Talk:Carpal tunnel syndrome

message: Icarus3 wanted to delete the following bullet points from the <B>Non-traumatic</B> part of the Causes section, because "the controversy over whether or not such things cause CTS is covered in more depth in earlier section or article":
*Common activities that have been identified as contributing to repetitive stress induced carpal tunnel syndrome include:
** Use of power tools
** Construction work such as handling many bricks, stone and/or lumber
** Computer keyboarding, typing and using a mouse
** Playing video games or computer games
** Playing a musical instrument
** Cycling, due to pressure and vibration on hands
** Any activity where hand use is vigorous and routine could contribute (surgeons, dentists). Still, these activities are often merely associated with, but do not actually cause, carpal tunnel syndrome.
I disagree, because the following words do not have any other instances in the entire article:
'power', 'construction', 'bricks', 'typing', 'games' or 'cycling'.
I have reversed Icarus3's change, but would welcome discussion on how to integrate these points in a better way.  From my own point of view, the above points were enlightening when I was first investigating Carpal tunnel syndrome, and I think there's a great benefit in having them listed together.  Perhaps it's worthwhile putting some disclaimer againt them to indicate that there is some disagreement between experts, with a reference to the relevant section.  --Matthew 1130 02:50, 24 December 2006 (UTC)
thread_title: Editing Non-traumatic part of the Causes section

message: Let's shine some light down the dark hole this article has been hiding in. Please go to the AID page and vote to have this article spotlighted for a thourough cleaning-up! --DanielCD 00:40, 17 February 2006 (UTC)
thread_title: AID appeal

message: Does anyone know anything about prevention? (Without commercial products)
:There are many ways to prevent CTS. They are very simple yet effective and remain as the crucial part in CTS recovery. Believe me, they are general common sense:
# Maintain a good body posture, especially in the work place. In most of the cases, while sitting in front of a computer desk you want to make sure your shoulders are approaching a 90 degree angle and that your wrists are not resting on the edge of your desk.
# A break from work from time to time is definitely beneficial, lots of shorterm breaks have proven more effective that a few long breaks.  A good pattern would be a 30sec break every 3-5mins.
# A person with a healthier lifestyle can be more immune to contracting CTS, longtime exposure to a repetitive task WILL EVENTUALLY lead to CTS, even if it takes 20yrs.  Improved health can prevent and treat CTS being a combination of: if using a computer use a CTS prevention app, consuming B complex, wearing wrist braces at night and taking hypercium (an extract of St John's Wart).
:I was reading the article and noticed that the Treatment section states that there are 6 types of treatment, and then proceeds to list 4 with 5 and 6 only being numbers in the paragraph.  I have altered the paragraph to read 4 types of treatment and removed the numbers 5 and 6.  this can be changed back when these mysterious fifth and sixth treatments are found.
--Tralfaz (Ralraz, yech) (talk) 16:00, 14 July 2008 (UTC)
thread_title: Treatment

message: An update regarding the Diagnosis of CTS. An article published by Kuschner SH, Ebramzadeh E, Johnson D, Brien WW, Sherman R. at Entrez PubMed, Nov, 1992, suggested that Tinel's sign is not useful in CTS diagnosis. While Phalen's test, remains as a accurate method. Shall this to be revised? OR anyone has any comments? See this:
Tinel's sign and Phalen's test in carpal tunnel syndrome. --Garlics82 16:23, Nov 1, 2004 (UTC)
Another thing on the current diagnosis part; on the Phalen's test paragraph is merely state that if you feel pain/burning/tingling, it would be a sign, but it did not tell you that you're supposed to be looking for these sensations at the fingers, such as stated at the link to the Phalen's test. Pretty much anyone who bent to the extremes of their flexibility would experience discomfort at the wrist.--24.85.147.171 19:00, 31 August 2005 (UTC)
thread_title: Diagnosis

message: Is carpal tunnel syndrome some type of compartmental syndrome? If so, can it be treated using mannitol? --Eleassar777 17:19, 10 Feb 2005 (UTC)
thread_title:  Some questions 

