Symptoms Of Carpal Tunnel Syndrome Research Articles

It Workers' Rehabilitation Manual for Carpal Tunnel Syndrome: A Case Study

A group of symptoms known as carpal tunnel syndrome (CTS) are brought on by compression of the median nerve in the carpal tunnel of the wrist. The primary signs and symptoms of CTS are numbness, pain, and tingling in the radial side of the ring finger as well as the first three fingers. Pain also causes nocturnal awakenings and impairs fine motor control due to hand weakness. Thus far, research findings pertaining to the use of conservative approaches in the management of CTS have been inconsistent. Exercises, splints, laser therapy, ultrasound therapy, manual therapy, neurodynamic methods, functional massage, and more are all part of CTS rehabilitation. Acupuncture, massages, and Chinese cupping massage are some alternative therapies for CTS.

Perineural Injection of Mecobalamin Versus Dextrose 5% Against Clinical Changes and Electrophysiological Features of Carpal Tunnel Syndrome Patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

Background: Carpal tunnel syndrome (CTS) is a common compression neuropathy with symptoms of pain, tingling, and numbness in the hands. Perineural injections of steroids and mecobalamin have been shown to be effective in relieving CTS symptoms. This study aims to compare the effectiveness of the perineural injection of mecobalamin and 5% dextrose on clinical changes and electrophysiological features in CTS sufferers.
 Methods: This research is a pilot study open-label randomized controlled trial conducted at Dr. Mohammad Hoesin General Hospital Palembang. A total of 24 CTS patients were randomly divided into two groups: the mecobalamin group (n=12) and the 5% dextrose group (n=12). Patients in both groups received a single perineural injection.
 Results: In the mecobalamin group, there were significant improvements in pain scores (NPRS), Boston carpal tunnel questionnaire (BCTQ) - symptom severity scale (SSS) and functional status scale (FSS), as well as median nerve motor and sensory conduction after 2 weeks. In the 5% dextrose group, there were significant improvements in pain scores and BCTQ-SSS but not in BCTQ-FSS and nerve conduction. Comparison between groups showed significant differences in BCTQ-SSS and sensory conduction amplitude.
 Conclusion: Perineural injection of mecobalamin and 5% dextrose is effective in improving clinical symptoms of CTS. Mecobalamin showed better effects on BCTQ-SSS and sensory conduction amplitude than 5% dextrose.

Effect of low level laser therapy versus pulsed ultrasound on postpartum carpal tunnel syndrome

Background. Carpal tunnel syndrome (CTS) is a major health issue that can impede postpartum women's activities and skills in both their personal and professional lives. Purpose. To compare the effectiveness of low-level laser therapy (LLLT) and pulsed ultrasound (US) in relieving postpartum CTS. Methods. Forty-eight women with mild to moderate CTS were divided into three groups. In addition to wrist exercises, Group (A) (n = 16) received LLLT, Group (B) (n = 16) received pulsed US, and Group (C) (n = 16) performed wrist exercises alone. For all groups, the treatment sessions were applied to the affected hand, 3 sessions weekly for four weeks. All postpartum women were evaluated pre- and post-treatment via a visual analogue scale (VAS) for pain intensity, the Boston Questionnaire of CTS (BCTS) for diagnosing CTS symptoms, electromyography for measuring motor conduction velocity (MCV), sensory conduction velocity (SCV), motor distal latency (MDL), and sensory peak latency (SPL), and a hand grip dynamometer for assessing hand grip strength. Results. All measured variables were significantly improved in the three groups post-treatment compared to pre-treatment. Between-groups comparison showed a highly significant decrease in the VAS, BCTS, and SPL and a significant increase of SCV and hand grip strength between groups A and C in favor of group A and between groups B and C in favor of group B, while the significant change in MDL and MCV was found between groups A and C only in favor of group A (p < 0.05), with no significant change in all outcome measures between groups A and B (P > 0.05). Conclusion. Either LLLT or pulsed US are useful modalities that can be used as an effective conservative therapy for alleviating postpartum CTS.

Higher densities of T-lymphocytes in the subsynovial connective tissue of people with carpal tunnel syndrome.

