© Springer International Publishing Switzerland 2016 329
Y. El Miedany (ed.), Patient Reported Outcome Measures in Rheumatic Diseases,
DOI 10.1007/978-3-319-32851-5_13
Chapter 13
PROMs for Carpal Tunnel Syndrome
Yasser El Miedany
Introduction
Carpal tunnel syndrome (CTS), fi rst reported by Phalen [ 1 ], is one of the most com-
mon compression peripheral mono-neuropathies, which occurs due to localized
entrapment of the median nerve (MN) as it passes through the carpal tunnel. CTS is
a common clinical condition presenting with numbness, paresthesia, and sometimes
pain or weakness of the hand muscles. Whilst symptoms severity may vary from
one person to another, if left untreated, it may lead to permanent “ median nerve
damage ,” causing irreversible numbness, muscle wasting, and weakness of the
affected hand. Earlier studies revealed it has an overall prevalence of 3.0–5.8 %
among women and 0.6–2.1 % among men in general population samples [ 2 , 3 ]. The
vast expanding use of new technology gadgets led to widening of the age range of
people suffering from CTS symptoms and a signifi cant increase in the condition
prevalence. Recent reports depicted that CTS account for up to 90 % of all entrap-
ment neuropathies [ 4 – 6 ].
Whilst its onset in most of the cases is insidious and progressive, a growing body
of evidence indicates that the common pathway for CTS development is increased
pressure within the carpal canal. Experimental studies reported that the changes in
the CTS are linked to the amount and duration of the increased interstitial fl uid pres-
sure and could be reversible up to a point with management [ 7 ]. Therefore, under-
standing the pathophysiological changes in the carpal tunnel and its effect on the
median nerve would have a positive impact not only on the diagnosis but also on the
management of the condition. Earlier reports revealed that CTS pathophysiology is
Y. El Miedany (*)
Honorary Senior Clinical Lecturer, King’s College London , London , UK
Professor of Rheumatology and Rehabilitation, Ain Shams University , Cairo , Egypt
Department of Rheumatology , Darent Valley Hospital , Dartford , Kent , UK
e-mail: [email protected]