message: Not quite sure how to weave this into the article, but the double-crush syndrome needs to be mentioned.
See http://www.icpa4kids.org/research/chiropractic/carpal.htm and http://www.erinelster.com/carpal_tunnel.html for some references.
The key message is that the primary cause of carpal tunnel syndrome may actually be in the upper back or lower neck.
Excercises that relax and strengthen the back muscles can relieve the wrist symptoms in some cases.
I speak from experience -- a regular regimen of exercises approved by my osteopath prevents my carpal tunnel symptoms from flaring up.  I was able to avoid any surgery.
No one has made mention oc CT Cream which is available and helps to alleviate the pain  —Preceding unsigned comment added by 62.173.35.230 (talk) 11:49, 9 March 2008 (UTC)
replies: text: We have an article for Crush syndrome -- are they related? --Arcadian 00:01, 15 December 2005 (UTC)

text: No, double crush refers to the median or ulnar nerve being compressed in the back as well as in the wrist.  The compression in the back inflames the nerve so it is more sensitive to compression at the wrist.  A problem with the median nerve causes numbness in the forefinger, 2nd finger, and one side of the 3rd (ring) finger.  A problem with the ulnar nerve causes numbness in the 4th (pinky) finger and the side of the 3rd finger.  If either nerve is inflamed, there can be a burning sensation at the wrist where the actual carpal tunnel resides.  Note that I am not a doctor, just a person who has had carpal tunnel syndrome that was luckily treatable with exercise: pushups, situps, touch toes, etc. Rick Rutt 16:47, 16 December 2005 (UTC)
thread_title:  Need to discuss ''Double Crush Syndrome'' 

message: It is unfortunate that Dr. Michael Brown has used the Wikipedia as an advertising page and in the process produced disinformation reguarding CTS surgical treatement and results.  His results are not unlike most surgical treatments, and there are more widely used endoscopic methods out there with similar results.  Attempts at correcting his entry are reversed.  This lack of integrity of contributors is a weakness of this community forum, when greed and commercialism predominates.  So sad. Shame on Dr. Brown.
<follow-up comment by different submitter>
Agreed.  With a little research one will find that carpal tunnel surgery is highly ineffective, with a high rate of relapse because the initial diagnosis is often incorrect.  This Wikipedia entry is, unfortunately, very misleading and should be corrected.  —Preceding unsigned comment added by 70.90.239.173 (talk) 14:12, 3 June 2008 (UTC)
thread_title:  Dr. Brown, Dr. Brown... Paging Dr. Brown

message: I removed the soft tissue therapy section entirely, since it is part of a group of edits across multiple articles by individuals seeking to push their own commercial products.  If anyone has verifiable evidence that soft tissue therapy is actually a real medically approved therapy to treat CTS, feel free to remake the section.  But include sources.  --Xyzzyplugh 00:00, 14 February 2006 (UTC)
thread_title:  Soft Tissue Therapy? 

message: Why does this topic link to writer's cramp (and vice versa)?  Apart from being disorders that affect the hand, the two have nothing in common. Ikkyu2 01:11, 14 February 2006 (UTC)
replies: text: The link may serve to help people realize this difference if the two are often confused. In fact, it might not hurt to mention in the article that there is a difference and what it is. This information could likely prove helpful to people not familiar with the terminology. --DanielCD 19:55, 16 February 2006 (UTC)
thread_title:  writer's cramp 

message: Ok, is it just me or is this article a little confusing if your not a doctor? I"m trying to write a report on CTS and I'm reading this too help as a first chice and I'm having to find places I can understand easier. What is a lateral 3.5 finger? I suggest we make the article more understandable to readers not in the medical field, like those of us in high school.
H-BOMB 13:51, 20 October 2006 (UTC)
thread_title:  Vocabulary 

message: In the Immobilizing Braces section of the article, the article states that there is a new type of brace (policarpal) that is very successful.  When following the 'policarpal' link, you come to a wiki page that says there is no article by that name.  When I googled 'policarpal', the first couple links are the manufacturers page, and then the exact same blurb as the one in the wiki article has been posted on a numer of different sites.  Policarpal appears to be a proprietary name, and does not appear to be reviewed anywhere, nor is does it appear to be available from any other site.
I think it's SPAM.  What do you think?
Meira Voirdire 04:19, 11 December 2006 (UTC)
thread_title:  Policarpal SPAM? 

