Carpal tunnel syndrome

What is the carpal tunnel syndrome?

The carpal tunnel syndrome is a common hand complaint caused by the pinching of a nerve in the wrist. The wrist contains a space called the carpal tunnel through which a major nerve and a number of tendons pass to the hand. The carpal tunnel syndrome involves an increase in pressure and swelling in this space, and the associated increase in the pressure on the nerve.

 

What are the complaints associated with the carpal tunnel syndrome?

Pain, numbness or tingling in the hand may occur separately or at the same time. The numbness and tingling are usually felt in the thumb, index finger, middle finger and part of the ring finger. The complaints usually occur at night and sometimes interfere with normal sleep so severely that the person will find it difficult to function normally during the day.


There is sometimes a loss of strength and the ball of the hand becomes thin. The carpal tunnel syndrome is often seen in both hands, with one hand being more affected than the other.


People with intellectual disabilities sometimes find it impossible to communicate these symptoms. The people around them may then notice only a change in behaviour.

 

How common is the carpal tunnel syndrome in the general population?

In the Netherlands, prevalence rates vary from 9.2% in women to 0.6% in men, with a peak incidence between 40 and 60 years. 180


Different studies have found different lifetime prevalences between 1% and 3.8% 181 182


In the general Dutch population, the one-year prevalence of various hand and wrist complaints (including carpal tunnel syndrome) is estimated at 125 per 1000 people. 503

 

How common is the carpal tunnel syndrome in people with intellectual disabilities?

No studies were found of prevalence in people with intellectual disabilities in general.


A Danish study of 48 people with Down syndrome showed electrophysiological anomalies in 44% (27% had proven carpal tunnel syndrome and 17% had a probable carpal tunnel syndrome). Only one person complained about this. 183


The carpal tunnel syndrome is also seen more frequently in people with mucopolysaccharidosis type II (Hunter syndrome). 504

9.2% General population of Dutch women
27% to 44% People with Down syndrome
Not known in people with intellectual disabilities but no Down syndrome

108

108

Wijngaarden S. Prevalentie van het carpale-tunnelsyndroom in een algemene populatie. Ned. Tijdschr Geneesk 2000;144:393-4

Wijngaarden S. Prevalentie van het carpale-tunnelsyndroom in een algemene populatie. Ned. Tijdschr Geneesk 2000;144:393-4

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109

Marshall SC, Tardif G, Ashworth NL. Local corticosteroid injection for carpal tunnel syndrome (Review). 2009 The Cochrane Collaboration Issue 1 www.thwcochranelibrary.com

Marshall SC, Tardif G, Ashworth NL. Local corticosteroid injection for carpal tunnel syndrome (Review). 2009 The Cochrane Collaboration Issue 1 www.thwcochranelibrary.com

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110

O’Connor D, Marshall SC, Massy-Westropp N. Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome (Review) 2009 The Cochrane Collaboration Issue 1 www.thwcochranelibrary.com

O’Connor D, Marshall SC, Massy-Westropp N. Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome (Review) 2009 The Cochrane Collaboration Issue 1 www.thwcochranelibrary.com

473

473

Peters-Veluthamaningal C, Willems W, Smeets JGE, Van der Windt DAWM, Spies MN, Strackee SD, Vos K, Wind LA, Geraets JJXR. NHG-Standaard Hand- en polsklachten. Huisarts Wet 2010:53(1):22-39

Peters-Veluthamaningal C, Willems W, Smeets JGE, Van der Windt DAWM, Spies MN, Strackee SD, Vos K, Wind LA, Geraets JJXR. NHG-Standaard Hand- en polsklachten. Huisarts Wet 2010:53(1):22-39

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111

Christensen JE, Peter PJ, Nielsen VK, Mai J. Prevalence of carpal tunnel syndrome among individuals with Down syndrome. Am J Ment Retard. 1998 May;102(6):547-51.

Christensen JE, Peter PJ, Nielsen VK, Mai J. Prevalence of carpal tunnel syndrome among individuals with Down syndrome. Am J Ment Retard. 1998 May;102(6):547-51.

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474

Al Sawaf S, Mayatepek E, Hoffmann B.  Neurological findings in Hunter disease: pathology and possible therapeutic effects reviewed. J Inherit Metab Dis. 2008 Aug;31(4):473-80

Al Sawaf S, Mayatepek E, Hoffmann B.  Neurological findings in Hunter disease: pathology and possible therapeutic effects reviewed. J Inherit Metab Dis. 2008 Aug;31(4):473-80