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Optimal treatment of carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is the most recognized occupational maladies as well as one of the most reported. Marked by numbness, weakness, and pain in the wrist and hand particularly the thumb and index finger, and frequently shooting up the arm CTS occurs when the median nerve, which runs from the forearm to the base of the palm, becomes compressed. This constriction or pinching is commonly attributed to repetitive motion and stress. Yet, in spite of its association with heavy computer use, carpal tunnel syndrome is not confined to data entry workers. Butchers, mechanics, musicians, dental hygienists, tennis players and golfers are vulnerable. According to recent studies, CTS affects about 3 percent of the general population, whether on the job or at play. Women are more likely than men to develop it. Individuals with rheumatoid arthritis are also at high risk.

Despite the prevalence of CTS and its considerable economic impact in terms of both worker absenteeism and compensation claims there is no universally accepted therapy. Mild cases are usually left untreated. Moderate cases may be treated with local injections of corticosteroids, if patients fail to respond to splinting and anti-inflammatory drugs like ibuprofen. In severe cases, with the threat of permanent loss of sensation, the preferred treatment is surgery. Surgery, however, is often recommended to patients before trying less invasive and less expensive treatments. Is surgery always the best course for carpal tunnel syndrome's sufferers? A team of researchers in Madrid recently set out to find the answer. The results of their clinical trial, published in the February 2005 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis), suggest that local steroid injection is just as effective as surgery for the long-term symptom
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Contact: Amy Molnar
amolnar@wiley.com
John Wiley & Sons, Inc.
3-Feb-2005


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