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1. Carpal tunnel syndrome: Scenario: Management of carpal tunnel syndrome.

(such as a rheumatologist, orthopaedic surgeon, hand surgeon, neurologist or intermediate musculoskeletal assessment and treatment service) depending on local policy, with urgency depending on clinical judgement, where: The diagnosis is unclear. Symptoms are severe or functional ability is reduced. Symptoms recur following carpal tunnel surgery. The patient requests a referral. Conservative management in primary care has failed. A serious condition such as neurological disease, inflammatory joint disease, peripheral (...) limb ischaemia or cervical nerve root entrapment is suspected. If referral is not indicated, manage carpal tunnel syndrome (CTS) in primary care by: Optimizing treatment of any underlying condition, such as osteoarthritis, rheumatoid arthritis or hypothyroidism. See the CKS topics on , and for further information. Advise the person that lifestyle modifications (such as avoidance of repetative movements or breaks from tasks that precipitate symtoms) may help. If CTS is work related – advise

2017 NICE Clinical Knowledge Summaries

2. Carpal tunnel syndrome: How should I assess a person with suspected carpal tunnel syndrome?

, for example, they may have sensory changes in all digits. Severe disease may cause unremitting sensory symptoms, weakness or thenar muscle wasting. which may be associated with carpal tunnel syndrome such as osteoarthritis or inflammatory arthritis. Red flags for serious conditions such as fracture, onset of tingling/ numbness after injury, or suspected tumour. Exacerbating factors such as sleep, sustained hand or arm positions, and repetitive movements of the hand or wrist. Relieving factors (...) Carpal tunnel syndrome: How should I assess a person with suspected carpal tunnel syndrome? Diagnosis | Diagnosis | Carpal tunnel syndrome | CKS | NICE Search CKS… Menu Diagnosis Carpal tunnel syndrome: How should I assess a person with suspected carpal tunnel syndrome? Last revised in September 2016 How should I assess a person with suspected carpal tunnel syndrome? Take a history asking about: Onset, duration, site and severity of symptoms. Typical symptoms include intermittent tingling

2017 NICE Clinical Knowledge Summaries

3. Carpal tunnel syndrome

Carpal tunnel syndrome Evidence Maps - Trip Database or use your Google+ account Liberating the literature ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 (...) of known issues . Also read , explaining issues with the system. NOTE : Chrome is the best browser to use! To get started, type a condition/disease into the search box above. Here are some examples to get you started: Building Evidence Map X Axis Alphabetically Risk of bias No. Articles Sample Size Risk of bias any low Minimum sample size Apply Follow us: © 2019 Trip Database Ltd. company number 04316414. Trip is proud to be made in the UK.

2018 Trip Evidence Maps

4. Carpal tunnel syndrome: sometimes drug-related

the shoulder. Carpal tunnel syndrome is common in adults, more so in pregnant or postmenopausal women, obese patients and those with diabetes, hypothyroidism, or amylosis. Trauma to the hand and wrist area, such as a broken wrist, repetitive, forceful movements, or hand and wrist vibrations, can lead to carpal tunnel syndrome. Median nerve neuropathy, connective tissue disease or joint disorders such as osteoarthritis or rheumatoid arthritis can also be a cause. Carpal tunnel syndrome is sometimes (...) caused by certain drugs, and disappears when the medication is stopped. Carpal tunnel syndrome is a set of sensory and sometimes motor disorders caused by compression of the median nerve at the wrist in the carpal tunnel. Its symptoms are pain, tingling, numbness in the sensory area of the median nerve: thumb, index finger, middle finger and the side of the ring finger facing the middle finger. In some patients, these symptoms extend to the entire hand or sometimes spread to the forearm and even

2019 Prescrire

5. Value of ultrasonography in the diagnosis of carpal tunnel syndrome-a new ultrasonographic index in carpal tunnel syndrome diagnosis: A clinical study. Full Text available with Trip Pro

