“Idiopathic” Shoulder Pain and Dysfunction from Carpal Tunnel Syndrome and Cubital Tunnel Syndrome

Hagiwara, Yusuke; Nakamura, Tatsuo; Sonoki, Kentaro; Moroi, Keishichiro; Morimoto, Shigeru; Natsume, Y; Yoshida, Ruriko

doi:10.1097/gox.0000000000004114

Cited by 4 publications

(1 citation statement)

References 25 publications

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“…There are mainly three theories explaining the RNP. The convergence theory is a phenomenon that has been demonstrated in various other nerves (14). It explains the possibility of combining specific pathways that carry sensory information from related regions to the brain.…”

Section: Discussionmentioning

confidence: 97%

Carpal tunnel syndrome with shoulder symptoms; is it a different entity? A prospective cohort study comparing recovery patterns following decompression

Ekanayake

Manilgama

2023

Asian J. Internal Med.

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Background: Carpal tunnel syndrome (CTS) may present with atypical proximal symptoms other than hand symptoms.Among proximal symptoms, shoulder symptoms are most distant to the site of compression and leads to a battery of investigations to exclude other pathologies. The recovery patterns of proximal symptoms have not been studied following carpal tunnel decompression. Methods: A prospective cohort study was conducted to compare the recovery patterns between subgroup-A; CTS patients (n=55) with shoulder symptoms, with subgroup-B; patients (n=55) without shoulder symptoms. A pre-tested questionnaire was administered prior and after the surgery and information was gathered on day-7, day-14 and day-21. Results: Of 110 patients, 81.8% were females. The mean age(+SD) of the total population was 49.2(+10.6), that of subgroup-A was 48.7(+10.3), and subgroup-B was 49.7(+11) years. They were predominantly right-handed (82.7%), 73% had their dominant hand affected while 74.5% were affected bilaterally at presentation. All had hand symptoms: numbness in 94.5%, pain in 85.4%, tingling of hand in 66.3% and all-three symptoms in 57.2%. In subgroup-A, pain was the predominant shoulder symptom which appeared before hand symptoms in 34.5%, after in 47.3% and simultaneously in 18.2%. It was aching-type in 91%. The pain radiated proximally (neck and scapula) in 61.8% and to the arm in 81.8%. The recovery rates (RR) of hand symptoms following decompression on day-7 were 41.8% in subgroup-A and 40.0% in subgroup-B. RR of hand symptoms in subgroup-A and subgroup-B on day-14 were 72.7% and 70.9%, while on day-21 were 83.6% and 85.5% respectively. RR of shoulder symptoms in subgroup-A were 38.2% on day-7, 65.4% on day-14, and 78.2% on day-21. Conclusions: Near identical RR of hand and shoulder symptoms were seen between the two subgroups after decompression, which indicates CTS with shoulder symptoms is not a different entity.

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Section: Discussionmentioning

confidence: 97%

Carpal tunnel syndrome with shoulder symptoms; is it a different entity? A prospective cohort study comparing recovery patterns following decompression

Ekanayake

Manilgama

2023

Asian J. Internal Med.

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Carpal tunnel syndrome with shoulder symptoms; is it a different entity? A prospective cohort study comparing recovery patterns following decompression

Ekanayake

Manilgama

2023

Preprint

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IntroductionCarpal tunnel syndrome (CTS) may present with atypical proximal symptoms other than hand symptoms. Among proximal symptoms, shoulder symptoms are most distant to the site of compression and leads to a battery of investigations to exclude other pathologies. The recovery patterns of proximal symptoms have not been studied following carpal tunnel decompression.MethodA prospective cohort study was conducted to compare the recovery patterns between subgroup-A; CTS patients (n=55) with shoulder symptoms, with subgroup-B; patients (n=55) without shoulder symptoms. A pre-tested questionnaire was administered prior and after the surgery and information was gathered on day-7, day-14, and day-21.ResultsOf 110 patients, 81.8% were females. The mean age(±SD) of the total population was 49.2(±10.6), that of subgroup-A was 48.7(±10.3), and subgroup-B was 49.7(±11) years. They were predominantly right-handed (82.7%), 73% had their dominant hand affected while 74.5% were affected bilaterally at presentation. All had hand symptoms: numbness in 94.5%, pain in 85.4%, tingling of hand in 66.3% and all-three symptoms in 57.2%. In subgroup-A, pain was the predominant shoulder symptom which appeared before hand symptoms in 34.5%, after in 47.3% and simultaneously in 18.2%. It was aching-type in 91%. The pain radiated proximally (neck and scapula) in 61.8% and to the arm in 81.8%.The recovery rates (RR) of hand symptoms following decompression on day-7 were 41.8% in subgroup-A and 40.0% in subgroup-B. RR of hand symptoms in subgroup-A and subgroup-B on day-14 were 72.7% and 70.9%, while on day-21 were 83.6% and 85.5% respectively. RR of shoulder symptoms in subgroup-A were 38.2% on day-7, 65.4% on day-14, and 78.2% on day-21.ConclusionNear identical RR of hand and shoulder symptoms were seen between the two subgroups after decompression, which indicates CTS with shoulder symptoms is not a different entity.

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Acroparesthesias: An Overview

Slouma,

Ben Dhia,

Cheour

et al. 2024

CRR

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Acroparesthesia is a symptom characterized by a subjective sensation, such as numbness, tingling, prickling, and reduced sensation, affecting the extremities (fingers and toes). Despite its frequency, data regarding its diagnostic approach and management are scarce. The etiological diagnosis of acroparesthesia is sometimes challenging since it can be due to abnormality anywhere along the sensory pathway from the peripheral nervous system to the cerebral cortex. Acroparesthesia can reveal several diseases. It can be associated with rheumatic complaints such as arthritis or myalgia. Further cautions are required when paresthesia is acute (within days) in onset, rapidly progressive, severe, asymmetric, proximal, multifocal, or associated with predominant motor signs (limb weakness) or severe dysautonomia. Acroparesthesia may reveal Guillain-Barré syndrome or vasculitis, requiring rapid management. Acroparesthesia is a predominant symptom of polyneuropathy, typically distal and symmetric, often due to diabetes. However, it can occur in other diseases such as vitamin B12 deficiency, monoclonal gammopathy of undetermined signiﬁcance, or Fabry’s disease. Mononeuropathy, mainly carpal tunnel syndrome, remains the most common cause of acroparesthesia. Ultrasonography contributes to the diagnosis of nerve entrapment neuropathy by showing nerve enlargement, hypoechogenic nerve, and intraneural vascularity. Besides, it can reveal its cause, such as space-occupying lesions, anatomical nerve variations, or anomalous muscle. Ultrasonography is also helpful for entrapment neuropathy treatment, such as ultrasound-guided steroid injection or carpal tunnel release. The management of acroparesthesia depends on its causes. This article aimed to review and summarize current knowledge on acroparesthesia and its causes. We also propose an algorithm for the management of acroparesthesia.

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“Idiopathic” Shoulder Pain and Dysfunction from Carpal Tunnel Syndrome and Cubital Tunnel Syndrome

Cited by 4 publications

References 25 publications

Carpal tunnel syndrome with shoulder symptoms; is it a different entity? A prospective cohort study comparing recovery patterns following decompression

Carpal tunnel syndrome with shoulder symptoms; is it a different entity? A prospective cohort study comparing recovery patterns following decompression

Carpal tunnel syndrome with shoulder symptoms; is it a different entity? A prospective cohort study comparing recovery patterns following decompression

Acroparesthesias: An Overview

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