• 대한한의학회지
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• 제36권2호
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• pp.43-49
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• 2015

Objectives: We evaluated the effect of the traditional Korean medical therapy of catgut-embedding therapy in patients with carpal tunnel syndrome (CTS). Methods: Thirteen patients(20 hands) with CTS underwent catgut-embedding therapy once per week for a total of 1-4 sessions. We measured the time to tingling in the fingers on performing Phalen's test. We also had patients use a visual analog scale (VAS) to indicate the severity of tingling. We also asked about the awakening time at night due to pain and tingling. We controlled the treatment as being limited to four sessions. Even if a patient had not been treated for four sessions, we ended the patient's treatment if symptoms resolved. Results: Patients who received catgut-embedding therapy showed significant improvements in the clinical symptoms of CTS. After treatment, in a total of 19 hands, the status of fourteen was changed from positive to negative in Phalen's test and the average of tingling occurrence time in that test was delayed. Among the 20 hands, the VAS in eight hands changed to zero and the average of VAS score decreased. Furthermore, in nine patients, four could sleep well without the use of a splint. Conclusions: Patients undergoing this traditional Korean medical therapy showed alleviation of finger tingling after even a single treatment. We thus concluded that this traditional Korean catgut-embedding therapy, may be effective for treating CTS. However, to confirm the effects of catgut-embedding therapy on CTS, further tests are required, including under the defined, strict conditions of a randomized controlled trial.

• 한방재활의학과학회지
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• 제30권4호
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• pp.119-132
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• 2020

Objective The purpose of this study was to investigate clinical studies between 2015 and 2020 on the traditional Chinese medicine treatment for carpal tunnel syndrome (CTS) using the China National Knowledge Infrastructure (CNKI) database. Methods We searched clinical studies on the Chinese medicine treatment published in traditional Chinese medical journals on CTS through the CNKI search. Fifteen published studies between 2015 and 2020 were chosen and examined for the year of publication, sample size, study design type, diagnosis and evaluation of diverse criteria, treatment period, purpose of the study, and classification based on the treatment technique. Results Out of 73 studies, 15 had practiced various Chinese medical treatments, such as acupuncture, moxibustion, manipulation, herbal medicine application therapy, and external herbal treatment. Conclusions Various studies have investigated the Chinese medicine treatment for CTS in China. To envelope the treatment of CTS in Korean medicine, steady and valuable therapies for high-level clinical research are required. In the future, this study could be helpful in the development of the treatment of CTS with Korean medicine.

• Journal of Korean Neurosurgical Society
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• 제51권5호
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• pp.286-291
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• 2012

Objective : To investigate the change of latency of cervical dermatomal somatosensory evoked potential (DSEP) according to stimulation intensity (SI) and severity of carpal tunnel syndrome (CTS). Methods : Stimulation sites were the C6, C7, and C8 dermatomal areas. Two stimulation intensities $1.5{\times}$sensory threshold (ST) and $2.5{\times}ST$ were used on both normal and CTS patients. Results : In moderate CTS, the latencies of C6 and C7 DSEP during $1.5{\times}ST$ SI and those of C7 DSEP during $2.5{\times}ST$ SI were significantly delayed compared with the values of normal subjects. Significant correlation between the latency of C7 DSEP of $2.5{\times}ST$ stimulation and the median sensory nerve conduction velocity was observed. Conclusion : We suggest that these data can aid in the diagnosis of cervical sensory radiculopathy using low stimulation intensity and of those who have cervical sensory radiculopathy combined with CTS patients.

• Annals of Clinical Neurophysiology
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• 제2권2호
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• pp.89-94
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• 2000

Purpose : Carpal tunnel syndrome (CTS) is a disorder of median nerve at wrist. It is usually diagnosed through clinical manifestation and nerve conduction study (NCS). However, sometimes, NCS does not provide a reliable evidence to reach the diagnosis. Thus, authors performed this study to determine whether NCS was correlated with specific parameters measured on magnetic resonance imaging (MRI) which might become a potential complemental diagnostic tool. Methods : We performed MRI in 34 wrists of 18 patients with clinical manifestations of CTS and pathologic nerve conduction values and analyzed them at levels of the distal radioulnar joint, pisiform and hook of hamate, Results : Increase in the cross-sectional area of the median nerve at the pisiform level and flattening, increased signal intensity, and contrast enhancement of the median nerve at levels of the pisiform and hook of hamate were statistically significant. Change in cross sectional areas between the distal radioulnar joint and hamate and the signal intensities at levels of pisiform and hamate were well correlated with the median nerve conduction velocity. Conclusions : Characteristic MRI findings in CTS reported previously were well demonstrated and some of MRI parameters are well correlated with nerve conduction study. MRI, despite cost, may help in evaluating CTS.