Symptoms in people with carpal tunnel syndrome (CTS) are traditionally attributed to neural tissue, but recent studies suggest that the subsynovial connective tissue (SSCT) may also play a role in CTS. The SSCT undergoes fibrotic thickening which is generally described as "non-inflammatory" based on basic histology. This study uses immunohistochemistry to determine the presence of macrophages and T-cells within SSCT and their relationship with symptoms in people with CTS. SSCT was collected from twenty people with CTS and eight controls undergoing wrist fracture surgery. Immunohistochemical quantification of CD3+ T-cells and CD68+ macrophage densities as well as CD4+/CD8+ T-cell subpopulations were compared between groups using independent t-tests. Spearman correlations were used to identify associations between immune cell densities and CTS symptom scores. The density of CD3+ T-cells was significantly higher in SSCT of people with CTS compared to controls (CTS mean 26.7 (SD 13.7); controls 6.78 (6.3), p = 0.0005) while the density of CD68+ macrophages was lower (CTS mean 9.5 (SD 6.0); controls 17.7 (8.2), p = 0.0058). Neither CD68+ nor CD3+ cell densities correlated with symptom scores. In contrast to previous assumptions, our data show that the SSCT in the carpal tunnel in both people with CTS and controls is not devoid of immune cells. Whereas the higher density of CD68+ macrophages in control participants may be associated with their early recruitment after acute fracture, CD3+ cells within the SSCT may play a role in chronic CTS.

Do Carpal Tunnel Syndrome Symptoms During Pregnancy Affect the Sleep Quality of Pregnant Women?

Do Carpal Tunnel Syndrome Symptoms During Pregnancy Affect the Sleep Quality of Pregnant Women?

Final 1-Year Results of the TUTOR Randomized Trial Comparing Carpal Tunnel Release with Ultrasound Guidance to Mini-open Technique.

Studies comparing carpal tunnel release with ultrasound guidance (CTR-US) to mini-open CTR (mOCTR) are limited. This randomized trial compared the efficacy and safety of these techniques. In this multicenter randomized trial, patients were randomized (2:1) to unilateral CTR-US or mOCTR. Outcomes included Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SSS) and Functional Status Scale (BCTQ-FSS), numeric pain scale (0-10), EuroQoL-5 Dimension 5-Level (EQ-5D-5L), scar outcomes, and complications over 1 year. Patients received CTR-US (n = 94) via wrist incision (mean 6 mm) or mOCTR (n = 28) via palmar incision (mean 22 mm). Comparing CTR-US with mOCTR, the mean changes in BCTQ-SSS (-1.8 versus -1.8; P = 0.96), BCTQ-FSS (-1.0 versus -1.0; P = 0.75), numeric pain scale (-3.9 versus -3.8; P = 0.74), and EQ-5D-5L (0.13 versus 0.12; P = 0.79) over 1 year were comparable between groups. Freedom from scar sensitivity or pain favored CTR-US (95% versus 74%; P = 0.005). Complications occurred in 2.1% versus 3.6% of patients (P = 0.55), all within 3 weeks postprocedure. There was one revision surgery in the CTR-US group, and no revisions for persistent or recurrent symptoms in either group. CTR-US and mOCTR demonstrated similar improvement in carpal tunnel syndrome symptoms and quality of life with comparable low complication rates over 1 year of follow-up. CTR-US was performed with a smaller incision and associated with less scar discomfort.

