Carpal Tunnel Syndrome is the most common compressive nerve problem in the upper extremity. Carpal Tunnel Syndrome is compression of the median nerve at the wrist. There are over 490,000 cases each year in the United States. It affects 10% of the general population. It is important to know that there are many risk factors for Carpal Tunnel Syndrome also.
Idiopathic Carpal Tunnel Syndrome is the most common form of Carpal Tunnel Syndrome in adults. These patients present with the symptoms of Carpal Tunnel Syndrome and there is no clear reason why they have these issues. Henceforth, this is deemed “idiopathic”. The most common risk factors for Carpal Tunnel Syndrome include the following: Diabetes, Obesity, Thyroid Disease, Pregnancy, Alcoholism, Chronic Kidney Failure. Individuals exposed to increased daily vibration inducing jobs such as the use of a jack hammer or other power tools, can also develop Carpal Tunnel Syndrome.
Many people believe that extensive typing, data entry, mouse use and keyboarding can cause Carpal Tunnel Syndrome; however, a well-correlated, direct relationship between repetitive work activities has not been established with any double-blind clinic trials.
Individuals with Carpal Tunnel Syndrome present with numbness, tingling, weakness and pain. Sometimes they have “night pain” which awakens them. The numbness may be most prominent in the thumb index finger, long finger and the thumb-side (radial side) of the ring finger. A late sign of Carpal Tunnel Syndrome includes atrophy of the muscles of the thumb, thenar atrophy, which is due to significant loss of median nerve function.
Carpal Tunnel Syndrome is best diagnosed via the patient’s history, physical/sensory examination and a Semmes-Weinstein (Threshold) test. The Semmes- Weinstein is for detection of the early stages of Carpal Tunnel Syndrome. Many surgeons diagnose Carpal Tunnel Syndrome based solely on the clinical examination. The median nerve compression test is the most sensitive provocative test for Carpal Tunnel Syndrome. Many physicians get electrodiagnostic tests called EMG/NCV tests to diagnose Carpal Tunnel Syndrome but they are not necessary; yet, these tests do assist when the diagnosis is not clear cut. The American Academy of Orthopedic Surgeons Clinical Practice Guideline on the Diagnosis of Carpal Tunnel Syndrome recommends getting an EMG/NCV when both the clinical exam and provocative tests are positive and the doctor is considering surgical intervention for treatment.
D. Levi Harrison, MD
What is Carpal Tunnel Syndrome?Copyright©2014 by D. Levi Harrison, MD