• 한국전문물리치료학회지
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• 제16권1호
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• pp.61-69
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• 2009

The objective of this study was to investigate the relationship between addiction to online games and carpal tunnel syndrome (CTS) in college students. A total of 377 (205 male and 172 female) college students completed an online game addiction scale, a Symptom Severity Scale (SSS), and a Function Status Scale (FSS) for CTS. It was found that five (1.3%) students were diagnosed with an online game addiction, 74 (19.6%) students were diagnosed with a pre-addiction to online games, and 298 (79.0%) students were diagnosed as being average users. The pre-addiction group had significantly higher scores on the SSS than did the average user group (p<.05). The average user group scored significantly lower than did the online game addiction group (p<.05). Symptoms of wrist pain and hand numbness in the daytime were common in the addiction group. There were statistically significant but poor positive relationships between the online game addiction scale and the SSS (r=.312, p<.01), and between the online game addiction scale and the FSS (r=.149, p<.01). The information about online game addiction and CTS identified in this study could contribute to the prevention of online game addiction and CTS in college students.

• 척추신경추나의학회지
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• 제16권2호
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• pp.9-19
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• 2021

Objectives This systematic review aimed to provide evidence for the effectiveness and safety of Chuna manual therapy (CMT) for carpal tunnel syndrome (CTS). Methods We searched 12 electronic databases (PubMed, Ovid-MEDLINE, EMBASE, The Cochrane Library, CNKI, CiNii, ScienceON, KMbase, KISS, OASIS, KMTANK, and RISS) up to the end of October 2021. We only included randomized controlled trials (RCTs) investigating CMT for the treatment of CTS. The methodological quality of the included RCTs was evaluated using the Cochrane Risk of Bias Tool 1.0. Results Six RCTs were eligible for inclusion in our study. A meta-analysis of four studies demonstrated positive results for the use of CMT when used in conjunction with Korean medicine treatment compared to those for Western conservative treatment for CTS. Conjunction treatment significantly improved the total efficacy rate compared to conservative treatment alone (P=0.0007, n=4). Conclusions There is reliable evidence for the use of CMT in treating CTS based on a published meta-analysis. To measure only the effect of Chuna, an experimental group should be designed with Chuna alone to evaluate its effectiveness. However, it should be noted that the studies included in this systematic review were heterogeneous and of low quality, thus warranting further investigation using well-designed RCTs.

• Annals of Clinical Neurophysiology
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• 제4권2호
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• pp.114-118
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• 2002

Backgrounds : Carpal tunnel syndrome (CTS) is a common condition that is usually diagnosed by electrophysiologic studies. However, CTS provide limited information to determine the causes of CTS and to choose the treatment method. We evaluated diagnostic sensitivity of MR imaging and treatment decisions by MR imaging in electrodiagnosed CTS. Methods : 14 patients (26 wrists) with electrodiagnosed CTS were studied using MR imaging. In 26 wrists for which axial T1 & T2 weighted images were obtained at 1.5T with a decided wrist coil. Previously described MR imaging of CTS such as increased median nerve signal, flattening of median nerve, reticular bowing, tenosynovitis and space occupying lesions were retrospectively evaluated. Degree of improvement was evaluated by global symptom score (GSS). The GSS rated symptoms from 0 (no symptoms) to 10 (severe) in each of five categories: pain, numbness, paresthesia, weakness/clumsiness, and nocturnal awakening. Subjects' GSS was recorded at baseline, 2 weeks, 1 month, 6 months after treatment. We decided to medical treatment that showed mainly inflammatory sign such as increased median nerve signal, tenosinovitis and to surgical treatment such as space occupying lesion, high canal pressure sign. Results : MR imaging showed that increased median nerve signal were in 20 wrists (77%), flattening of median nerve were in 6 wrists (23%), reticular bowing were in 3 wrists (12%), tenosynovitis were in 8 wrists (32%), decreased canal size in 2 wrists (7.6%), space occupying lesion were in 1 wrist (4%). A good outcome was revealed in 21 wrists by medical treatment that showed mainly increased median nerve signal, tenosynovitis. The mean GSS were 27.7 at baseline, 11.2 at 2 weeks, 11.0 at 6 months in medical treatment group. Another 5 wrist had surgical treatment shown by ganglion and high canal pressure sign such as median nerve flattening, reticular bowing, decreased canal size: 3 wrists had good prognosis, but 2 wrists (one patient) had no significant improvement due to small carpal tunnel size. Conclusions : Our results are in agreement with most previously described MR imaging signs of CTS. MR imaging plays an important role in several cases and especially in the assessment of failure of surgical treatment. Knowledge of MR findings may permit more rational choice of treatment.