message: * I've removed the follow sentence from the article, "B vitamins, specifically Vitamin B6, can have an anti-inflammatory effect on the nerves decreasing symptoms. A B-50 or B-100 complex daily provides relief for many people. It should be noted that dosages of B6 should not exceed 300mg per day." A statement this broad must be cited per WP:ATTRIB. -- MarcoTolo 02:25, 2 March 2007 (UTC)
thread_title: Uncited statements

message: The diagram is kind of creepy, can we get one that doesn't look like a severed hand? --Candy-Panda 08:35, 8 March 2007 (UTC)
replies: text: I've spent a fair amount of time looking for a freely-available alternative image (i.e. meets Wikipedia image policies); any suggestions? -- MarcoTolo 08:01, 13 March 2007 (UTC)

text: I created an SVG version of the diagram to replace the Gray's Anatomy Image: http://commons.wikimedia.org/wiki/File:Carpal-Tunnel.svg (DoPhotoShop (talk) 20:05, 15 March 2011 (UTC)
thread_title:  Diagram 

message: :"The most recent data, from Mayo Clinic microscopic studies (published in a November 2006 issue of Plastic and Reconstructive Surgery): indicates that it is in fact a shearing injury caused from the acute trauma of repeated motions. The scar tissue from during healing impedes the sliding motion at the tendon. Clearing any doubt that it is in fact work related."
I've pulled this paragraph from the article because it appears to exaggerate the study outcome based on the  abstract (i.e. it does not appear to "clear any doubt".) I haven't had a chance to dig up the full article; will do so as soon as possible. -- MarcoTolo 07:58, 13 March 2007 (UTC)
thread_title: Plastic and Reconstructive Surgery article (November 2006)

message: Good day. Perhaps I've msised something but the "medication and diet" section does not seem to have any info on diet. Is this an oversight or should the word "diet" be removed from the section (or perhaps dietary content added). Thanks, Hu Gadarn 22:41, 22 March 2007 (UTC)
replies: text: This is left over from a unreferenced dietary segment that was removed; I've corrected the subheading. Thanks for catching the error. -- MarcoTolo 22:50, 22 March 2007 (UTC)
thread_title:  "medication and diet" section (what diet?) 

message: WAS IN ACCIDENT HURT THE NECK AREA, LOTS OF PAIN, ALSO SHOULDER AREA, SO FOR ALMOST FIVE YEARS HAVE BEEN RUBBING NECK AND SHOULDERS AS IM IN SO MUCH PAIN, LAST FEW MONTHS HAVE HAD NUMBNESS IN FINGERS BURNING AND PAIN IN WRIST PAIN IN THUMB INDEX FINGER BOTH WRISTS IF I HOLD HANDS IN A STRETCHED POSTION BURNING AND PAIN START, ALSO IF I HOLD EVEN A CUB SOME TIMES WILL DO THIS AND HAVE DROPPED THINGS  COULD THIS BE CARPEL TUNNELL FROM RUBBING MY NECK AND SHOULDERS MOST OF THE TIME??SANDRA —The preceding unsigned comment was added by 209.226.176.31 (talk) 03:01, 9 April 2007 (UTC)
replies: text: It might be the strain of holding down the shift key too hard. --LiamE 16:07, 26 July 2007 (UTC)
replies: text:  Please stop yelling, it will aggravate your neck injury. Hu Gadarn 22:07, 26 July 2007 (UTC)
thread_title:  CARPEL TUNNEL 

message: I, perhaps temporarily, move unreferenced claims of osteopath treatment to this page, since it might need discussion before any possible reinsertion:
CTS can also be treated with Osteopathic Manipulative Medicine, using a technique called carpal tunnel release. The carpal bones surrounding the tunnel are pressed apart and maintained in this position for several seconds. Although this technique is not curative, it does offer relief in mild cases.
Spinal manipulations performed by an osteopath, physical therapist or chiropractor may be appropriate to relieve compression of the nerve.
Mikael Häggström 07:58, 30 September 2007 (UTC)
thread_title:  Osteopath claims 

message: Can we get a list of differential diagnoses?  CTS is well known, so people often think anything involving upper extremity discomfort must be CTS.  I'd like to see a list that includes ulnar nerve problems, cervical disk problems, tennis elbow, and so forth. WhatamIdoing (talk) 04:24, 7 December 2007 (UTC)
thread_title: Differentials

