EAST LANSING, MI - New guidelines designed to help doctors better diagnose carpal tunnel syndrome (CTS) guidelines that include the increased use of nerve-conduction studies have been issued by a team of CTS experts, including a Michigan State University physician.
The new guidelines are the result of more than two years of study by the American Academy of Neurology, the American Academy of Electrodiagnostic Medicine and the American Academy of Physical Medicine and Rehabilitation. They were published in a recent issue of the journal Neurology.
The major feature of the guidelines is a call for increased use of sophisticated nerve-conduction studies, said Michael Andary, an MSU associate professor of physical medicine and rehabilitation and a member of the team.
“This is a process in which we introduce a small electrical current into a patient’s hand, wrist or finger and measure how fast that impulse moves,” Andary said. “It is the best test available for diagnosing CTS.”
Studies show that the slower the
electrical impulse moves through
the hand, the more likely the patient is to have CTS.
As in many diseases, misdiagnosis is a serious problem among CTS sufferers. It can lead to unnecessary surgery or, if not diagnosed at all, to permanent nerve damage.
“If a diagnosis is missed if a person does not get the treatment he or she needs there is a risk that the nerve will die,” Andary said.
A diagnosis of carpal tunnel syndrome does not automatically mean surgery for the patient. Sometimes the patient can try using a wrist splint or other non-operative treatments before undergoing surgery, Andary said.
There are several risk factors to predisposing people to develop CTS. This can occur when tendons in the wrist become enlarged. The narrowed tunnel of bones and ligaments in the wrist pinches the median nerve and its branches that reach the fingers and the muscles at the base of the thumb.
Symptoms can include pain, numbness or tingling in the wrist, hand and fingers. Treatments can include use of a splint, medications and, in some cases, surgery.
About one in every 1,000 Americans is diagnosed with CTS every year.
For additional information on carpal tunnel syndrome, see the National Institute of Neurological Disorders and Stroke Web site at http://www.ninds.nih.gov
Printed in Volume 1 Issue 12