• 대한한방부인과학회지
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• 제28권4호
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• pp.65-76
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• 2015

Objectives : This study is to report the effect of Korean medical treatment on a patient suffered from carpal tunnel syndrome (CTS) occurred in pregnancy and worsened after birth. Methods : We treated the patient diagnosed as carpal tunnel syndrome by Korean medical treatment such as acupuncture, pharmacopuncture and herbal medicine at ⃝⃝Hospital of Korean Medicine from July 31th 2015 to August 6th 2015. And we evaluated changes of symptoms by Visual Analog Scale (VAS), Tinel sign, Phalen’s test, and Digital Infrared Thermographic Imaging (DITI). Results : 1. Through Korean medical treatment, postpartum carpal tunnel syndrome was significantly improved. VAS was decreased from 4 to 2, Phalen’s test was manifested from 10 seconds to 26 seconds and Tinel sign was changed from positive to negative. 2. We compared the gap of temperature between palm and forearm before and after Korean medical treatment through DITI. The temperature on the right side was changed from 0.74℃ to 1.01℃ and the left one from 0.63℃ to 1.01℃. Conclusions : This case report shows that Korean medical treatment is useful to treat pregnancy-related carpal tunnel syndrome worsened after birth.

• Journal of Korean Neurosurgical Society
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• 제56권5호
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• pp.390-394
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• 2014

Objective : In most patients with carpal tunnel syndrome (CTS), pain and/or paresthesia disappeared or decreased in a month after endoscopic carpal tunnel release (ECTR). However, subpopulation of patients showed delayed improvement following ECTR. We analyzed the delayed improvement hands to investigate the characteristics of those patients and to determine the predictable factors of delayed improvement. Methods : Single-portal ECTRs were performed in 1194 hands of 793 CTS patients from 2002 to 2011. Five-hundred seventy hands with minimal 1-year postoperative follow-up were included. We divided the 545 satisfied hands into early (group A) and delayed (group B) groups according to improvement period of 1 month. Demographic data, clinical severity and electrodiagnostic abnormality were compared between groups. Results : Group A included 510 hands and group B included 35 hands. In group B, 11 hands improved in 2 months, 15 hands in 3 months and 9 hands in 6 months, respectively. In group A/B, according to clinical severity, 60/1 hands were graded to I, 345/24 hands to II, 105/10 hands to III. In group A/B, based on electrodiagnostic abnormality, 57/3 hands were classified to mild, 221/11 hands to moderate and 222/21 hands to severe group. Statistical analysis between groups did not reach significance but electrodiagnostic or clinical severity had a tendency to affect the delayed response. Conclusion : It is difficult to predict the factors contributing to postoperatively-delayed response in subpopulation of CTS patients. However, we recommend that postoperative observation for at least 6 months is necessary in patients without symptomatic improvement.

• Annals of Clinical Neurophysiology
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• 제5권2호
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• pp.177-180
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• 2003

Background and Objectives: A nerve conduction study (NCS) has been known as a useful method to evaluate the therapeutic effect of operation in carpal tunnel syndrome (CTS). To evaluate the temporal relationship between symptomatic and electrophysiological improvement, we compared the preoperative symptoms and electrophysiological results with postoperative those. Methods: We analyzed the NCS changes before and after minimal release of carpal tunnel in 26 patients (34 hands) with CTS. The time of postoperative symptomatic changes, postoperative electrophysiological changes and temporal relationship between symptomatic and electrophysiological changes were evaluated. Results: The mean age was $49{\pm}13$ years. The proportion of males to female was 8 and 92 percent. The median interval days between date of operation and those of postoperative NCS was 28.5 days. Postoperative symptoms improved in 17 hands, slightly improved in 13 hands, and have not changed in 4 hands. Electrophysiological improvements after operation were observed in 26 hands, and mostly appeared within 2 months. Symptomatic relief accompanied with electrophysiological improvement reported in 13 hands (50%). Moreover, the four hands with symptom, not relieved by decompression, showed electrophysiological improvement. Conclusions: In this study, electrophysiological improvement was in consistency with symptomatic relief to some extent, but we got the result of disagreement between electrophysiological and symptomatic improvement.