Carpal Tunnel Syndrome Physiotherapy Case Study
KPJ HEALTHCARE UNIVERSITY COLLEGE OF NURSING AND HEALTH SCIENCES
DIPLOMA IN PHYSIOTHERAPY CLINICAL POSTING AT KEDAH MEDICAL CENTRE
‘CARPAL TUNNEL SYNDROME’
NAME : Noor Syafiqah Izzati binti Suhairi MATRIX NO. : 10DPY0140 SEMESTER/COHORT : 6/Cohort 9 LECTURER IN-CHARGE : Miss Nurshazana Akmal Binti Jamaludin Contents No. | Topic | Page | 1 | Definition | 1 | 2 | Pathogenesis and pathophysiology | 1 | 3 | Causes | 2 | 4 | Symptoms | 3 | 5 | Diagnosis | 3 | 6 | Doctor’s management | 3 | 7 | Physiotherapy management | 4 | 8 | Patient Assessment | 5 | 9 | References | 12 |
Definition The median nerve, which controls movement and feeling in the palm-side of the hand, runs from the forearm to the hand through the carpal tunnel in the wrist. The bottom and sides of this tunnel are formed by bones, and the top of the tunnel is covered by strong band of connective tissue called a ligament. Repetetive movement, or certain conditions such as pregnancy and arthritis, can cause swelling within the carpal tunnel. The swelling puts pressure on the median nerve and can cause numbness, tingling, or pain in the thumb or fingers. This is known as carpal tunnel syndrome. (Eversmann, 1993) Pathogenesis and Pathophysiology * The pathogenesis and pathophysiology of carpal tunnel syndrome is predominantly attributable to nerve dysfunction secondary to chronic mechanical compression. * Histological abnormalities consist of paranodal myelin retraction with bulbous paranodal swellings, segmental demyelination, and variable degrees of axonal degeneration as well as remyelination and axonal regeneration. * There is also focal increase in endoneurial and perineural connective tissue and thickening of blood vessels. * The contribution of superimposed ischemia in causing some of these connective
DIPLOMA IN PHYSIOTHERAPY CLINICAL POSTING AT KEDAH MEDICAL CENTRE
‘CARPAL TUNNEL SYNDROME’
NAME : Noor Syafiqah Izzati binti Suhairi MATRIX NO. : 10DPY0140 SEMESTER/COHORT : 6/Cohort 9 LECTURER IN-CHARGE : Miss Nurshazana Akmal Binti Jamaludin Contents No. | Topic | Page | 1 | Definition | 1 | 2 | Pathogenesis and pathophysiology | 1 | 3 | Causes | 2 | 4 | Symptoms | 3 | 5 | Diagnosis | 3 | 6 | Doctor’s management | 3 | 7 | Physiotherapy management | 4 | 8 | Patient Assessment | 5 | 9 | References | 12 |
Definition The median nerve, which controls movement and feeling in the palm-side of the hand, runs from the forearm to the hand through the carpal tunnel in the wrist. The bottom and sides of this tunnel are formed by bones, and the top of the tunnel is covered by strong band of connective tissue called a ligament. Repetetive movement, or certain conditions such as pregnancy and arthritis, can cause swelling within the carpal tunnel. The swelling puts pressure on the median nerve and can cause numbness, tingling, or pain in the thumb or fingers. This is known as carpal tunnel syndrome. (Eversmann, 1993) Pathogenesis and Pathophysiology * The pathogenesis and pathophysiology of carpal tunnel syndrome is predominantly attributable to nerve dysfunction secondary to chronic mechanical compression. * Histological abnormalities consist of paranodal myelin retraction with bulbous paranodal swellings, segmental demyelination, and variable degrees of axonal degeneration as well as remyelination and axonal regeneration. * There is also focal increase in endoneurial and perineural connective tissue and thickening of blood vessels. * The contribution of superimposed ischemia in causing some of these connective
References: 1) Atroshi I, Gummesson C, Ornstein E, et al. Carpal tunnel syndrome and keyboard use at work: a population-based study. Athritis Rheum. 2007;56(11):3620-3625 2) Pomerance J, Fine I. Outcomes of carpal tunnel surgery with and without supervised postoperative therapy. J Hand Surg [Am]. 2007;32(8):1159-1163 3) Futami T. Kobayashi A, Wakabayashi N, Kouiichi Y, Nakamura K. Natural history of Carpal Tunnel Syndrome. Journal of Japanese Society for Surgery of The Hand. 1992;8:410-412. 4) www.lef.org 5) Health.nytimes.com/health/guides/disease/carpal-tunnel-syndrome