User:Mr. Ibrahem/Carpal tunnel syndrome

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Mr. Ibrahem/Carpal tunnel syndrome
Transverse section at the wrist. The median nerve is colored yellow. The carpal tunnel consists of the bones and transverse carpal ligament.
SpecialtyOrthopedic surgery, plastic surgery
SymptomsPain, numbness, tingling in the thumb, index, middle finger, and half of ring finger, weak grip[1][2]
CausesCompression of the median nerve at the carpal tunnel[1]
Risk factorsGenetics, obesity, repetitive wrist work, pregnancy, rheumatoid arthritis[3][4][5]
Diagnostic methodBased on symptoms, specific physical tests, electrodiagnostic tests[2]
PreventionPhysical activity[3]
TreatmentWrist splint, corticosteroid injections, surgery[3]
Frequency5–10%[6][7]

Carpal tunnel syndrome (CTS) is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel.[1] The main symptoms are pain, numbness and tingling in the thumb, index finger, middle finger and the thumb side of the ring finger.[1] Symptoms typically start gradually and during the night.[2] Pain may extend up the arm.[2] Weak grip strength may occur, and after a long period of time the muscles at the base of the thumb may waste away.[2] In more than half of cases, both hands are affected.[1]

Risk factors include obesity, repetitive wrist work, pregnancy, genetics, and rheumatoid arthritis.[3][4][5] There is tentative evidence that hypothyroidism increases the risk.[8] Diabetes mellitus is weakly associated with CTS.[3][7] The use of birth control pills does not affect the risk.[3] Types of work that are associated include computer work, work with vibrating tools and work that requires a strong grip.[3] Diagnosis is suspected based on signs, symptoms and specific physical tests and may be confirmed with electrodiagnostic tests.[2] If muscle wasting at the base of the thumb is present, the diagnosis is likely.[3]

Being physically active can decrease the risk of developing CTS.[3] Symptoms can be improved by wearing a wrist splint or with corticosteroid injections.[3] Taking NSAIDs or gabapentin does not appear to be useful.[3] Surgery to cut the transverse carpal ligament is effective with better results at a year compared to non-surgical options.[3] Further splinting after surgery is not needed.[3] Evidence does not support magnet therapy.[3]

About 5% of people in the United States have carpal tunnel syndrome.[6] It usually begins in adulthood, and women are more commonly affected than men.[2] Up to 33% of people may improve without specific treatment over approximately a year.[1] Carpal tunnel syndrome was first fully described after World War II.[9]

References[edit]

  1. ^ a b c d e f Burton, C; Chesterton, LS; Davenport, G (May 2014). "Diagnosing and managing carpal tunnel syndrome in primary care". The British Journal of General Practice. 64 (622): 262–3. doi:10.3399/bjgp14x679903. PMC 4001168. PMID 24771836.
  2. ^ a b c d e f g "Carpal Tunnel Syndrome Fact Sheet". National Institute of Neurological Disorders and Stroke. January 28, 2016. Archived from the original on 3 March 2016. Retrieved 4 March 2016.
  3. ^ a b c d e f g h i j k l m n American Academy of Orthopaedic Surgeons (February 29, 2016). "Management of Carpal Tunnel Syndrome Evidence-Based Clinical Practice Guideline". Archived from the original on March 30, 2020. Retrieved July 19, 2020. {{cite journal}}: Cite journal requires |journal= (help)
  4. ^ a b Osterman, M; Ilyas, AM; Matzon, JL (October 2012). "Carpal tunnel syndrome in pregnancy". The Orthopedic Clinics of North America. 43 (4): 515–20. doi:10.1016/j.ocl.2012.07.020. PMID 23026467.
  5. ^ a b Lozano-Calderón, S; Anthony, S; Ring, D (April 2008). "The quality and strength of evidence for etiology: example of carpal tunnel syndrome". The Journal of Hand Surgery. 33 (4): 525–38. doi:10.1016/j.jhsa.2008.01.004. PMID 18406957.
  6. ^ a b Bickel, KD (January 2010). "Carpal tunnel syndrome". The Journal of Hand Surgery. 35 (1): 147–52. doi:10.1016/j.jhsa.2009.11.003. PMID 20117319.
  7. ^ a b Padua, L; Coraci, D; Erra, C; Pazzaglia, C; Paolasso, I; Loreti, C; Caliandro, P; Hobson-Webb, LD (November 2016). "Carpal tunnel syndrome: clinical features, diagnosis, and management". Lancet Neurology (Review). 15 (12): 1273–84. doi:10.1016/S1474-4422(16)30231-9. PMID 27751557.
  8. ^ Shiri, R (December 2014). "Hypothyroidism and carpal tunnel syndrome: a meta-analysis". Muscle & Nerve. 50 (6): 879–83. doi:10.1002/mus.24453. PMID 25204641.
  9. ^ Amadio, Peter C. (2007). "History of carpal tunnel syndrome". In Luchetti, Riccardo; Amadio, Peter C. (eds.). Carpal Tunnel Syndrome. Berlin: Springer. pp. 3–9. ISBN 978-3-540-22387-0. {{cite book}}: |access-date= requires |url= (help); |archive-url= requires |url= (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)
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