Natural evolution of carpal tunnel syndrome in untreated patients
Introduction
Carpal tunnel syndrome is a clinical condition that is frequently seen in medical evaluations by primary healthcare practitioners (Latinovic et al., 2006). The recommended therapies are substantiated by randomly allocated sample studies that demonstrate the benefits of injections or surgery. It is believed that due to its progressive nature, the disease produces severe sensory alterations and a greater disability if it is not treated in time. Transversal studies suggest that the disease progresses rapidly with age (Bland and Rudolfer, 2003). In the presence of co-morbidities such as diabetes or hypothyroidism, the progress of CTS is worse, due to the pathophysiological nature of these conditions (Kennedy and Zochodne, 2005). However, it is not yet known whether idiopathic CTS follows a defined pattern or that regardless of its severity, the duration of CTS itself is enough to produce functional and electrophysiological deterioration.
This study monitored patients diagnosed with CTS to determine the evolution of the disease, using clinical and electrophysiological classification.
Section snippets
Materials and methods
Since 2001, in our Electrophysiological Laboratory at the Carlos Lleras Restrepo Clinic, a clinical examination and a standardized questionnaire were applied to every patient that was referred for the evaluation of CTS. Demographic, clinical and electrophysiological data were collected. Specifically, databases including age, sex, Rempel’s clinical criteria for CTS (Rempel et al., 1998), functional tests and musculoskeletal co-morbidities (rheumatoid arthritis, cervical pain, shoulder
Results
One hundred and eighty-nine patients accepted the invitation to return for the clinical and electrophysiological follow-up exam. Fifty-seven patients of this group were treated with surgery, a brace or injections. One hundred and thirty-two patients did not receive any form of treatment. These patients did not receive treatment because of institutional difficulties. Testing was done at 24.2 months (SD = 4.2). The average age was 48.8 years (SD = 10.2), and 81.1% of the patients were female. Primary
Discussion
This research examined the natural evolution of idiopathic CTS in a group of patients who did not undergo any form of treatment. It was observed that over a period of approximately 24 months, the disease remained in a relatively stable electrophysiological state. This study confirms the natural course of CTS. In general, the findings support the conclusions obtained by other authors (Padua et al., 2001).
Although a high number of patients did not return for a follow-up exam, we consider that the
Acknowledgments
The authors thank Patricia Sierra, Sandra Katerine Garzón, Darío Vargas and Miguel Gutierrez for their editorial assistance in preparation of this manuscript.
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