Carpal Tunnel Syndrome

The carpal tunnel syndrome is a compression neuropathy of the median nerve, caused by swelling of the carpal transverse ligament.This initially results in paraesthesia of the first to fourth digits, which is usually worse at night. Eventually,when the compression is allowed to persist, muscular atrophy and even contractures may ensue.

Epidemiology

CTS occurs in about 25% of patients with type 1 diabetes, in 15% of those with type 2 diabetes and in 4% of the general population. Those with pre-diabetic states also seem to have an increased risk for CTS. Both duration of diabetes and repetitive movements seem to increase the risk of CTS.

Diagnosis and treatment

The diagnosis is made based on the clinical symptoms. However, sometimes it is difficult to differentiate the neuropathy of CTS from diabetic polyneuropathy. In such cases neurophysiological investigation can help to differentiate. Incidentally both neuropathies can co-exist. CTS is painful and in the long run disabling. It can be relatively easy treated by surgical transsection of the swollen ligament. Early diagnosis helps to avoid unnecessary delay in performing surgery.

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