Abstract
Carpal tunnel syndrome is the syndrome of peripheral nerve entrapment more common throughout the world, represents the 90% of all neuropathy, with a higher prevalence among women. This review aimed to provide an overview of the syndrome. Symptoms include numbness, tingling, and/or pain in lateral ventral-hand, possibly atrophy and weakness tenar, that is usually worse at night. Carpal tunnel syndrome has a profile of predisposing risk factors that include individual factors, comorbidities and occupational risk factors, and these are noted briefly. This review discusses the anatomy of the carpal tunnel, pathophysiological mechanisms, its causes, clinical presentation of this syndrome, as well as the classification, diagnosis and treatment of the condition. Finally, there is a paucity of evidence on the best approaches for evaluation of carpal tunnel syndrome and to guide treatment decisions. Although the best way to integrate clinical, functional and anatomical information to select treatment options has not been identified, patients can be diagnosed quickly and respond well to treatment.
References
Peters S, Page MJ, Coppieters MW, et al, Rehabilitation following carpal tunnel release (Review), Cochrane Database of Systematic Reviews 2016, Issue 2. Art. No.: CD004158 https://doi.org/10.1002/14651858.CD004158.pub3
Moutasem S. Aboonq, Pathophysiology of carpal tunnel syndrome, Neurosciences 2015;20(1):4-9.
Newington L, Harris E, Walker-Bone K, Carpal tunnel syndrome and work, Best Practice & Research Clinical Rheumatology. 2015; 29(3):440-453 https://doi.org/10.1016/j.berh.2015.04.026
Bionka M. Huisstede, Jan Fride'n, et al, Carpal Tunnel Syndrome: Hand Surgeons, Hand Therapists, and Physical Medicine and Rehabilitation Physicians Agree on a Multidisciplinary Treatment Guidelined Results From the European HANDGUIDE Study, Archives of Physical Medicine and Rehabilitation 2014;95:2253-63. https://doi.org/10.1016/j.apmr.2014.06.022
Jonathan D. Gillig, Stephen D. et al, Acute Carpal Tunnel Syndrome A Review of Current Literature. Orthop Clin N Am. 2016; 47(3):599-607. https://doi.org/10.1016/j.ocl.2016.03.005
Kozak A, Schedlbauer G, Wirth T, et al, Association between work-related biomechanical risk factors and the occurrence of carpal tunnel syndrome: an overview of systematic reviews and a meta-analysis of current research, BMC Musculoskeletal Disorders. 2015;16:231. https://doi.org/10.1186/s12891-015-0685-0
Rempel D, Evanoff B, Amadio PC, et al. Consensus criteria for the classification of carpal tunnel syndrome in epidemiologic studies. Am J Public Health 1998;88:1447-51. https://doi.org/10.2105/AJPH.88.10.1447
Franklin G, Andrew S. et al, Work-Related Carpal Tunnel Syndrome Diagnosis and Treatment Guideline, Phys Med Rehabil Clin N Am. 2015; 26(3):523-537. https://doi.org/10.1016/j.pmr.2015.04.003
Giannini F, Cioni R, Mondelli M, et al., A new clinical scale of carpal tunnel syndrome: validation of the measurement and clinical-neurophysiological assessment, Clinical Neurophysiology. 2002;113(1):71-77. https://doi.org/10.1016/S1388-2457(01)00704-0
Middleton S, Anakwe R, Carpal tunnel Syndrome, BMJ. 2014;349:g6437. https://doi.org/10.1136/bmj.g6437
De Rijk MC, Vermeij FJ, Suntjens M, Et al., Does a carpal tunnel syndrome predict an underlying disease? J Neurol Neurosurg Psychiatry 2007;78:635-7. https://doi.org/10.1136/jnnp.2006.102145
Ortiz C, López M, Aproximación a valores de referencia de estudios electrofisiológicos para el diagnóstico de Síndrome de Túnel del Carpo,
Rev. salud pública. 2009;11(5):794-801. https://doi.org/10.1590/S0124-00642009000500012
American Academy of Physical Medicine and Rehabilitation, American Association of Electrodiagnostic Medicine, and American Academy of Neurology. Practice parameter for electrodiagnostic studies in carpal tunnel syndrome (summary statement). Arch Phys Med Rehabil. 1994;75:124-125. https://doi.org/10.1016/0003-9993(94)90352-2
Padua L., Monaco M., Padua R., et al, Neurophysiological classification of tunnel syndrome: assessment of 600 symptomatic hands, Ital J. Neurol. Sci. 1997;18:145-150. https://doi.org/10.1007/BF02048482
Atroshi I, Gummesson C, Johnsson R, et al, Diagnostic properties of nerve conduction tests in population-based carpal tunnel syndrome. BMC Musculoskelet Disord. 2003;4:9. https://doi.org/10.1186/1471-2474-4-9
Bland JDP. A neurophysiological grading scale for carpal tunnel syndrome. Muscle Nerve 2000;23:1280-1283. https://doi.org/10.1002/1097-4598(200008)23:8<1280::AID-MUS20>3.0.CO;2-Y 4598(200008)23:8<1280::AID-MUS20>3.0.CO;2-Y
Stevens JC. AAEM minimonograph #26: The electrodiagnosis of carpal tunnel syndrome. Muscle Nerve 1997;20:1477-1486. https://doi.org/10.1002/(SICI)1097-4598(199712)20:12<1477::AID-MUS1>3.0.CO;2-5 org/10.1002/(SICI)1097-4598(199712)20:12<1477::AID-MUS1>3.0.CO;2-5
Leventoglu A, Kuruoglu R. Do electrophysiological findings differ according to the clinical severity of carpal tunnel syndrome? J Neurol Sci (Turkish) 2006;23:272-278. https://doi.org/10.1002/ppsc.200601066
Benjamin Sucher, Do, Grading Severity of Carpal Tunnel Syndrome in Electrodiagnostic Reports: Why Grading is Recommended, Muscle Nerve
;48: 331-333. https://doi.org/10.1002/mus.23824
Graham B, Peljovich A., Afra R, Et al, The American Academy of Orthopaedic Surgeons Evidence-Based Clinical Practice Guideline on Management of Carpal Tunnel Syndrome, J Bone Joint Surg Am.2016;98:1750-4. https://doi.org/10.2106/JBJS.16.00719
Padua L, Coraci D, Erra, et al, Carpal tunnel syndrome: clinical features, diagnosis, and Management, Lancet Neurol 2016; 15: 1273-84. https://https://doi.org/10.1016/S1474-4422(16)30231-9