MUSCULO- SKELETAL
CARPAL TUNNEL SYNDROME (CTS) IS A COMMON, BUT OFTEN RESTRICTIVE, DISORDER THAT CAUSES A TINGLING SENSATION, NUMBNESS AND SOMETIMES PAIN IN THE HAND AND FINGERS. PHARMACIST TIMOTHY MCCLURE TAKES A CLOSER LOOK…
CARPAL TUNNEL SYNDROME M
by Timothy McClure
usculoskeletal disorders are defined as injuries and disorders affecting
the body’s musculoskeletal system – this includes the joints, muscles, tendons, ligaments, nerves and discs.1
There are over 100 different types of musculoskeletal disorders, ranging from the very common to the extremely rare. These disorders can be episodic or chronic in duration and may progress in their severity over time. Though seldom life threatening, musculoskeletal disorders impair the quality of life of a large proportion of the adult population.2
Indeed,
the annual Scottish musculoskeletal health budget is £353 million - the tenth largest NHS annual programme budget in Scotland.3
32 - SCOTTISH PHARMACIST
Carpal tunnel syndrome (CTS) is a common musculoskeletal disorder that can affect the activities of daily life and sleep. It is the most common compression neuropathy of the upper limbs. With most studies citing prevalence at around five per cent in the general population and incidence on the increase, community pharmacists are ideally placed to counsel those affected with CTS in the primary care setting.4
CAUSES
The carpal tunnel comprises eight small carpal bones, bound by the carpal ligament that lies across the palm-side of the wrist. Between this ligament and the carpal bones forms a passage called the carpal tunnel, through which various tendons and
the median nerve pass. The median nerve gives feeling to the thumb, index and middle fingers and half of the ring finger, in addition to controlling movement of small muscles at the base of the thumb.5
Anything
that decreases the amount of space in the carpal tunnel, or increases the pressure within it can compress the median nerve and potentially lead to symptoms of CTS.6,7
cause of CTS is not known.8
there are certain recognised risk factors. These include:
• Activities with high hand/wrist repetition rate
• Pregnancy (up to 50 per cent of pregnant women develop CTS)
• Obesity • Injuries to the wrist including
In most cases, the However,
fractures • Patients with rheumatoid arthritis
• Family history of CTS (about one in four people with CTS have a close family member who also has or had the condition)4,5,7,8
CTS is three times more common is women than men, and becomes more likely as you get older.8
Studies have
shown strong evidence to support the increased risk of CTS associated with overuse of the hand and wrist in such jobs as assembly-line work, gardening and occupations requiring a forceful grip. There is less robust evidence to suggest an association between computer-based work and CTS.7 Interestingly, some studies show that CTS is actually less common in people who type all day than those who carry
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