Carpal tunnel syndrome pathophysiology

Overview

Carpal tunnel syndrome (CTS) is known as a common pathology in hand. Most common diagnosis of CTS is idiopathic but it is accepted that the median nerve neuropathy could be caused due to the chronic increased pressure within the carpal tunnel. But the exact pathophysiology of this pressure increase is not well known yet. CTS usually occurs due to the mechanical compression and/or local ischemia. CTS is diagnosed based on symptoms such as numbness, tingling and/or burning in the distribution of the median nerve in the hand. However, the symptoms are frequently documented outside the distribution of the median nerve as well.

Pathophysiology

Increased carpal tunnel pressure

The carpal tunnel is a anatomic space surrounded by the carpal bones on the medial, dorsal, and lateral sides and the the flexor retinaculum located on the palmar side and nine flexor tendons and the median nerve are concealed by the subsynovial connective tissue (SSCT). It is clear that the CTS is a chronic peripheral nerve compression neuropathy, but its pathophysiology are less clear. Various studies have confirmed that the increased canal pressure can be found in patients with CTS; this elevation is correlated with clinical signs in patients. Fro example tenosynovitis or synovial fibrosis, are known as the potential cause of elavation in carpal tunnel pressure. Another proposed mechanism is canal stenosis.

The pathophysiological knowledge of compression neuropathies has come from animal studies but there have been a few pressure related