Prevalence of Carpal Tunnel Syndrome During Pregnancy

Background: Carpal Tunnel Syndrome (CTS) is a common condition during pregnancy, associated with symptoms like tingling, numbness, and pain in the hand and arm due to median nerve compression. The prevalence and severity of CTS can increase due to physiological changes during pregnancy, such as fluid retention and hormonal fluctuations. Objective: This study aimed to determine the prevalence of CTS in pregnant women, identify the trimester with the highest occurrence, and assess the effectiveness of Phalen's and Durkan compression tests in diagnosing CTS during pregnancy. Methods: A cross-sectional study was conducted over six months at Akhtar Saeed Trust Teaching Hospital and Farooq Hospital, Lahore, involving 121 pregnant women. Participants were selected using non-probability convenience sampling and were divided by trimester. The diagnosis of CTS was confirmed through Phalen's and Durkan compression tests. Data analysis was performed using SPSS version 25, with a chi-square test to evaluate the association between CTS prevalence and pregnancy trimester. Results: The prevalence of CTS among the participants was identified as 33.1% with Phalen's test and 55.4% with Durkan's compression test. The third trimester showed the highest occurrence of CTS symptoms, with a significant increase in prevalence (p=0.005 for Phalen’s test and p=0.394 for Durkan compression test). The frequency of CTS symptoms was 28.9% in the first trimester, 32.2% in the second trimester, and 38.8% in the third trimester. Conclusion: The study confirms that CTS is prevalent among pregnant women, particularly in the third trimester. The findings emphasize the need for healthcare providers to be aware of the increased risk of CTS during pregnancy and the importance of early diagnosis and management to alleviate symptoms.

CONTENT EVALUATION OF DIAGNOSTIC AND TREATMENT INFORMATION QUALITIES OF YOUTUBE VIDEOS ON CARPAL TUNNEL SYNDROME

Introduction: One of the leading video sharing platforms is YouTube (YT). Due to their increased use, these can possibly create misconceptions about the condition, especially the associated treatment and signs and symptoms of carpal tunnel syndrome. Thus, this evaluates the information quality of YT videos about carpal tunnel syndrome (CTS). Methods: This is a descriptive-evaluated study focused on assessing the information qualities of CTS videos on YT. Using Macleod et al. information quality index (2015), modified Diagnostic Information Quality Assessment Checklist (DIQAC) and Treatment Information Quality Assessment Checklist (TIQAC) were utilized. DIQAC measures the elements explanation, history, physical examination and ancillary procedures; while TIQAC, presurgical, surgical procedure, rehabilitation and complication elements. YT videos from 2020 onwards were searched using keywords "carpal tunnel syndrome", "diagnosis" and "treatment", and screened for duplicates, non-related to topic and without audio. Out of 31 videos retrieved, 11 YT videos on CTS were evaluated by physical therapists to determine the reliability of YT videos on CTS. Results: Results showed that YT-CTS videos are highly reliable in the elements explanation (45%) and history (36.36%), moderate to reliable in ancillary procedure (54.54%) and moderately reliable in physical examination (36%), in terms of DIQAC scoring. Whereas in TIQAC scoring, YT-CTS videos obtained a highly reliable presurgical scoring (45.45%). Surprisingly, it is poorly reliable in complication scoring (45.45%), very poorly to poor reliable in rehabilitation scoring (72.72%), and very poorly reliable in surgical scoring (45.45%). Overall, diagnosis information quality is high (65%), but low treatment information quality (32%). Discussion: This demonstrates that YT videos are technological tool that a physical therapist or a clinicians can utilize to educate and diagnose. Treatment information can hardly be explained in videos, which can vary form case to case, and is best explained through medical advice of a doctor to his patient with CTS.

Effectiveness of prevention exercises protocol among office workers with symptoms of carpal tunnel syndrome.

Carpal tunnel syndrome (CTS) is common among office workers and limits functional hand ability and the ability to work. Carpal tunnel syndrome prevention programs implementation are still insufficient among office workers. In view of the fact that physical activity is the best method of preventing musculoskeletal complaints the aim of the study was to evaluate the effectiveness of prevention exercises protocol for hand and wrist pain among office workers. Study group consists form 62 office workers, reporting complaints of hand and wrist pain. Exercise group it was 49 subjects who performed the exercise protocol and the non-exercise group consisted of 13 subjects. An exercises program, consisting of 7 exercises. The program was planned for daily routine during 8 weeks. The effectiveness of the exercise program was assessed by physical parameters (hand grip and pinch grip strength, force of forearm muscles) and questionnaires (Visual Analog Scale pain scale, Carpal Tunnel Syndrome Symptom Severity Scale, and Carpal Tunnel Syndrome Functional Status Scale functional hand assessment questionnaires) were performed. Assessment was performed before and after the intervention. Statistical analysis of the data showed significant changes in the value of measured hand grip of the right hand (Z = -2.85, p < 0.01). For pinch grip, changes were significant for both the right (Z = -2.12, p < 0.05) and the left hands (Z = -2.35, p < 0.05). Functional performance improved significantly in bought groups. There was no statistically significant change in the intensity of experienced pain. The results of the study indicate that performing a preventive exercise program regularly has an effect on increasing forearm muscle strength in a group of office workers. Office workers with symptoms of CTS who exercised regularly had higher results in hand grip and pincer grip strength. Exercises do not affect the level of pain complaints, which may indicate a more complex etiology of pain perception in this study group. Int J Occup Med Environ Health. 2024;37(1):45-57.