message: Often we see "better seating", "better sitting position". Well, some
of us use the computer only when lying on our stomachs in bed, never sitting
down in front of it. Just wanted to let you know. Not especially
healthy perhaps, but that's how we use them. Jidanni (talk) 05:11, 23 February 2008 (UTC)
thread_title: some of use the computer only when lying on our stomachs

message: "Physiology and family history may have a significant role in individual's susceptibility." I didn't understand the meaning of the word "physiology" in this context. Was it originally supposed to be "genetics", or something else? Kindly clarify.
Also, the article has been rated "B" class under Project medicine, but only a "start-class" under Neurology. I think it is good enough to be "B" even for neurology. May be a GA, too with some improvements.
Regards.
—KetanPanchaltaLK 16:31, 12 June 2008 (UTC)
thread_title:  Unclear sentence 

message: It is common knowledge that carpal tunnel syndrome can be acquired through guitar playing if the guitar neck is held improperly. this is also the case for a lot of other activities, though, such as typing, for example. So I'm not sure that anything about this should be added to the page or not-- just thought I'd throw it out there that CTS is common discussion amongst guitar players.  —Preceding unsigned comment added by 75.16.231.26 (talk) 23:18, 27 August 2008 (UTC)
thread_title:  Guitar. 

message: i was dignosed with cts a few months ago and tend to disagree with the following bit in the article:
"Psychosocial factors
Studies have related activity-related upper extremity pain with psychological and social factors, but most such pains are nonspecific but commonly mislabeled as carpal tunnel syndrome. Psychological distress correlates with increased pain at work, as do other psychosocial stressors such as job demands, poor support from colleagues, and work dissatisfaction.[9]
As mentioned elsewhere on this page, carpal tunnel is characterized by numbness, not pain. Therefore, any associations between stress and carpal tunnel syndrome are debatable."
when first diagnosed i was experiencing numbness for a few months including my index finger.  but i get bouts of pain, especially sewing by hand, picking up objects "the wrong way", leaning on my hands etc.  so pain in my opinion is definitely associated with cts.  after a long day at work, i get pain up and down my forearm, which i believe is how far the nerve runs?? and being a nerve, shouldn't it experience some pain being under pressure and all??
Jashca (talk) 09:17, 20 January 2009 (UTC)
thread_title:  symptoms and indications 

message: as discussed above, I have found an interesting article in a newer medical journal that will back up my view above.  When I have the energy I will update the article.
Jashca (talk) 07:39, 4 February 2009 (UTC)
thread_title: Further Evidence

message: The article mentions atrophy of the adductor pollicis in carpal tunnel syndrome.  But, adductor pollicis is innervated by the ulnar nerve and not by the median nerve.  Does it really atrophy or is this a mistake?
Tyger25 (talk) 03:16, 26 April 2009 (UTC)
thread_title: Adductor Pollicis

message: there were too many symptoms that i couldn't ignore, now a year after being diagnosed with cts, i have discovered that i have a thyroid problem - an under active one at that - hypothyroidism.  Its more common than anyone thinks and this symoptom is actually a rather common one to indicate hypothyroidism.
Jashca (talk) 13:11, 22 June 2009 (UTC)
thread_title: An Answer At Last

message: I've pulled these edits from the article:
: Carpal tunnel syndrome can be caused by sexual intercourse when either the male or the female partner uses the wrists as anchors to support the weight of the upper body, which puts tremendous pressure on the wrists. Add to that the repetitive motion needed to achieve orgasm and you have the perfect recipe for carpal tunnel syndrome(author=Zenian J title=The role of sexual intercourse in the etiology of carpal tunnel syndrome.journal= Med Hypotheses year=2010 date=Jan 7 {Epub ahead of print}. The reason why no one has yet come forward to blame sexual intercourse for his/her condition is because sexual intercourse is considered a normal avtivity. Besides, it takes several hours after the initial injury for the symptoms of carpal tunnel syndrome to develop, during which time most people are asleep, having had sex just before going to sleep. The first time patients become aware of their condition is when they wake up in the morning or when they try to use their hands later that day by which time it is too late to make the connection between sexual intercourse and carpal tunnel syndrome.
Medical Hypotheses is not considered a reliable source (per WP:MEDRS). -- MarcoTolo (talk) 15:29, 27 January 2010 (UTC)
thread_title: Removal of "caused by sexual intercourse" section

