Síndrome do Túnel Cárpico: mais que movimentos repetitivos?

Abstract

INTRODUCTION/ FRAMEWORK/ OBJECTIVES Carpal tunnel syndrome (CTS) is a progressively painful condition of the wrist and hands, caused by compression of the median nerve, at the level of the carpal tunnel, on the anterior side of the wrist. There are several known risk factors, such as repetitive movements, loads, vibrations, diabetes or pregnancy, but some authors consider that in 50% of cases the etiology is idiopathic. This review aims to visualize CTS in addition to repetitive movements, seeking to provide a different perspective when relating it to inappropriate lifestyles, such as metabolic syndrome or insulin resistance. METHODS It is an integrative bibliographic review in the EBSCO databases: CINAHL Plus, Nursing & Allied Health Collection, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), MedicLatina; MEDLINE, PUBMED and RCAAP, held in January 2020, considering what is described in the literature regarding carpal tunnel syndrome and insulin resistance or metabolic syndrome. RESULTS/DISCUSSION We found cross-sectional and case-control studies, in which CTS is associated with changes in glycemic metabolism (between 50 to 75% of cases), or manifestations at the insulin level, including changes in fasting insulin or HOMA-IR. CONCLUSIONS Approaching the link between idiopathic CTS as an indicator of an inadequate lifestyle (marked by metabolic syndrome or insulin resistance) represents a first step towards early approaches in individuals with tendinopathies. It is proposed that professionals study possible insulin resistance as a suspect of all workers with idiopathic tendinopathies, requiring an effort from the entire multidisciplinary team. More than stretching, massages, anti-inflammatory drugs and muscle relaxers, it is necessary not to look at CTS as just “a fist”, but as a system that acts (repetitively) in synergy with inappropriate lifestyles, resulting from exposure to more risk factors beyond the most obvious.