Value of ultrasonography in the diagnosis of carpal tunnel syndrome-a new ultrasonographic index in carpal tunnel syndrome diagnosis: A clinical study. We analyze the effectiveness of ultrasonography in diagnosing carpal tunnel syndrome (CTS) and propose the use of sonographic index of median nerve (MN) in carpal tunnel (SIMNCT) in a diagnostic algorithm and in establishing a scale of severity.We studied a group of 344 patients with CTS symptoms, examining them by ultrasound. We measured in all (...) patients, on the affected hand: the size of the cross-sectional area of the MN at carpal tunnel (CT) inlet and outlet, nerve morphology at passage through CT, the vertical thickness of the MN entering into the CT - G1, the lowest vertical thickness into the CT or leaving the CT - G2, the thickness of the MN in the transversal plane as entering in the CT - L. Normal values were considered the similar measurements taken on the healthy hand and we established as normal SIMNCT = 16%. We proposed

2020 Medicine

6. In adults with mild to moderate carpal tunnel syndrome (CTS) are physiotherapy led exercises better than no treatment in improving pain and function?

? Clinical bottom line There is no evidence found that can answer this question. Why is this important? CTS is the commonest peripheral neuropathy and causes considerable disability with pain, decreased function and work absence. Although clinically treatment of patients with this condition was rare, it raised the question what is the best evidence based physiotherapy treatment for carpal tunnel syndrome. Search timeframe (e.g. 2006-2016) Inclusion Criteria Description Search terms Population and Setting (...) In adults with mild to moderate carpal tunnel syndrome (CTS) are physiotherapy led exercises better than no treatment in improving pain and function? Getting Evidence into Clinical Practice: Musculoskeletal Research Facilitation Group (CAT Group) Date:10/05/2018 CAT Lead: Julie Shufflebotham. Date CAT completed: February 2018 Specific Question: In adults with mild to moderate carpal tunnel syndrome (CTS) are physiotherapy led exercises better than no treatment in improving pain and function

2018 Public Health England

7. Are 24 hour use splints more effective than night splints in the improvement of symptoms in mild to moderate carpal tunnel syndrome?

Are 24 hour use splints more effective than night splints in the improvement of symptoms in mild to moderate carpal tunnel syndrome? Getting Evidence into Clinical Practice: Musculoskeletal Research Facilitation Group (CAT Group) Date: 31.10.2018 CAT Lead: Dr Graham Davenport Date CAT completed: 31.10.2018 To be reviewed in 5 years i.e. 31.10.2023 g.j.davenport@keele.ac.uk Specific Question: Are 24 hour use splints more effective than night splints in the improvement of symptoms in mild (...) to moderate carpal tunnel syndrome? Clinical bottom line There is no evidence that 24 hour use splints are more effective than night splints in the improvement of symptoms in mild to moderate carpal tunnel syndrome. The practice of using night splints in the management of symptoms in mild to moderate carpal tunnel syndrome remains unchanged. Further research in the use of splints for varying periods of time is recommended to find the optimum period of splint use to improve symptoms of pain and increased

2018 Public Health England

8. Correction to: Sonographic follow-up after endoscopic carpal tunnel release for severe carpal tunnel syndrome: a one-year neuroanatomical prospective observational study. Full Text available with Trip Pro

Correction to: Sonographic follow-up after endoscopic carpal tunnel release for severe carpal tunnel syndrome: a one-year neuroanatomical prospective observational study. An amendment to this paper has been published and can be accessed via the original article.