message: Need to rename ‘Frequency’ section as  ‘Prevalence’. and put near top of the document
All anatomical structure (median nerve, carpal tunnel, any muscles/bones) should be linked to another page using the double brackets.
Under Physiotherapy, create a link for physiotherapy and occupational therapy
Needs a section on stretching, perhaps with some pictures.
Scholarchanter (talk) 01:00, 1 June 2010 (UTC)
replies: text: So, have you started, yet?  — Preceding unsigned comment added by Ragityman (talk • contribs) 14:00, 11 December 2010 (UTC)
thread_title: Editorial Comments 

message: I moved the following section below to here because reinsertion of any of it needs some cleanup first, including:
* Scientific evidence of efficacy in CTS, that is basically, some references
* Rewrite to summarize concepts rather than seemingly to advertising individual brands
Now it looks like only the bottom part is of interest: In short there is no study or paper that shows that these over the counter devices work.
Mikael Häggström (talk) 14:22, 27 June 2010 (UTC)
thread_title:  Active devices need cleanup 

message: This page keeps crashing firefox for me. 70.26.75.218 (talk) 00:27, 23 August 2010 (UTC)
thread_title:  Crashing Firefox 

message: I am no medical expert, but the following sentence is problematic:
The carpal tunnel is an intentionally tight area and it seems that the variation occasionally tends towards "too tight".
Intentionally?
Whose intention?
Gods? Evolutions? 
I don't think we need God's intentions in this article, and evolution doesn't have a goal/intention anyway.
So "Intentionally" is a poor formulation and seems to say more about the worldview of the author than CTS. 
I suggest removing the word completely.
(Since I am no medical expert I won't change the main article, just in case I misunderstand something completely about the use of the word "intentionally". I hope somebody else can confirm this and change it.)
80.101.129.221 (talk) 09:56, 13 January 2011 (UTC)
thread_title:  Very strange formulation in opening section (intentionally tight area) 

message: Don't know of any International Standard Serial Number (ISSN) citation tool. I'm new to this.
CARPEL TUNNEL SYNDROME : A REVIEW
Gadhave S. V.1*,
Moon R.S., Kshirsagar R.V.
1Department of pharmaceutics,
School of Pharmacy, SRTM University
Nanded-431606, Maharashtra.
Publication Ref No.: IJPRD/2011/PUB/ARTI/VOV-2/ISSUE-12/FEB/017 ISSN 0974 – 9446
http://www.ijprd.com/CARPEL%20TUNNEL%20SYNDROME%20_%20A%20REVIEW.pdf
"A predominance of pain rather than numbness is unlikely to be caused by carpal tunnel syndrome no matter what the result of electrophysiological testing."
Thanks  — Preceding unsigned comment added by 68.149.158.238 (talk) 10:03, 28 February 2012 (UTC)
thread_title:  "A predominance of pain rather than numbness is unlikely to be caused by carpal tunnel syndrome no matter what the result of electrophysiological testing." Can't see citation, but found the citation. Can someone add?  

message: I am confused by the statement in Carpal tunnel syndrome#Work related, "in one recent representative series of a consecutive experience, most patients were older and not working". It is supported by. 
 
I don't have access to this paper and would like some help from anyone who does.
# What is the meaning of "representative series of a consecutive experience". 
# The paper does not appear to be about epidemiology. Is our use of the paper an instance of synthesis or is the paper a good source for statements that 
##most CTS patients are older and not working and 
##this means CTS is unlikely to be work related
Jojalozzo 21:18, 12 March 2012 (UTC)
thread_title:  Extrapolating the patient population from one study 

message: An image refers to left and right hands, but the right hand is on the left, and the left hand is on the right, and it is difficult to tell which hand the image is referring to.  — Preceding unsigned comment added by 125.253.96.100 (talk) 11:34, 6 May 2012 (UTC)
thread_title:  Ambiguous 

