What symptoms are truly caused by median nerve compression in carpal tunnel syndrome?

Nora, Daniel Bocchese; Becker, Jéfferson; Ehlers, João Arthur; Gomes, Irênio

doi:10.1016/j.clinph.2004.08.013

Cited by 83 publications

(44 citation statements)

References 32 publications

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“…Pain in the forearm, elbow, arm or shoulder represents a CTS symptom (Nora et al, 2005), which can be found in 45% of patients, despite thorough exclusion of other coexisting reasons for pain (Zanette et al, 2007). Patients with proximal symptoms report higher CTS symptoms severity and their exclusion would result in the selection bias of a subgroup with milder pain and sensory complaints.…”

mentioning

confidence: 99%

Abnormalities of intraterritorial and extraterritorial sensory processing in carpal tunnel syndrome and their pathophysiological significance: A comment on the paper by Schmid et al. (Eur J Pain, 2011)

Tamburin¹,

Zanette

2011

European Journal of Pain

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confidence: 99%

Abnormalities of intraterritorial and extraterritorial sensory processing in carpal tunnel syndrome and their pathophysiological significance: A comment on the paper by Schmid et al. (Eur J Pain, 2011)

Tamburin¹,

Zanette

2011

European Journal of Pain

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“…CTS is a neuropathy caused by the entrapment of the median nerve at the level of the carpal tunnel; its symptoms typically follow the median nerve distribution, but sensory symptoms involving the ulnar nerve territory and symptoms affecting the whole hand are frequently reported as well (Nora et al, 2004(Nora et al, , 2005. Ulnar nerve territory symptoms can be attributed to concomitant ulnar nerve entrapment in CTS cases with neurologic signs of ulnar damage (Gozke et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the function status of the ulnar nerve in carpal tunnel syndrome

Zhang¹,

Liu²,

Wang³

et al. 2015

Genet. Mol. Res.

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ABSTRACT. Many carpal tunnel syndrome (CTS) patients have symptoms in both the median and ulnar digits more frequently than in the median digits alone. This is possibly because of close anatomical contiguity of the carpal tunnel and Guyon's canal, and the high pressure may also affect the latter, causing indirect compression of ulnar nerve fibers. Thus, we evaluated the functional status of the ulnar nerve in patients with CTS in order to investigate the relationship between ulnar nerve impairment and sensory symptoms of the ulnar territory. Electrophysiological studies were conducted in CTS patients and healthy controls. CTS patients were divided into the mild/moderate group and severe group; they were further divided into the symptomatic and asymptomatic subgroups according to the sensory symptom of the fifth digit region. The findings suggest that CTS patients could have coexisting ulnar nerve wrist entrapments that might exacerbate the severity of CTS. Sensory impairment in the ulnar territory was observed more frequently in the mild/moderate stage of CTS, which is associated with ulnar nerve involvement. These findings also suggest that damage Ulnar nerve in carpal tunnel syndrome to the ulnar nerve fibers caused by compression forces in Guyon's canal may underlie the ulnar spread of symptoms in CTS.

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“…Many studies have reported that the pain spread to extramedian areas and proximal part of the upper extremity. This phenomenon has contributed to central sensitization [3][4][5][6]. Additionally, patients with CTS complain shoulder pain frequently [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…However, the sensory symptoms can also be seen out of median nerve distribution. Pain or paraesthesia can referred commonly to wrist, forearm or arm in CTS [2,3]. Many studies have reported that the pain spread to extramedian areas and proximal part of the upper extremity.…”

Section: Introductionmentioning

confidence: 99%

Ultrasonographic assessment of the shoulder in patients with carpal tunnel syndrome

Kaplan

Yağcı

Leblebiciler

2016

MMJ

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Objectives: To detect the causes of shoulder pain with shoulder ultrasonography in patients with carpal tunnel syndrome (CTS) and compare the findings of the patients with CTS to healthy controls. Patients and Methods:Patients with CTS and healthy controls were evaluated clinically, electrophysiologically. and ultrasonographically by three masked researchers. Electrophysiological assessment consisted median and ulnar nerve conduction studies (NCS). In ultrasonographic assessment, crosssectional areas of the median nerve were measured at hamatum hook, psiform bone, radio-ulnar joint levels. Shoulder joint, axial and longitudinal biceps tendon, subscapularis tendon, supraspinatus tendon, infraspinatus tendon, rotator cuff, acromioclavicular joint were evaluated by a standardized protocol. Results:The study was completed with 30 patients with CTS and 30 healthy subjects. The presence of shoulder pain in the last week was 53.3% in the CTS group and 30% in the control group but there was no statistically significant difference between the groups (p=0.16; p>0.05). Subdeltoid bursitis was significantly more common in CTS group when compared to the control group (p=0.03) in ultrasonographic assessment, and there was no significant difference between the two groups for other parameters. Conclusion:Shoulder pain and subdeltoid bursitis were common in patients with CTS however, shoulder pain was not directly related to shoulder problems alone. Central sensitization may play a role for shoulder pain rather than shoulder problems. Sonuç: KTS'li hastalarda omuz ağrısı ve subdeltoid bursit sık görülmesine rağmen omuz ağrısı tek başına bu bulguya dayanmamaktadır. Omuz ağrısının santral sensitizasyon mekanizmaları ile gelişmesi muhtemeldir. Keywords

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What symptoms are truly caused by median nerve compression in carpal tunnel syndrome?

Cited by 83 publications

References 32 publications

Abnormalities of intraterritorial and extraterritorial sensory processing in carpal tunnel syndrome and their pathophysiological significance: A comment on the paper by Schmid et al. (Eur J Pain, 2011)

Abnormalities of intraterritorial and extraterritorial sensory processing in carpal tunnel syndrome and their pathophysiological significance: A comment on the paper by Schmid et al. (Eur J Pain, 2011)

Evaluation of the function status of the ulnar nerve in carpal tunnel syndrome

Ultrasonographic assessment of the shoulder in patients with carpal tunnel syndrome

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