Carpal Tunnel Syndrome
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- Carpal tunnel syndrome (CTS) is the most common cause of peripheral nerve compression.
- Increased pressure within the carpal tunnel leads to entrapment and compression of the median nerve.
- The tunnel is composed of the carpal bones dorsally and the transverse carpal ligament palmarly:
- The tunnel contains flexor tendons and the median nerve.
- Symptoms tend to affect the dominant hand, but >50% of patients experience bilateral symptoms.
- System(s) affected: Musculoskeletal; Nervous
Pregnancy: Increased incidence during pregnancy; incidence estimates vary
- Predominant age: 40–60
- Predominant sex: Female > Male (3:1–10:1)
- 2 peaks: Late 50s in women, and late 70s when the sex ratio is more equal
- Incidence rates of up to 276/100,000 have been reported.
- Incidence of 9.2% in women, and 6% in men.
- Diabetic patients have a prevalence rate of 14% and 30% without and with diabetic neuropathy.
- Increasing prevalence may be due to increased lifespan of population, as well as increasing prevalence of diabetes.
- Prolonged postures in extremes of wrist flexion or extension, and exposure to vibration are primary reported exposures for development of carpal tunnel syndrome.
- Conditions that alter the fluid balance in the body, including pregnancy, menopause, obesity, renal failure, hypothyroidism, congestive heart failure (CHF), and oral contraceptive use
- Neuropathic factors, such as diabetes, alcoholism, vitamin deficiency, or exposure to toxins, can play a role in eliciting CTS symptoms.
- No universal agreement that CTS is job-related
Unknown; however, a familial type has been reported.
There is no known prevention for CTS. It is recommended to take a break once an hour when doing repetitive work involving hands.
Combination of mechanical trauma, inflammation, increased pressure, and ischemic injury to the median nerve within the carpal tunnel.
- Disorders affecting the musculoskeletal system in the region of the wrist, including the following:
- Trauma or distal radius fracture
- Degenerative joint disease
- Rheumatoid arthritis
- Ganglion cyst
- Hypothyroidism and diabetes are frequently associated with this condition, which also occurs with increased frequency during pregnancy.
- Other miscellaneous causes include the following:
- Lupus erythematosus
- Pyogenic infections
- Primary amyloidosis
- Paget disease
- Hyperparathyroidism, hypocalcemia
Commonly Associated Conditions