Algorithm Versus Expert: Machine Learning Versus Surgeon-Predicted Symptom Improvement After Carpal Tunnel Release.

Surgeons rely on clinical experience when making predictions about treatment effects. Incorporating algorithm-based predictions of symptom improvement after carpal tunnel release (CTR) could support medical decision-making. However, these algorithm-based predictions need to outperform predictions made by surgeons to add value. We compared predictions of a validated prediction model for symptom improvement after CTR with predictions made by surgeons. This cohort study included 97 patients scheduled for CTR. Preoperatively, surgeons estimated each patient's probability of improvement 6 months after surgery, defined as reaching the minimally clinically important difference on the Boston Carpal Tunnel Syndrome Symptom Severity Score. We assessed model and surgeon performance using calibration (calibration belts), discrimination (area under the curve [AUC]), sensitivity, and specificity. In addition, we assessed the net benefit of decision-making based on the prediction model's estimates vs the surgeon's judgement. The surgeon predictions had poor calibration and suboptimal discrimination (AUC 0.62, 95%-CI 0.49-0.74), while the prediction model showed good calibration and appropriate discrimination (AUC 0.77, 95%-CI 0.66-0.89, P = .05). The accuracy of surgeon predictions was 0.65 (95%-CI 0.37-0.78) vs 0.78 (95%-CI 0.67-0.89) for the prediction model (P = .03). The sensitivity of surgeon predictions and the prediction model was 0.72 (95%-CI 0.15-0.96) and 0.85 (95%-CI 0.62-0.97), respectively (P = .04). The specificity of the surgeon predictions was similar to the model's specificity (P = .25). The net benefit analysis showed better decision-making based on the prediction model compared with the surgeons' decision-making (ie, more correctly predicted improvements and/or fewer incorrectly predicted improvements). The prediction model outperformed surgeon predictions of improvement after CTR in terms of calibration, accuracy, and sensitivity. Furthermore, the net benefit analysis indicated that using the prediction model instead of relying solely on surgeon decision-making increases the number of patients who will improve after CTR, without increasing the number of unnecessary surgeries.

Carpal tunnel syndrome prediction with machine learning algorithms using anthropometric and strength-based measurement.

Carpal tunnel syndrome (CTS) stands as the most prevalent upper extremity entrapment neuropathy, with a multifaceted etiology encompassing various risk factors. This study aimed to investigate whether anthropometric measurements of the hand, grip strength, and pinch strength could serve as predictive indicators for CTS through machine learning techniques. Enrollment encompassed patients exhibiting CTS symptoms (n = 56) and asymptomatic healthy controls (n = 56), with confirmation via electrophysiological assessments. Anthropometric measurements of the hand were obtained using a digital caliper, grip strength was gauged via a digital handgrip dynamometer, and pinch strengths were assessed using a pinchmeter. A comprehensive analysis was conducted employing four most common and effective machine learning algorithms, integrating thorough parameter tuning and cross-validation procedures. Additionally, the outcomes of variable importance were presented. Among the diverse algorithms, Random Forests (accuracy of 89.474%, F1-score of 0.905, and kappa value of 0.789) and XGBoost (accuracy of 86.842%, F1-score of 0.878, and kappa value of 0.736) emerged as the top-performing choices based on distinct classification metrics. In addition, using variable importance calculations specific to these models, the most important variables were found to be wrist circumference, hand width, hand grip strength, tip pinch, key pinch, and middle finger length. The findings of this study demonstrated that wrist circumference, hand width, hand grip strength, tip pinch, key pinch, and middle finger length can be utilized as reliable indicators of CTS. Also, the model developed herein, along with the identified crucial variables, could serve as an informative guide for healthcare professionals, enhancing precision and efficacy in CTS prediction.

