Abstract

Background and Purpose: Increasingly larger numbers of patients present with repetitive strain injuries of the upper extremities, especially carpal tunnel syndrome (CTS). A large number of these patients appear to have more than one upper extremity condition. The purpose of this study was to determine the probability that a patient diagnosed with carpal tunnel syndrome will also be diagnosed with other upper extremity and/or cervical spine disorders.

Subjects: A group of 188 subjects diagnosed with carpal tunnel syndrome and a group of 203 subjects without carpal tunnel syndrome were selected through a chart review of patients at Loma Linda University Medical Center. Subjects were Caucasian or African-American, between the ages of 24 and 75 years.

Methods: Patients were selected for the carpal tunnel syndrome group based on both clinical diagnosis and validation through electrodiagnosis. A group of subjects who had not been diagnosed with carpal tunnel syndrome, the control group, was selected by a chart review of patients seen by the same surgeons as the carpal tunnel group. The prevalence of different upper extremity disorders and other conditions was compared in the two groups.

Results: Of the 188 subjects in the carpal tunnel group, 25 (13.3%) were also diagnosed with at least one ulnar nerve disorder, compared to none of the 203 subjects in the control group. Thirty-four subjects (20.2%) were diagnosed with at least one nerve disorder other than carpal tunnel syndrome in the carpal tunnel syndrome group, compared to 12 (5.9%) in the control group. Also, 21 subjects (11.2%) in the carpal tunnel syndrome group were diagnosed with trigger finger while only one (0.5%) had the same diagnosis in the control group. Seven subjects (3.7%) were diagnosed with ganglion cysts, and 30 subjects (16.0%) were diagnosed with at least one other upper extremity disorder that involved muscle, tendon, or joint capsule in the carpal tunnel group while one (0.5%) and two (1.0%) subjects respectively had these diagnoses in the control group.

Discussion and Conclusion: As often seen in physical therapy clinics, when a patient has been diagnosed with carpal tunnel syndrome, there is a good chance that other upper extremity disorders have or will be diagnosed in the same patient. These conditions may or may not be related to carpal tunnel syndrome. An apparent predisposition of some patients to upper extremity disorders has been observed before and appears to be the case in this study. Clinicians should consider screening their patients for all these disorders, when only one of them may be readily apparent.

Key Words: Carpal tunnel syndrome, Upper extremity disorders, Repetitive strain injury.

LLU Discipline

Physical Therapy

Department

Physical Therapy

School

School of Allied Health Professions

First Advisor

Grenith J. Zimmerman

Second Advisor

Everett Lohman

Third Advisor

Gail Rice

Fourth Advisor

Arnold Tripp

Degree Name

Doctor of Physical Therapy (DPT)

Degree Level

D.Sc.

Year Degree Awarded

2002

Date (Title Page)

3-2002

Language

English

Library of Congress/MESH Subject Headings

Carpal Tunnel Syndrome; Arm Injuries -- rehabilitation.

Type

Thesis

Page Count

v; 46

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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