Carpal tunnel syndrome causes
Overview
Carpal tunnel syndrome is the most common entrapment neuropathy, affecting 2-10% of adults in the general population. The underlying cause of CTS is not well known yet but trauma, repetitive maneuvers, certain diseases, and even pregnancy are known to be causes in this regard. In most cases the CTS is found idiopathic. Meanwhile .
Causes
Etiologies of Carpal Tunnel Syndrome
| Repetitive maneuvers |
| Obesity |
| Pregnancy |
| Arthritis |
| Hypothyroidism |
| Diabetes mellitus |
| Trauma |
| Mass lesions |
| Amyloidosis |
| Sarcoidosis |
| Multiple myeloma |
| Leukemia |
The international debate regarding the relationship between CTS and repetitive motion and work is ongoing. The Occupational Safety and Health Administration (OSHA) has adopted rules and regulations regarding cumulative trauma disorders. Occupational risk factors of repetitive tasks, force, posture, and vibration have been cited. However, the American Society for Surgery of the Hand has issued a statement that the current literature does not support a causal relationship between specific work activities and the development of diseases such as CTS.
The relationship between work and CTS is controversial; in many locations workers injured at work are entitled to time off and compensation. Many cases of carpal tunnel syndrome are provoked by repetitive grasping and manipulating activities, and the exposure can be cumulative. Symptoms are commonly exacerbated by forceful and repetitive use of the hand and wrists in industrial occupations. Carpal tunnel syndrome results in billions of dollars of workers compensation claims every year.
Studies done by the National Institute for Occupational Safety and Health (NIOSH), indicated that job tasks involving highly repetitive manual acts or necessitating wrist bending or other stressful wrist postures were connected with incidents of CTS or related problems. However, it appears that the 30+ studies reviewed were concerned with the occupations of assembly line workers, meat packers, food processors, and the like, not general office work.
In addition, a 2005 study found that people who have discomfort at the base of the neck or in the shoulder or work with their shoulder in elevation (indicators of poor working postures) are more likely to develop a repetitive overuse injury. These factors can affect the biomechanics of the upper limb or tissue tolerance to repetitive tasks resulting in injury, or both. Postural and spinal assessment along with ergonomic assessments should be included in the overall determination of the condition. Addressing these factors have been found to improve the status of work related upper limb injuries.
Hypothyroidism, osteoarthritis and diabetes were most often associated with CTS-like symptoms, as were variables such as age, obesity and wrist dimension. In a 1998 study, only 35 of 297 subjects were aware of the underlying health condition which could account for their CTS-like symptoms. Hence, these causes would be missed by doctors if they were relying on a patient's health history to rule out other causative factors. It is important that a doctor rule out other causes of CTS-like symptoms. If a patient does not have CTS, corrective surgery is destined to fail.
Studies have also related carpal tunnel and other upper extremity complaints with psychological and social factors. A large amount of psychological distress showed doubled risk of the report of pain, while job demands, poor support from colleagues, and work dissatisfaction also showed an increase in the report of pain, even after short term exposure. A minority viewpoint holds that stress is the main cause, rather than a contributing factor, of a large fraction of pain symptoms usually attributed to carpal tunnel syndrome.