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Carpal tunnel syndrome(CTS)

MedGen UID:
2856
Concept ID:
C0007286
Disease or Syndrome
Synonym: CTS
SNOMED CT: Distal median nerve compression (57406009); Distal median nerve entrapment (57406009); Carpal tunnel (57406009); Carpal canal (57406009); CTS - Carpal tunnel syndrome (57406009); Carpal tunnel syndrome (57406009)
 
Related gene: TTR
 
Monarch Initiative: MONDO:0007275
OMIM®: 115430
OMIM® Phenotypic series: PS115430
Orphanet: ORPHA50838

Definition

Carpal tunnel syndrome is a disorder caused by disturbances in nerve function (neuropathy), leading to pain and numbness or tingling (paresthesia) primarily in the wrist and hand. While carpal tunnel syndrome can occur at any age, it most often affects people between the ages of 40 and 60. In more than half of cases, both hands are affected; however, the severity may vary between hands. When only one hand is affected, it is most often the hand used for writing (the dominant hand).

In carpal tunnel syndrome, the pain or paresthesia is usually felt in the wrist, the palm, and the first four fingers of the hand. These signs and symptoms often develop during sleep and are noticeable upon waking. Affected individuals typically shake their hand to get rid of the pain and numbness, a characteristic move known as the flick sign. As the condition advances, the signs and symptoms begin to occur during the day as well. Affected individuals may have difficulty performing manual tasks such as turning doorknobs, fastening buttons, or opening jars. The symptoms of carpal tunnel syndrome may be triggered by certain activities that flex or extend the wrist, such as driving, typing, or holding a telephone.

Over time, people with carpal tunnel syndrome can have muscle and nerve wasting (atrophy) in the affected hand and a reduced ability to detect sensations, which can be mistaken for an improvement of symptoms. [from MedlinePlus Genetics]

Term Hierarchy

Professional guidelines

PubMed

Wang L
Phys Med Rehabil Clin N Am 2018 Nov;29(4):751-760. Epub 2018 Sep 17 doi: 10.1016/j.pmr.2018.06.009. PMID: 30293628
Wipperman J, Goerl K
Am Fam Physician 2016 Dec 15;94(12):993-999. PMID: 28075090
Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, Caliandro P, Hobson-Webb LD
Lancet Neurol 2016 Nov;15(12):1273-1284. Epub 2016 Oct 11 doi: 10.1016/S1474-4422(16)30231-9. PMID: 27751557

Recent clinical studies

Etiology

Du J, Yuan Q, Wang XY, Qian JH, An J, Dai Q, Yan XY, Xu B, Luo J, Wang HZ
J Integr Complement Med 2022 Dec;28(12):919-926. Epub 2022 Jul 27 doi: 10.1089/jicm.2022.0542. PMID: 35895497
Calandruccio JH, Thompson NB
Orthop Clin North Am 2018 Apr;49(2):223-229. Epub 2018 Feb 1 doi: 10.1016/j.ocl.2017.11.009. PMID: 29499823
Aboonq MS
Neurosciences (Riyadh) 2015 Jan;20(1):4-9. PMID: 25630774Free PMC Article
Kim PT, Lee HJ, Kim TG, Jeon IH
Clin Orthop Surg 2014 Sep;6(3):253-7. Epub 2014 Aug 5 doi: 10.4055/cios.2014.6.3.253. PMID: 25177448Free PMC Article
Aroori S, Spence RA
Ulster Med J 2008 Jan;77(1):6-17. PMID: 18269111Free PMC Article

Diagnosis

Osiak K, Elnazir P, Walocha JA, Pasternak A
Folia Morphol (Warsz) 2022;81(4):851-862. Epub 2021 Nov 16 doi: 10.5603/FM.a2021.0121. PMID: 34783004
Wang L
Phys Med Rehabil Clin N Am 2018 Nov;29(4):751-760. Epub 2018 Sep 17 doi: 10.1016/j.pmr.2018.06.009. PMID: 30293628
Wipperman J, Goerl K
Am Fam Physician 2016 Dec 15;94(12):993-999. PMID: 28075090
Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, Caliandro P, Hobson-Webb LD
Lancet Neurol 2016 Nov;15(12):1273-1284. Epub 2016 Oct 11 doi: 10.1016/S1474-4422(16)30231-9. PMID: 27751557
Middleton SD, Anakwe RE
BMJ 2014 Nov 6;349:g6437. doi: 10.1136/bmj.g6437. PMID: 25378457

Therapy

Ijaz MJ, Karimi H, Ahmad A, Gillani SA, Anwar N, Chaudhary MA
Biomed Res Int 2022;2022:2155765. Epub 2022 Jun 22 doi: 10.1155/2022/2155765. PMID: 35782066Free PMC Article
Ezzati K, Laakso EL, Saberi A, Yousefzadeh Chabok S, Nasiri E, Bakhshayesh Eghbali B
Eur J Phys Rehabil Med 2020 Dec;56(6):733-740. Epub 2019 Nov 18 doi: 10.23736/S1973-9087.19.05835-0. PMID: 31742366
Jiménez Del Barrio S, Bueno Gracia E, Hidalgo García C, Estébanez de Miguel E, Tricás Moreno JM, Rodríguez Marco S, Ceballos Laita L
Neurologia (Engl Ed) 2018 Nov-Dec;33(9):590-601. Epub 2016 Jul 22 doi: 10.1016/j.nrl.2016.05.018. PMID: 27461181
Peters S, Page MJ, Coppieters MW, Ross M, Johnston V
Cochrane Database Syst Rev 2016 Feb 17;2(2):CD004158. doi: 10.1002/14651858.CD004158.pub3. PMID: 26884379Free PMC Article
Page MJ, O'Connor D, Pitt V, Massy-Westropp N
Cochrane Database Syst Rev 2012 Jun 13;(6):CD009899. doi: 10.1002/14651858.CD009899. PMID: 22696387

