ABSTRACT

Objective:

Carpal tunnel syndrome (CTS) is the most common peripheral mononeuropathy developed by compression of the median nerve within the Carpal tunnel at the wrist. Diagnosis is made by history and physical examination, and confirmed objectively by electrodiagnostic study evaluating median nerve dysfunction. If untreated CTS can cause permanent damage. In this study, we have reviewed the patients diagnosed CTS without any secondary causes and untreated.

Material and Methods:

The patients who presented to the outpatient clinic consecutively with complaints of numbness, tingling, pain and weakness in their hands were evaluated for their demographic features and done Phalen-Tinel provocation tests, sensory testing with cotton and needle tip after obtaining the Ethics Committee approval. Muscle strength was assessed by first and fifth finger opposition, and presence of thenar atrophy was investigated. After the initial evaluation, the diagnosis of CTS was confirmed by electromyography (EMG). Cases were evaluated for the presence of any disease that may lead to for CTS (metabolic, rheumatic, trauma, etc.). The severity of pain, numbness and weakness were evaluated by functional status scale (FSS), symptom severity score (SSS), and by visual assessment scale (VAS). Mann-Whitney U test, independent t test were used to compare the data; Spearman correlation analysis was used for the relationship between parameters (significance p<0.05).

Results:

All 45 cases with mild-to-moderate CTS by EMG were women; The mean age was 47.86±9.74 years (29-66 years). Mean height was 159.16±5.16 cm (148-170 cm) and mean weight was 76.31±12.67 kg (53-115 kg). All cases were housewifes, and 32 cases had bilateral while 13 cases had unilateral CTS (total 77 hands). The mean of weekly cleaning frequency was 4.16±2.3 days (1-7 days). At the evaluation of 77 hands, 56 (72.7%) had numbness, 2 (2.6%) had pain, 15 (19.5%) had numbness and pain, and 4 (5.2%) had numbness and weakness. Thenar atrophy were detected at 23/77 (70.1%) hands. At 45/77 hands (58.4%), we were detected hypoesthesia. Muscle strength was 5/5 at 58/77 (75.3%) hands and 4/5 at 19/77 (24.6%) hands. In all hands (n=77), Phalen and Tinel signs were present. Fifty-two of seventy-seven EMG (67.5%) showed sensory CTS, and 25 of 77 EMG (32.5%) showed sensory and motor CTS. Mean FDS was 24.1±5.6 (10 to 33); mean SSS was 31±9.3 (14 to 52), and mean VAS was 6.66±1.99 (2 to 10). There were significant correlation with the number of weekly cleaning days and FDS (r=0.376, p=0.011) and SSS (0.341, p=0.022). There were no difference between EMG groups (sensory vs sensory and motor) for the number of weekly cleaning days, for VAS, FSS and SSS (p>0.05).

Conclusions:

Most of our cases presented with complaints of numbness in their affected hands. Thenar atrophy was present in important number of patients. Doing house work is noted as an important risk factor for CTS in our cases.