PubMed · 8414367
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I Chong. 1993. Solving 'white collar' pain problems.. https://pubmed.ncbi.nlm.nih.gov/8414367/
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Carpal tunnel syndrome (CTS) is a clinical entity characterized by pain, paresthesias, and numbness in the distribution of the median nerve with weakness and atrophy of the thenar muscles in advanced cases. It is universally accepted that CTS is the clinical concomitant of compression of the median nerve as it passes through the carpal canal. It is reported to be the most common of the entrapment neuropathies. Increasing evidence suggests that occupational factors, including forceful use of the hands, repetitive use of the hands, and hand-arm vibration, are etiologic for CTS. When occurring as a result of occupational exposures, the term "work-related carpal tunnel syndrome" is applied. Clinical approaches to the diagnosis and treatment of work-related CTS are described in this paper. Particular attention is paid to the clinical features and pathophysiology of CTS, the epidemiology of work-related CTS, ascertainment of work-relatedness in the clinical setting, treatment including both work and non-work interventions, and control of occupational ergonomic risk factors that may contribute to the illness.
The purpose of this report was to critically review studies of the clinical diagnostic tests for carpal tunnel syndrome. The reports were located through Medline, Current Contents, related readings, and the reference lists of the articles. They all explored the use of clinical diagnostic tests for carpal tunnel syndrome compared with the results of NCS. Criteria for systematically reviewing the studies were developed, tested for reliability, and applied to the studies. Many studies did not have sufficient detail to allow repetition of the protocol by other researchers. The sensitivities and specificities reported for each can be compared with the quality criteria ratings they each received. The literature supports the use of the wrist flexion and carpal compression test and suggests that 2-point discrimination has low sensitivity for diagnosing carpal tunnel syndrome. Many reports do not include methodology, which makes the results difficult to reproduce and to apply to other populations. (J Hand Surg 2000; 25A:120-127.
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