Prevalence and associated risk factors of carpal tunnel syndrome among orthopedic surgeons working in Riyadh, KSA

Objective: This study aimed to investigate the prevalence of carpal tunnel syndrome (CTS) and its associated risk factors among orthopedic surgeons working in Riyadh, Saudi Arabia. Methods: This cross-sectional study was conducted among orthopedic surgeons working in multiple hospitals in Riyadh, Saudi Arabia. The data were collected from the participants through Boston Carpal Tunnel Syndrome Questionnaire (BCTQ). Results: This study enrolled 151 orthopedic surgeons. Around 39.1% were aged between 25 and 29 years old, with males being dominant (88.1%). And 39.7% were overweight (25 – 29.9 kg/m2). Most of them were right-handed (93.4%). The prevalence of surgeons who were diagnosed with CTS was 3.3%. Around 20.5% were consultant surgeons with 57.6% had 1 to 5 years of experience and 55.6% had 5 or less performed surgeries per week. The overall mean score of the Symptom Severity Scale (SSS) domain was 13 (SD 4.12), with 62.3% considered as having no symptoms. Regarding the Functional Status Scale (FSS) domain, the total mean score was 8.38 (SD 1.49), with nearly all categorized as no difficulty (83.4%). It was observed that increasing SSS score was associated with increasing BMI level (Z=2.164; p=0.030) and performing arthroscopic procedures (Z=2.653; p=0.008), while a higher FSS score was more associated with conducting arthroscopic procedures (Z=1.438; p=0.021) Conclusion: The prevalence of mild to severe CTS symptoms among orthopedic surgeons was 37.7%. Increased severity was more prevalent among surgeons with elevated body mass index, while those regularly dealing with arthroscopic procedures had increased symptom severity and functional difficulties.

Long-Term Outcomes of Non-surgical versus Surgical Treatment for Carpal Tunnel Syndrome: An Observational Cohort Study

Background: Carpal Tunnel Syndrome (CTS) is a common condition that significantly impacts patients' quality of life and work productivity. While both non-surgical and surgical treatments are employed, there is a lack of consensus regarding the most effective management strategy.&#x0D; Objective: This study aims to compare the outcomes of non-surgical and surgical treatments for CTS, focusing on symptom severity, functional status, and patient satisfaction.&#x0D; Methods: This observational cohort study included 74 participants, with 37 in each treatment group (non-surgical and surgical). Demographic data, including age, gender, occupation, and hand dominance, were recorded. Clinical parameters assessed were duration and severity of CTS symptoms, previous treatments, and comorbid conditions. The non-surgical group underwent treatments like wrist splinting, NSAIDs, and physical therapy, while the surgical group underwent decompression surgery. Outcomes measured included frequency and severity of symptoms, impact on daily activities, and satisfaction with treatment outcomes. Data were analysed using descriptive statistics to compare between groups.&#x0D; Results: The average age was 50 ± 9 years in the non-surgical group and 52 ± 8 years in the surgical group, with a predominance of females in both. The non-surgical group showed higher frequency and severity of symptoms, with daily symptoms reported by 76.1% of patients, compared to 44.4% in the surgical group. Severity of pain was higher in the non-surgical group (5.8 out of 10) than in the surgical group (2.8 out of 10). Satisfaction with surgical outcomes was high, with all patients in the surgical group reporting satisfaction despite a 100% rate of postoperative complications.&#x0D; Conclusion: The study indicates that surgical treatment for CTS may be more effective in reducing symptom severity and improving patient satisfaction compared to non-surgical methods. However, the high rate of postoperative complications in the surgical group necessitates careful consideration and patient counselling regarding treatment choices.&#x0D; Keywords: Carpal Tunnel Syndrome, Non-surgical Treatment, Surgical Treatment, Patient Outcomes, Symptom Severity, Treatment Satisfaction

Prevalence of Carpal Tunnel Syndrome Symptoms in Excavator Machine Drivers in District Swat, Pakistan

