 99%

Effects of tendon and nerve gliding exercises and instructions in activities of daily living following endoscopic carpal tunnel release

et al. 2016

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Abstract:The effects of postoperative therapy on psychological function following endoscopic carpal tunnel release (ECTR) have not been sufficiently investigated. This study investigated the effectiveness of instruction in tendon and nerve gliding exercises and activities of daily living (ADL) as postoperative treatment for 49 patients with carpal tunnel syndrome. Patients were randomized into 2 groups (intervention and control). After surgery, tendon and nerve gliding exercises and instruction in ADL were performed only on the experimental group on the day of the surgery. All patients were examined preoperatively and again 5−13 days postoperatively. Outcomes of pain, numbness, sensation, range of motion (ROM), anxiety, ADL and quality of life (QOL) were compared between groups. Differences were seen in pain, static 2-point discrimination, ROM, anxiety, and QOL. Tendon and nerve gliding exercises and instruction in ADL after ECTR appear likely to accelerate recovery.

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“…Tanısı anamnez ve fizik muayene ile konur ve el bileğinde median sinir disfonksiyonunu değerlendi-ren objektif bir metot olan elektrodiagnostik test ile doğ-rulanır (1). Tedavi edilmezse el fonksiyonlarında kalıcı hasara neden olabilir (3)(4)(5). Bu çalışmada daha önce tanı konup tedavi edilmemiş ve sekonder neden saptanmayan KTS vakalarının genel özelliklerini değerlendirdik.…”

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Evaluation of 45 patients with Carpal tunnel syndrome

Biçer¹,

Yanmaz²,

Çabalar³

2015

Bakirkoy

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ÖZET Karpal tünel sendromu olan 45 vakanın değerlendirilmesiAmaç: Karpal tünel sendromu (KTS), median sinirin el bileğinde karpal tünelde kompresyonu ile oluşan en sık görülen periferik mononöropatidir. Tanısı anamnez ve fizik muayene ile konur ve el bileğinde median sinir disfonksiyonunu değerlendiren objektif bir metod olan elektrodiagnostik test ile doğrulanır. Tedavi edilmezse el fonksiyonlarında kalıcı hasara neden olabilir. Bu çalışmada daha önce tanı konup tedavi edilmemiş ve sekonder neden saptanmayan KTS vakalarını değerlendirdik. Gereç ve Yöntem: Ardı ardına ellerde uyuşma, karıncalanma, ağrı ve güç kaybı ile başvuran hastaların Etik Kurul onayı alınarak demografik özellikleri, Phalen-Tinel provokasyon testleri, pamuk ve iğne ucu ile duyu testleri değerlendirildi. Kas kuvveti 1 ile 5. parmak oppozisyon gücü ile değerlendirildi ve tenar atrofi varlığı araştırıldı. İlk değerlendirmeden sonra elektromiyografi (EMG) uygulanarak tanı doğrulandı. Ayrıca vakalar KTS'ye yol açabilecek herhangi bir hastalığı olup olmadığı (metabolik, romatizmal, travma öyküsü vb.) açısından da değerlendirildiler. Vakaların ağrı, uyuşma ve güçsüzlüğü fonksiyonel durum skalası (FDS), semptom şiddet skalası (SŞS), görsel değerlendirme skalası (VAS) ile değerlendirildi. Verilerin karşılaştırılmasında Mann Whitney U testi, independent t testi; parametreler arası ilişkilerin değerlendirmesinde Spearman korelasyon analizi kullanıldı (anlamlılık p<0.05). ABSTRACT Evaluation of 45 patients with Carpal tunnel syndromeObjective: Carpal tunnel syndrome (CTS) is the most common peripheral mononeuropathy developed by compression of the median nerve within the Carpal tunnel at the wrist. Diagnosis is made by history and physical examination, and confirmed objectively by electrodiagnostic study evaluating median nerve dysfunction. If untreated CTS can cause permanent damage. In this study, we have reviewed the patients diagnosed CTS without any secondary causes and untreated. Material and Methods: The patients who presented to the outpatient clinic consecutively with complaints of numbness, tingling, pain and weakness in their hands were evaluated for their demographic features and done Phalen-Tinel provocation tests, sensory testing with cotton and needle tip after obtaining the Ethics Committee approval. Muscle strength was assessed by first and fifth finger opposition, and presence of thenar atrophy was investigated. After the initial evaluation, the diagnosis of CTS was confirmed by electromyography (EMG). Cases were evaluated for the presence of any disease that may lead to for CTS (metabolic, rheumatic, trauma, etc.). The severity of pain, numbness and weakness were evaluated by functional status scale (FSS), symptom severity score (SSS), and by visual assessment scale (VAS). Mann-Whitney U test, independent t test were used to compare the data; Spearman correlation analysis was used for the relationship between parameters (significance p<0.05). Results: All 45 cases with mild-to-moderate CTS by EMG were women; The mean age was 47.86±9....

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Primary care management of carpal tunnel syndrome

Cited by 60 publications

References 31 publications

Longitudinal excursion and strain in the median nerve during novel nerve gliding exercises for carpal tunnel syndrome

Longitudinal excursion and strain in the median nerve during novel nerve gliding exercises for carpal tunnel syndrome

Effects of tendon and nerve gliding exercises and instructions in activities of daily living following endoscopic carpal tunnel release

Evaluation of 45 patients with Carpal tunnel syndrome

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