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Carpal Tunnel Synchrone

Carpal Tunnel Syndrome (CTS), is associated by symptoms and signs, which are caused by compression of the median nerve travelling through the carpal tunnel.Carpal Tunnel Syndrome affects the hands since it is an upper limb neuropathy that results in motor and sensory disturbance of the median nerve.

This condition affects individuals by causing pain, paresthesias, and sometimes weakness in the median nerve distribution. Those diagnosed with Carpal Tunnel Syndrome may experience pain, numbness and tingling sensations in the arm, which may extend to the shoulder and neck area; these feelings are more prevalent at night due to various sleeping positions. To aid in the prevention of Carpal Tunnel Syndrome, stretching exercises of the wrist, hand, and fingers have been used to combat against the pain and numbness caused by repetitive actions. Other than using recommended stretches and exercises, useful treatments for CTS include use of night splints, corticosteroid injections and ultimately surgery.

Most cases of Carpal Tunnel Syndrome have been found to be without a specific cause and certain individuals may be genetically predisposed to this condition.

Treatment

There have been numerous scientific papers evaluating treatment efficacy in CTS. It is important to distinguish treatments that are supported in the scientific literature from those that are advocated by any particular device manufacturer or any other party with a vested financial interest. Generally accepted treatments, as described below, may include splinting or bracing, steroid injection, activity modification, physical or occupational therapy (controversial), medications, and surgical release of the transverse carpal ligament.

According to the 2007 guidelines by the American Academy of Orthopaedic Surgeons, [37] early surgery with carpal tunnel release is indicated where there is clinical evidence of median nerve denervation or the patient elects to proceed directly to surgical treatment. Otherwise, the main recommended treatments are local corticosteroid injection, splinting (immobilizing braces), oral corticosteroids and ultrasound treatment. The treatment should be switched when the current treatment fails to resolve the symptoms within 2 to 7 weeks. However, these recommendations have sufficient evidence for carpal tunnel syndrome when found in association with the following conditions: diabetes mellitus, coexistent cervical radiculopathy, hypothyroidism, polyneuropathy, pregnancy, rheumatoid arthritis, and carpal tunnel syndrome in the workplace.

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Victor Gutierrez MD

Victor Gutierrez MD