Prognosis

Chung KY, Ho G, Novak CB, Baltzer HL
Plast Reconstr Surg 2022 Mar 1;149(3):445e-452e. doi: 10.1097/PRS.0000000000008835. PMID: 35196681
Yeh KT, Lee RP, Yu TC, Wang JH, Liu KL, Peng CH, Chen HW, Chen IH, Hsu CY, Lin CL, Wu WT
Sci Rep 2020 Jan 16;10(1):469. doi: 10.1038/s41598-020-57415-x. PMID: 31949231Free PMC Article
Calandruccio JH, Thompson NB
Orthop Clin North Am 2018 Apr;49(2):223-229. Epub 2018 Feb 1 doi: 10.1016/j.ocl.2017.11.009. PMID: 29499823
Ashworth NL
Am Fam Physician 2016 Nov 15;94(10):830-831. PMID: 27929273
Hanewinckel R, Ikram MA, Van Doorn PA
Handb Clin Neurol 2016;138:263-82. doi: 10.1016/B978-0-12-802973-2.00015-X. PMID: 27637963

Clinical prediction guides

Arana-Achaga X, Goena-Vives C, Villanueva-Benito I, Solla-Ruiz I, Rengel Jimenez A, Gaspar TI, Urreta-Barallobre I, Barge-Caballero G, Seijas-Marcos S, Cabrera E, Garcia-Pavía P, Basurte Elorz MT, Ayestarán NM, Sierra LT, Robledo Iñarritu M, Lozano-Bahamonde A, Escolar-Perez V, Gómez-Ramírez C, Alzola E, Andrés RN, Francisco Matias JL, Limeres Freire J, Armengou Arxe A, Negre Busó M, Piqueras-Flores J, Martínez-Del Río J, Onaindia Gandarias JJ, Rodriguez Sanchez I, Querejeta Iraola R
JACC Cardiovasc Imaging 2023 Dec;16(12):1567-1580. Epub 2023 Jun 28 doi: 10.1016/j.jcmg.2023.05.002. PMID: 37389511
Siddiqi OK, Ruberg FL
Trends Cardiovasc Med 2018 Jan;28(1):10-21. Epub 2017 Jul 13 doi: 10.1016/j.tcm.2017.07.004. PMID: 28739313Free PMC Article
Werner RA
PM R 2013 May;5(5 Suppl):S14-21. Epub 2013 Mar 28 doi: 10.1016/j.pmrj.2013.03.027. PMID: 23542773
Werner RA, Andary M
Muscle Nerve 2011 Oct;44(4):597-607. doi: 10.1002/mus.22208. PMID: 21922474
Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S
Spine (Phila Pa 1976) 2003 Jan 1;28(1):52-62. doi: 10.1097/00007632-200301010-00014. PMID: 12544957

Recent systematic reviews

Karjalainen TV, Lusa V, Page MJ, O'Connor D, Massy-Westropp N, Peters SE
Cochrane Database Syst Rev 2023 Feb 27;2(2):CD010003. doi: 10.1002/14651858.CD010003.pub2. PMID: 36848651Free PMC Article
Jiménez-Del-Barrio S, Cadellans-Arróniz A, Ceballos-Laita L, Estébanez-de-Miguel E, López-de-Celis C, Bueno-Gracia E, Pérez-Bellmunt A
Int Orthop 2022 Feb;46(2):301-312. Epub 2021 Dec 3 doi: 10.1007/s00264-021-05272-2. PMID: 34862562Free PMC Article
Jiménez Del Barrio S, Bueno Gracia E, Hidalgo García C, Estébanez de Miguel E, Tricás Moreno JM, Rodríguez Marco S, Ceballos Laita L
Neurologia (Engl Ed) 2018 Nov-Dec;33(9):590-601. Epub 2016 Jul 22 doi: 10.1016/j.nrl.2016.05.018. PMID: 27461181
Ballestero-Pérez R, Plaza-Manzano G, Urraca-Gesto A, Romo-Romo F, Atín-Arratibel MLÁ, Pecos-Martín D, Gallego-Izquierdo T, Romero-Franco N
J Manipulative Physiol Ther 2017 Jan;40(1):50-59. Epub 2016 Nov 11 doi: 10.1016/j.jmpt.2016.10.004. PMID: 27842937
Page MJ, O'Connor D, Pitt V, Massy-Westropp N
Cochrane Database Syst Rev 2012 Jun 13;(6):CD009899. doi: 10.1002/14651858.CD009899. PMID: 22696387

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