Abstract
An increase in hand and forearm volume was induced without hand movement in ten subjects who had carpal tunnel syndrome (CTS). A tester, unaware of sides affected by CTS, performed the Volume Provocation Test (VPT) by inflating a sphygmomanometer cuff around the upper arm to 15 mm Hg less than diastolic pressure for four minutes. Pre- and post-test volumes, intensity of discomfort, and quality and distribution of produced symptoms were recorded. The VPT induced significant increases of segment volumes bilaterally (p1 tailed<0.05), but not more on the side of strongest symptoms compared to the less affected, or asymptomatic side (p1 tailed=0.07). Mean discomfort on the side of strongest symptoms (5.4/10) was significantly higher (p1 tailed<0.01) than on the contralateral side (2.4/10). In 44% of the affected arms, some or all of the subjects' nocturnal symptoms were reproduced after volume increase, suggesting that CTS is a vascular phenomenon in these patients. J HAND THER. 2002;15:22-30.
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