Introduction: Definition, Wrist Anatomy, Symptoms, Diagnosis, and Frequency of Occurrence
This research reviews carpal tunnel syndrome. Carpal tunnel syndrome in a medical context is a nerve entrapment disorder (Carpi, 1989). The tendons connecting the fingers to arm muscles pass through a small opening in the wrist, and they are surrounded by synovial sheaths. The synovial sheaths are thin, fluid-filled sacs, which swell when the tendons are overused. The swelling squeezes the median nerve against the wrist bone, or carpal ligament. The wrist is a freely movable joint in which the carpal bones glide across one another. Movement of the bonds is restricted by ligaments. The median nerve provides sensation to the entire hand, and pressure on the nerve causes pain. Presenting symptoms include paresthesias and weakness in the territory of the median nerve (Rakel, 1991). Carpal tunnel syndrome includes symptoms of pain, numbness, and weakness in the muscles that are enervated by branches of the median nerve (American Medical Association, 1989). Early complications of carpal tunnel syndrome include chronic peritoneal dialysis and hemodialysis (Bickness, 1991).
Diagnosis of carpal tunnel syndrome may occur through a variety of procedures. The measurement of differences in sensory conduction and velocity between different sensory branches and segments of the median and ulnar nerves is one such procedure (Joynt, 1989). Measurement of lumbrical latency and amplitude is another diagnosis procedure (Fitz, 1990). A third diagnostic procedure is electro-diagnosis, which is useful in diagnosing mild cases of carpal tunnel syndrome (Jackson, 1989). Diagnosis may also be made through the measurement and assessment of the anterior interosseous/median nerve latency ratio (Rosenberg, 1990). The extent to which one can flex one's wrist is also a diagnostic indicator of carpal tunnel syndrome (Duncan, 1991). Failure to correctly d...