When the median nerve is squeezed, there can be tingling,
pain, weakness, or numbness in the wrist and hand that radiates up the arm. Treatment options include rest, immobilization of the wrist, and surgery to reduce pressure on the nerve. “A common perception is that carpal tunnel is related to
hand use,” Ring
says.That perception is more common among consumers, he says, but some doctors also believe it. Studies on whether carpal tunnel syndrome is associated with hand use have been mixed.
Carpal Tunnel vs. Repetitive Strain Injury Ring differentiates between carpal tunnel syndrome and
repetitive strain injury, which he prefers to call idiopathic (cause unknown) arm pain. In this condition, he says, there is pain “but no evidence
of injury. It doesn’t involve the carpal tunnel.” The Study
To clarify the debate, Ring and his colleagues looked at 117
studies on carpal tunnel syndrome published in the medical lit- erature. They used scientific criteria that determines the strength of a cause-and-effect relationship by giving it a score. The researchers looked at biological factors -- such as ge-
netics -- and occupational factors -- such as a person’s job or the amount of repetitive hand use. After analyzing the studies, “The quality and strength of
evidence supporting genetic or inherent risk factors was felt to be moderate,” Ring says. “The quality and strength of evidence supporting occupational risk factors was felt to be poor,” he says.
Average scores for biological factors linked to carpal tunnel
syndrome were double those of occupational factors, such as occupation or repetitive hand use, Ring reports.
Implications of the Study “The link to genetics is strong and believable,” Ring says.
“If you are diagnosed with carpal tunnel, you are an innocent bystander. You did nothing to cause it.” “This should give reassurance to those who use their hands
a lot,” he says.
Written by By Kathleen DohenySOURCES: David Ring, MD, assistant professor of orthopaedic surgery, Harvard Medical School; hand and upper extremity surgeon, Massachusetts General Hospital, Boston. 74th Annual Meeting of the Ameri- can Academy of Orthopaedic Surgeons, San Diego, Feb. 16, 2007.
MARCH 2007
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