Pathophysiology of Carpal Tunnel Syndrome

doi:10.1007/978-3-319-57010-5_3

Paper

Pathophysiology of Carpal Tunnel Syndrome

Published 2017 · Scott F. M. Duncan, Oam Bhate, Hatim M. Mustaly

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Abstract

This chapter discusses the pathophysiological mechanisms and contributing factors underlying the etiology of carpal tunnel syndrome. The etiology of carpal tunnel syndrome is complex and still has not been fully elucidated. Many factors have been implicated in the development and progression of carpal tunnel syndrome. Injury due to repetitive mechanical stress and resulting nerve injury has been historically thought to be the cause of carpal tunnel syndrome. Additionally, systemic disease states including diabetes, acromegaly, thyroid dysfunction, and rheumatoid arthritis among others have been linked to carpal tunnel syndrome. Age, gender, and genetic factors have also been associated with the development of carpal tunnel syndrome. The various elements that may predispose to carpal tunnel syndrome have been explored in depth in this chapter.

Study Snapshot

Carpal tunnel syndrome's cause remains complex, with factors like repetitive mechanical stress, systemic diseases, age, gender, and genetic factors contributing to its development.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

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Pathophysiology of Carpal Tunnel Syndrome

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References

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Variants in collagen gene COL11A1 may play a role in carpal tunnel syndrome, and targeting modifiable risk factors could help reduce the incidence and morbidity of the condition.

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Acute carpal tunnel syndrome is often caused by wrist trauma and distal radius fractures, and timely diagnosis and treatment can lead to excellent outcomes with complete recovery.

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The GSTM1 null genotype may increase the risk of carpal tunnel syndrome, while the Val allele of the GSTP1-Ile105Val polymorphism may worsen functional and clinical status in carpal tunnel syndrome patients.

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Increased BMI is an important risk factor for carpal tunnel syndrome in patients with primary hypothyroidism, and clinical evidence of CTS is a sensitive parameter for this condition.

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The carpal tunnel cross-sectional area is smaller in women than in men, potentially contributing to the development of carpal tunnel syndrome.

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Overweight and obesity significantly increase the risk of carpal tunnel syndrome, with no significant differences between men and women and no evidence of bias or confounding.

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The AA genotype of IL-6R rs2228145 is associated with reduced carpal tunnel syndrome risk in a South African Coloured population, and interacts with previously reported COL5A1 and BGN variants to modulate the risk.

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Variants within the BGN gene, independently and through interactions with COL5A1 variants, are associated with carpal tunnel syndrome.

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