message: "There is little clinical data to prove whether repetitive and forceful movements of the hand and wrist during work or leisure activities can cause carpal tunnel syndrome. Other disorders such as bursitis and tendonitis have been associated with repeated motions performed in the course of normal work or other activities."
http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm  — Preceding unsigned comment added by Bboyjkang2 (talk • contribs) 03:30, 7 June 2013 (UTC)
thread_title:  "There is little clinical data to prove whether repetitive and forceful movements of the hand and wrist during work or leisure activities can cause carpal tunnel syndrome. Other disorders such as bursitis and tendonitis have been associated with repeated" 

message: "A type of therapy gaining in popularity aims to actually reverse the underlying cause of carpal tunnel syndrome by altering the anatomy and physiology of the carpal tunnel. This therapy can be applied using a device that actively changes soft tissues by reducing tendon micro-adhesions and inflammation. The Carpal Rx accomplishes this by producing a deep tissue massage called myofascial release over the wrist and forearm. This motion results in reduced compression on the median nerve and ultimately, alleviation of symptoms. http://bjp.sagepub.com/content/8/2_suppl/5.full.pdf#page=34"
*Study does not appear to be pubmed indexed.
*Data was 36 patients who received therapeutic message. There was no control group. Gah it is amazing what can get published. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:38, 8 June 2014 (UTC)
thread_title: Trimmed this

message: In the introduction:
"The use of birth control pills does not affect the risk."
But in the causes section:
"Some common conditions that can lead to CTS include obesity, oral contraceptives, [...]"
Seems like one of these needs correction. I don't know which one though. The second has a cite for the entire sentence, but the article is paywalled so I can't confirm citedness.
ChristopheBiocca (talk) 13:28, 30 May 2016 (UTC)
replies: text: Thanks for pointing this out and updated Doc James (talk · contribs · email) 09:33, 31 May 2016 (UTC)
thread_title:  Contradicting statements regarding birth control pills causing CTS? 

message: Lancet Neurology doi:10.1016/S1474-4422(16)30231-9 JFW | T@lk 22:47, 12 October 2016 (UTC)
thread_title:  Review 

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thread_title:  External links modified 

message: We propose eliminating the subsection “Physical Therapy” under the section “Treatment.” Physical therapy is a profession, not a treatment. There are several types of treatment that a physical therapist might offer or administer, and each of these could be offered or administered by other health professionals or self-administered by the patient. Therefore, each treatment should be considered independent of a give profession. Mitrakardes (talk) 19:19, 8 May 2023 (UTC)
replies: text: Whatever the merits of your arguments are, you do not simply and unilaterally delete the content at stake. That's not how consensus works. --Technopat (talk) 18:15, 12 May 2023 (UTC)
thread_title:  Request to Delete Physical Therapy Subsection 

message: We propose adding a sentence "But to date, there is mostly evidence of association with symptoms (CTS), not neuropathy (IMNCT), which is an important distinction" on "work-related factors" under Carpal tunnel syndrome (CTS) section. This is a very important point. There is very limited evidence of a small association with specific types of hand use.  So limited it may be irrelevant.  And we need to reproduce it in other studies. But the idea that activity causes neuropathy definitely reinforces common unhelpful thoughts such as fear of symptomatic activity and worst case thinking. Hadis.Askari (talk) 16:40, 26 April 2024 (UTC)
thread_title:  Carpal tunnel syndrome (CTS) 

message: Proposed changes in the first sentence of pathophysiology from "The carpal tunnel is formed a narrow canal surrounded.." to omission of "narrow canal". The carpal tunnel is not that narrow.  Certainly not narrow relative to other anatomic tunnels.
In the same section, other proposed changes are omission of "sheaths" in the second sentence since there are not "sheaths" in the carpal tunnel. Additionally, re-wording the beginning of the third sentence with "Theoretically" instead of "Specifically" since the pathophysiology and etiology of idiopathic median neuropathy at the carpal tunnel are uncertain. The last minor proposed change is the deletion of the "repetitive wrist movement" in the last sentence of the first paragraph since the role of activity in the etiology is debatable and uncertain and this discussion topic belongs in the etiology section. Hadis.Askari (talk) 04:44, 14 May 2024 (UTC)
thread_title:  Pathophysiology