The objective of this study was to investigate the prevalence of carpel tunnel syndrome (CTS) symptoms among excavator machine drivers in the district of Swat, Pakistan.  The duration of the research study was six months and the data was collected within two months. Data was collected by a CTS diagnostic questionnaire. The sample size calculated for the research study was 292. A convenience sampling technique was used in this study.  There were 3 categories of diagnostic CTS questionnaire in which 10(3.4%) fell in unlikely CTS (1-2 score category-1), 134(45%) fell in the suggested possibility of CTS (3-4 score category-2) and 148(50.7%) fell in strongly suggestive of CTS (5 or more score category-3). The mean and standard deviation of CTS symptoms among excavator driver participants was 2.4726±0.56465. We observed an association between CTS symptoms and excavator machine drivers through the Chi-square test. The results of this study demonstrate a high prevalence of CTS symptoms among excavator machine drivers in the district of Swat, Pakistan.

Comparative evaluation of low-level laser therapy and multi-wave locked system laser therapy for carpal tunnel syndrome: a retrospective study

Purpose: This study aimed to evaluate the effects of Low-Level Laser Therapy (LLLT) and Multi-Wave Locked System (MLS) Laser Therapy on clinical and functional parameters in Carpal Tunnel Syndrome.&#x0D; Methods: In the study, 60 patients with mild-moderate carpal tunnel syndrome were evaluated retrospectively in 3 groups. Group I; LLLT, Group II; MLS Laser therapy, Group III; It consisted of patients who did not receive any laser application and were given splints, a home exercise program and patient education. Visual Analogue Scale (VAS), Hand Grip Strength measurement and BOSTON Carpal Tunnel Questionnaire measurements were evaluated from the patients' files at baseline, 4th week and 12th week.&#x0D; Results: Statistically significant improvements were observed in all parameters in Group I and Group II at 4 weeks and 12 weeks compared to baseline. Group III showed no significant differences in grip strength measurements and the BOSTON Functional Status Scale at 4 weeks compared to baseline. The changes between baseline and 4 weeks were statistically significantly better in Group I and Group II compared to Group III for all parameters. No significant difference was found between Group I and Group II in VAS and grip strength improvements, but the improvement in Boston Symptom Severity Scale was significantly more prominent in Group II than in Group I.&#x0D; Conclusion: Both LLLT and MLS Laser Therapy can be considered as conservative treatment options along with splinting and exercise to control the symptoms of Carpal Tunnel Syndrome. MLS Laser Therapy may be superior to LLLT in reducing symptom severity.

Central Sensitization in Patients with Chronic Pain Secondary to Carpal Tunnel Syndrome and Determinants.

Central sensitization (CS) is commonly seen in chronic pain disorders, including neuropathic pain. However, there exist inconsistencies concerning the presence of CS in chronic pain secondary to carpal tunnel syndrome (CTS). CS and neuropathic pain manifestations in CTS remain not well established. Therefore, this study aims to investigate the CS and pain profiles in patients with CTS and to explore the potential determinants associated with CS. Patients with suspected CTS symptoms lasting 3 months or above and healthy controls were enrolled. History, physical examinations, and nerve conduction studies were employed to confirm the diagnosis and severity of median nerve dysfunction. The central sensitization inventory (CSI) was used to screen CS. Other outcomes included neuropathic pain, CTS-specific symptom severity and functions, emotion, and health-related quality of life. Between-group comparisons were conducted in terms of the CS presence. Logistic regression analysis was performed to identify determinants associated with CS. Over 60% of participants with CTS were found with clinical CS, significantly higher than that in the control group. More than 70% of the CTS participants were identified to have possible or very likely neuropathic pain components. In addition, one-fourth of CTS cases had depression or anxiety. Anxiety was associated with an increased risk of developing CS in CTS (adjusted OR=1.31, 95% CI 1.08-1.59), whereas higher self-perceived general health rating was negatively associated with the presence of CS (adjusted OR=0.92, 95% CI 0.88-0.97) in the multivariate adjusted regression model. CS is prevalent in patients with CTS. Predominant neuropathic pain characteristics were uncovered in CTS patients as well as comorbid psychological distress. Significant association was found between anxiety and CS presence. Self-perceived general health was inversely related to CS. Further research is warranted to explore the mechanisms of anxiety and central pain processing in painful entrapment neuropathy.

