Effects of Prolonged Wrist Flexion on Transmission of Sensory Information in Carpal Tunnel Syndrome

Richard F. Sesek, Mehdi Khalighi, Donald S. Bloswick, Mark Anderson and Robert P. Tuckett

Carpal tunnel syndrome presents a constellation of symptoms which include discomfort (eg, pain, paraesthesia) and diminished sense of touch. This exploratory study simultaneously measured changes in tactile threshold and discomfort ratings during prolonged wrist flexion in symptomatic patients from a rehabilitation clinic and from a control population. Prolonged (15 min) wrist flexion significantly increased tactile threshold and discomfort ratings above baseline levels in both symptomatic and control populations. The study demonstrated that increases in mechanosensory threshold and discomfort ratings during prolonged wrist flexion are more profound (and recovery less rapid) in patients with electrophysiologic evidence of injury. The authors conclude that this provocative procedure enhances the symptoms of carpal tunnel syndrome. This measure may help clinicians discriminate median nerve compression from other types of peripheral nerve injury and help researchers investigate the impact of mechanical stress, tissue compression, and vascular stasis on compression-related neuropathy.

The Journal of Pain, Volume 8, Issue 2, February 2007, Pages 137-151

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