2020 BMC Musculoskeletal Disorders

9. Carpal tunnel syndrome

Carpal tunnel syndrome Carpal tunnel syndrome - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Carpal tunnel syndrome Last reviewed: February 2019 Last updated: December 2017 Summary Most common entrapment neuropathy (prevalence about 1 in 25). Women aged between 40 and 60 years are at highest risk. Symptoms include numbness and/or tingling of the thumb and radial fingers, aching wrist, and clumsiness. Physical (...) examination mainly useful for ruling out other diagnoses. Electrodiagnostic studies are useful in diagnosis and management. Treatment options range from wrist splints through to surgical release. Definition Carpal tunnel syndrome (CTS) is a collection of symptoms and signs caused by compression of the median nerve in the carpal tunnel. Typical symptoms include numbness and tingling mainly in the thumb and radial fingers, aching and pain in the anterior wrist and forearm, and clumsiness in the hand

2017 BMJ Best Practice

10. Carpal Tunnel Release Surgery Plus Intraoperative Corticosteroid Injection versus Carpal Tunnel Release Surgery Alone: A Double Blinded Clinical Trial. (Abstract)

Carpal Tunnel Release Surgery Plus Intraoperative Corticosteroid Injection versus Carpal Tunnel Release Surgery Alone: A Double Blinded Clinical Trial. Background: Carpal tunnel syndrome is a prevalent disease with significant morbidity. The current treatments range from oral medication and local corticosteroid injection to surgical carpal tunnel release (CTR). In this study, we tried to assess the results of Carpal Tunnel Release surgery in combination with the anti-inflammatory effect (...) of local corticosteroid injection. Methods: 65 patients were enrolled by clinical and electrodiagnostic tests and randomly divided into two groups, 32 in group one which underwent surgery with Dexamethasone injection and 33 in group 2 which intervened with carpal tunnel release surgery alone. Data on Boston questionnaire of patients were conducted before and two weeks after surgery. Distal motor and sensory latencies of patients were recorded before and two months after surgery. Mean values were

2019 The journal of hand surgery Asian-Pacific volume Controlled trial quality: uncertain

11. [The effects of standardised cold and compression therapy on swelling, pain and functional outcome after division of the transverse carpal ligament in carpal tunnel syndrome]. (Abstract)

[The effects of standardised cold and compression therapy on swelling, pain and functional outcome after division of the transverse carpal ligament in carpal tunnel syndrome]. This prospective, randomised study examines the effect of standardised cold compression therapy on swelling, pain and functional outcome after division of the transverse carpal ligament in carpal tunnel syndrome in comparison to cooling alone.Fifty patients for division of the transverse carpal ligament were randomised (...) at any time point.In this study, no advantage could be demonstrated for standardised cooling and compression therapy with the Cryo/Cuff™-system in comparison with conventional cooling after division of the transverse carpal ligament.© Georg Thieme Verlag KG Stuttgart · New York.

2018 Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V... Controlled trial quality: uncertain

12. The usefulness of ultrasonography to diagnose the early stage of carpal tunnel syndrome in proximal to the carpal tunnel inlet: A prospective study. Full Text available with Trip Pro

The usefulness of ultrasonography to diagnose the early stage of carpal tunnel syndrome in proximal to the carpal tunnel inlet: A prospective study. This study aimed to investigate the relationship between the change of median nerve cross-sectional area (CSA) and the severity of carpal tunnel syndrome (CTS) determined by electrodiagnostic study based on the area immediately proximal to the carpal tunnel inlet (IPCTI).From December 2016 to August 2017, 34 patients (8 men and 26 women; mean age (...) , 61.68 years ± 11.83; range, 28-80 years) with CTS symptoms were recruited. Electrodiagnostic study was performed in all patients to categorize the severity of CTS according to Bland classification. The CSA of median nerve and carpal tunnel at IPCTI, and carpal tunnel inlet/outlet level was measured by one physician. The Kruskal-Wallis test was used for comparing the CSA of the median nerve and carpal tunnel among CTS severity groups divided by electrodiagnostic study. The Dunn procedure was used

2019 Medicine

13. Sonographic follow-up after endoscopic carpal tunnel release for severe carpal tunnel syndrome: a one-year neuroanatomical prospective observational study. Full Text available with Trip Pro