Reliability and Validity of the Turkish Version of the 6-item Carpal Tunnel Syndrome Symptoms Scale

Reliability and Validity of the Turkish Version of the 6-item Carpal Tunnel Syndrome Symptoms Scale

Case Series of Non-Specific Volar Wrist Swellings in a Malaysian Urban Tertiary Centre

We collected a series of 5 patients with non-specific volar wrist swellings which were not ganglions. These swellings were of a mean 4x4cm in measurement with a vague history. The dilemma was to decide a correct diagnosis in clinic to ensure the relevant investigations were performed and to adequately inform patients who were worried and anxious about the swelling. Symptom presentations were pain (n=4), carpal tunnel syndrome symptoms (n=3) and one had triggering of the middle finger. The mean age was 54.8 years and mean duration to surgery was 15 months. All had the swelling on their dominant wrist and underwent surgical excision. Finally, two swellings were tuberculosis (TB), one was gout and two were tenosynovitis.

Reported Symptoms and Associated Factors of Carpal Tunnel Syndrome in Qassim Region: A Cross-Sectional Study.

Background Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, occurring through compression of the median nerve as it passes under the transverse carpal ligament. Symptoms include nocturnal pain and paresthesias confined to the thumb, middle, and index fingers. Objective The purpose of this study is to determine the prevalence of CTS symptoms and the associated risk factors in Qassim Province, Kingdom of Saudi Arabia. Materials and methods A total of 314 participants were recruited from Qassim Province using an online survey, which included demographic questions and the Boston Carpal Tunnel Questionnaire (BCTQ). The association between categorical variables was assessed using the Chi-square test or Fisher's exact test, as appropriate. Additionally, an independent t-test was performed to compare quantitative variables. A p-value of less than 0.05 was considered statistically significant. Result The prevalence of CTS in the Qassim population was found to be 19.7%. The most significant risk factors for CTS were age, chronic illnesses, and employment status (p < 0.001). The most frequently reported symptoms included daytime pain and weakness (82.3%), while obesity emerged as the most prevalent chronic disease (21%). The mean symptom severity score (SSS) was significantly higher for individuals who were awoken from pain (t = -5.89; p < 0.001) and for those who experienced awakening due to numbness and tingling (t = -5.59; p < 0.001). Conclusion According to our sampled cohort, 19.7% of individuals had symptoms of CTS etiology. Multiple risk factors for CTS were identified. Notably, the development of CTS symptoms was significantly associated with individuals aged 50 and older, employment status, and the presence of related chronic diseases.

Psychophysiological and Neurophysiological Correlates of Dropping Objects from Hands in Carpal Tunnel Syndrome.

Dropping objects from hands (DOH) is a common symptom of carpal tunnel syndrome (CTS). We evaluated the clinical, neurophysiological, and psychophysiological features of 120 CTS patients to elucidate the DOH pathophysiology. Forty-nine healthy controls were included. In the patients, the Boston Carpal Tunnel Questionnaire (BCTQ), the Douleur Neuropathique 4 questions (DN4), and a numeric rating scale for pain (NRS) were evaluated. In patients and controls, we evaluated bilateral median and ulnar motor and sensory nerve conduction studies, cutaneous silent period and cutaneomuscular reflexes (CMR) of the abductor pollicis brevis, cold-detection threshold (CDT) and heat-pain detection threshold (HPT) at the index, little finger, and dorsum of the hand, and vibratory detection threshold at the index and little finger by quantitative sensory testing. CTS with DOH had higher BCTQ, DN4 and NRS, lower median sensory action potential, longer CMR duration, lower CDT and higher HPT at all tested sites than controls and CTS without DOH. Predictive features for DOH were abnormal CDT and HPT at the right index and dorsum (OR: 3.88, p: 0.03) or at the little finger (OR: 3.27, p: 0.04) and a DN4 higher than 4 (OR: 2.16, p < 0.0001). Thermal hypoesthesia in median and extra-median innervated territories and neuropathic pain are predictive of DOH in CTS.