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Musculoskeletal loading and carpal tunnel pressure.
Repetitive Motion Disorders of the Upper Extremity, Workshop, June 1994, Bethesda, MD 1994 Jun; :123-132
The role of musculoskeletal loading and carpal tunnel pressure (CTP) in carpal tunnel syndrome (CTS) was reviewed. A summary of the characteristics of CTS, the role of CTP in disease, the associations between wrist posture and CTP, tendon loading and CTP, and repetitive hand movements and CTP were presented. CTS results from an entrapment of the median nerve within the carpal tunnel and the wrist. The carpal tunnel is tightly occupied by the median nerve and by nine tendons, each of which are enclosed in a gelatinous sheath. Prolonged increases in CTP due to repeated hand movements have been postulated to initiate a cascade of events that leads to nerve entrapment. CTS is also associated with other factors such as space occupying lesions or conditions associated with tissue swelling that increase the pressure inside the carpal tunnel. A number of laboratory animal and clinical studies have provided strong evidence for CTP having a role in CTS. Clinical and experimental studies have shown that performing tasks with the wrist in awkward positions increases CTP, therefore providing a pathophysiologic link with epidemiologic studies which found that working with the wrist in non neutral positions increases the risk of CTS. Repetitive hand and finger motions have been linked to increases in CTP and this relationship is strongly influenced by the mean wrist angle involved in these activities.
NIOSH-Grant; Musculoskeletal-system-disorders; Carpal-tunnel-syndrome; Repetitive-work; Biomechanics; Physical-stress; Pathogenesis; Risk-factors
Medicine University of Calif., S.f. Sfgh Bldg 30 5Th FL San Francisco, CA 94110
Gordon SL; Blair SJ; Fine LJ
Repetitive Motion Disorders of the Upper Extremity, Workshop, June 1994, Bethesda, MD
University of California San Francisco, San Francisco, California
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