Sonographic follow-up after endoscopic carpal tunnel release for severe carpal tunnel syndrome: a one-year neuroanatomical prospective observational study. Endoscopic carpal tunnel release (ECTR) has been gradually adopted for the treatment of severe carpal tunnel syndrome (CTS). However, perioperative assessment of neuroanatomical parameters of median nerve, which are important determinant of median nerve recovery, has rarely been reported. This one-year prospective study aimed to investigate (...) the natural history of the neuroanatomical morphology of the median nerve after ECTR in severe CTS patients by high-frequency ultrasonography and assess the ability of neuroanatomical measures to quantify morphological recovery of the median nerve after ECTR.This study recruited 31 patients (44 wrists) with a definitive diagnosis of severe CTS and underwent ECTR operation. The edema length (EL) of median nerve from the inlet of the carpal tunnel to the proximal wrist was detected on long axis imaging

2019 BMC Musculoskeletal Disorders

14. Outcomes of Endoscopic Carpal Tunnel Release With Ring Finger Flexor Digitorum Superficialis Opponensplasty in Severe Carpal Tunnel Syndrome. (Abstract)

Outcomes of Endoscopic Carpal Tunnel Release With Ring Finger Flexor Digitorum Superficialis Opponensplasty in Severe Carpal Tunnel Syndrome. To evaluate the outcomes of endoscopic CTR with ring finger flexor digitorum superficialis (FDS) opponensplasty for the treatment of patients with severe carpal tunnel syndrome (CTS).We prospectively studied 52 patients who were graded as having severe CTS by physical examination and electrodiagnostic studies and who underwent endoscopic CTR-ring finger

2019 Journal of Hand Surgery - American

15. Group education, night splinting and home exercises reduce conversion to surgery for carpal tunnel syndrome: a multicentre randomised trial Full Text available with Trip Pro

Group education, night splinting and home exercises reduce conversion to surgery for carpal tunnel syndrome: a multicentre randomised trial Group education, night splinting and home exercises reduce conversion to surgery for carpal tunnel syndrome: a multicentre randomised trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable (...) Your RSS Feed Name of RSS Feed: Number of items displayed: Create RSS Cancel RSS Link Copy Actions Cite Share Permalink Copy Page navigation J Physiother Actions . 2020 Apr;66(2):97-104. doi: 10.1016/j.jphys.2020.03.007. Epub 2020 Apr 11. Group education, night splinting and home exercises reduce conversion to surgery for carpal tunnel syndrome: a multicentre randomised trial , , , , , Affiliations Expand Affiliations 1 Occupational Therapy Department, Gold Coast University Hospital, Gold Coast

2020 EvidenceUpdates

16. Ultrasound-Guided Corticosteroid Injection in Carpal Tunnel Syndrome: Comparison Between Radial and Ulnar Approaches Full Text available with Trip Pro

Ultrasound-Guided Corticosteroid Injection in Carpal Tunnel Syndrome: Comparison Between Radial and Ulnar Approaches Ultrasound-Guided Corticosteroid Injection in Carpal Tunnel Syndrome: Comparison Between Radial and Ulnar Approaches - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. COVID-19 is an emerging, rapidly evolving situation (...) at most: Send even when there aren't any new results Optional text in email: Save Cancel Create a file for external citation management software Create file Cancel Your RSS Feed Name of RSS Feed: Number of items displayed: Create RSS Cancel RSS Link Copy Actions Cite Share Permalink Copy Page navigation J Pain Res Actions . 2020 Jun 26;13:1569-1578. doi: 10.2147/JPR.S248600. eCollection 2020. Ultrasound-Guided Corticosteroid Injection in Carpal Tunnel Syndrome: Comparison Between Radial and Ulnar

