Carpal-tunnel syndrome. Results of a prospective trial of steroid injection and splinting.

Gelberman, Richard H.; Aronson, D. C.; Weisman, M H

doi:10.2106/00004623-198062070-00020

Cited by 272 publications

(122 citation statements)

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“…However, a purely vascular basis for the pathophysiology of nerve compression has some deficiencies. For instance, it does not explain the response of CIS to anti-inflammatory medication, especially injected corticosteroids [4,24]. We therefore postulate that nerve dysfunction from extraneural pressure and resultant vascular effects would likely be mediated by inflammatory and cellular phenomena.…”

Section: Discussionmentioning

confidence: 99%

“…CTS is hypothesized to be the direct result of increased pressure within the carpal canal-a confined anatomic space which is bounded by the carpal bones on the dorsal side, the trapezium on the radial side, the hook of the hamate on the ulnar side, and the transverse carpal ligament on the palmar side [4][5][6]9,12,14,19]. Numerous epidemiological studies support the etiologic role of nerve compression by demonstrating that repetitive and forceful gripping are major risk factors for the development of CTS [1,7,15,20,23].…”

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confidence: 99%

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Carpal tunnel pressure alters median nerve function in a dose‐dependent manner: A rabbit model for carpal tunnel syndrome

Diao

Fang

Liebenberg

et al. 2005

Journal Orthopaedic Research

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Background: An in vivo animal model for carpal tunnel syndrome (CTS) is presented which allows for graded application of pressure to the median nerve within the carpal canal. We hypothesized that such pressure would cause electrophysiologic changes in the median nerve in a dose-related manner, with NCSIEMG changes consistent with CTS in humans.Methods: In 40 New Zealand white rabbits, ranging from 2 to 2.5 kg, angioplasty catheters were placed in the carpal tunnel in the forepaws and pressures ranging from 50 to 80 m m H g applied to one side while the contralateral side served as the control and remained uninflated. Pressure was applied until a 15% increase in distal motor latency was obtained for 2 consecutive weeks by nerve conduction studies.Results: All the experimental limbs exhibited a 15% increase in distal motor latency. None of the control limbs showed a significant increase in distal motor latency. In the experimental animals the 15% delay was achieved in approximately 4-5 weeks in the 50-70 mm Hg groups and in approximately 1 week in the 80 mm Hg group.Conclusion: This new animal model for CTS demonstrates a direct cause and effect relationship between carpal tunnel pressure and median nerve dysfunction. We anticipate that this in vivo model with clinically relevant outcomes will facilitate identification of injury mechanisms, and will serve as a basis for future development of novel interventions and treatments.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Carpal tunnel pressure alters median nerve function in a dose‐dependent manner: A rabbit model for carpal tunnel syndrome

Diao

Fang

Liebenberg

et al. 2005

Journal Orthopaedic Research

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“…However, the main reason for using WOs in CTS differs. 2,18,19 Pain relief can be provided, but it cannot be an immediate result. SWO resulted in an average of 16% decrease in strength tests in both groups compared to 8% with the NeO.…”

Section: Discussionmentioning

confidence: 99%

“…[13][14][15][16] The rationale for using neutral-position wrist orthoses (WOs) in CTS lies in this relationship. 17 Orthotic treatment is advocated in mild and moderate CTS., [18][19][20][21] Custom-made static wrist orthoses (SWOs) have an advantage over prefabricated, flexible WOs in that they can intimately fit to an individual patient and thereby provide better stability. 1 However, volar SWOs may interfere with the accomplishment of activities of daily living.…”

Section: Introductionmentioning

confidence: 99%

The Development of a New Orthosis (Neuro-Orthosis) for Patients with Carpal Tunnel Syndrome

Uğurlu

Ozkan

Özdoğan

2008

Prosthetics &Amp; Orthotics International

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Static wrist orthoses (SWOs) are used in the treatment of carpal tunnel syndrome (CTS) with some drawbacks. As an alternate approach to SWOs, an active closed-loop wrist control strategy based on the principles of functional electrical stimulation was proposed to limit wrist movements. The purpose of the study was to determine whether the proposed 'neuro-orthosis' (NeO) system resulted in less restriction in the hand compared to clinically accepted custom-made SWOs while limiting the wrist movements. A case-control study was designed to determine the specific effects of the system on patients with CTS. A total of 24 right-handed female volunteers (12: CTS, 12: healthy) participated in the study. Function, dexterity, and strengths were measured under three different testing conditions: without orthosis, with SWO, and with the NeO system. Maximum angles in one subtest while the NeO system was on and off and general discomfort levels in SWO and NeO test conditions were recorded. The NeO system resulted in less restriction with respect to SWO and provided considerable angular limitation compared to placebo. It was concluded that the proposed prototype control system can be a good candidate to limit the wrist movements in place of SWOs with a better degree of freedom in patients with CTS.

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“…In acute cases, and in chronic cases when there are muscle changes in the thenar eminence (muscles in the palm at the base of the thumb) and when non-operative treatment fails, surgical treatment is indicated. [16][17][18][19][20][21][22] A steroid injection into the carpal tunnel can be useful in treating the symptoms, forecasting the results of surgery and confirming the diagnosis. 87% of patients who get some relief after an injection have had better symptoms after surgery.…”

Section: -8mentioning

confidence: 99%

Carpal Tunnel Syndrome

Doumas

2014

Rev LibrOfMed

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SummaryCarpal tunnel syndrome is a very common condition where the median nerve gets pinched at the wrist and hand. The patient can experience pain, weakness and burning feelings in the hands and fingers. The involved fingers are usually the thumb, index (pointer), long (middle) and half of the ring finger. Causes are due to changes in anatomy, general medical illnesses and possibly work-related conditions. Treatments include supports, therapy, steroid injections or surgery. The diagnosis is usually made by history and physical exam and a nerve conduction study that checks the speed and function of the nerves. Non-operative and operative treatments have been successful in most patients having carpal tunnel syndrome. The treatment outcomes of open and endoscopic carpal tunnel release have been shown to be the same at three months.Background Information

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Carpal-tunnel syndrome. Results of a prospective trial of steroid injection and splinting.

Cited by 272 publications

References 0 publications

Carpal tunnel pressure alters median nerve function in a dose‐dependent manner: A rabbit model for carpal tunnel syndrome

Carpal tunnel pressure alters median nerve function in a dose‐dependent manner: A rabbit model for carpal tunnel syndrome

The Development of a New Orthosis (Neuro-Orthosis) for Patients with Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

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