2020 EvidenceUpdates

17. Carpal Tunnel Syndrome (CTS) Guideline

disorder. It produces a constellation of specific symptoms and signs, described as carpal tunnel syndrome (CTS). The annual incidence in the general population has been reported to be approximately 1/1000. [1] The incidence in Washington’s workers’ compensation population peaked at approximately 2.73/1000 in the mid- 1990s. [2] Documentation of appropriate symptoms and signs, diagnostic testing, and a statement attesting to probable work-relatedness must be present for Labor and Industries to accept (...) a CTS claim. Nerve conduction velocity studies (NCVs) should be scheduled immediately to corroborate the clinical diagnosis. a http://app.leg.wa.gov/RCW/default.aspx?cite=51.36.010 4 Washington State Department of Labor and Industries Carpal Tunnel Syndrome Guideline – 2017, amended July 2020 B. Establishing Work-relatedness CTS may result from numerous conditions, including inflammatory or non-inflammatory arthropathies, recent or remote wrist trauma or fractures, diabetes mellitus, obesity

2017 Washington State Department of Labor and Industries

18. Carpal tunnel syndrome: What else might it be?

Carpal tunnel syndrome: What else might it be? Differential diagnosis | Diagnosis | Carpal tunnel syndrome | CKS | NICE Search CKS… Menu Differential diagnosis Carpal tunnel syndrome: What else might it be? Last revised in September 2016 What else might it be? The differential diagnosis for carpal tunnel syndrome includes: Cervical radiculopathy. Ulnar nerve compression. De Quervains tenosynovitis. Lateral epicondylitis. Osteoarthritis or inflammatory arthritis. Vibration white finger or hand (...) -arm vibration syndrome. Raynaud’s phenomenon. Neuropathy due to conditions such as diabetes mellitus, hypothyroidism, and B12 deficiency. Motor neurone disease. Multiple sclerosis. Stroke. Basis for recommendation The information on differential diagnosis is based on expert opinion in review articles [ ; ; ; ]. © .

2017 NICE Clinical Knowledge Summaries

19. Carpal tunnel syndrome

Carpal tunnel syndrome Carpal tunnel syndrome | Topics A to Z | CKS | NICE Search CKS… Menu Carpal tunnel syndrome Carpal tunnel syndrome Last revised in September 2016 Carpal tunnel syndrome (CTS) is a collection of symptoms and signs caused by compression of the median nerve in the carpal tunnel at the wrist. Diagnosis Management Background information Carpal tunnel syndrome: Summary Carpal tunnel syndrome (CTS) is a collection of symptoms and signs caused by compression of the median nerve (...) in the carpal tunnel at the wrist. In most people the cause of CTS is not known. Factors that have been associated with an increased risk of CTS include activities with high hand/wrist repetition rate, obesity, hypothyroidism and diabetes mellitus. CTS is the most common compression neuropathy of the upper limb and is more common in women than men. CTS can affect activities of daily life (including work) and sleep due to symptoms of intermittent tingling, altered sensation, pain, weakness and impaired fine

2017 NICE Clinical Knowledge Summaries

20. Comparison of the Michigan Hand Outcomes Questionnaire, Boston Carpal Tunnel Questionnaire, and PROMIS Instruments in Carpal Tunnel Syndrome. (Abstract)

Comparison of the Michigan Hand Outcomes Questionnaire, Boston Carpal Tunnel Questionnaire, and PROMIS Instruments in Carpal Tunnel Syndrome. Patient-reported outcomes are important to assess improvement after surgery. Common instruments for carpal tunnel syndrome include the Michigan Hand Outcomes Questionnaire (MHQ) and Boston Carpal Tunnel Questionnaire (CTQ). The Patient-Reported Outcomes Measurement Information System (PROMIS) are newer measures. We evaluated how the PROMIS Pain (...) Interference (PI) and Upper Extremity (UE) scores change after carpal tunnel release.All adult patients with carpal tunnel syndrome treated surgically were asked to participate in this prospective study. PROMIS instruments, MHQ, and CTQ were completed by 101 patients. Estimated means and standard errors were calculated, and piecewise linear fixed effects regression models were applied to the data. Standardized response means were calculated for each outcome measure.The MHQ Total Score did not show

2018 Journal of Hand Surgery - American

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