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Medical Disability Advisor  >  Carpal Tunnel Syndrome  >  Treatment  see more: ACOEM - Carpal Tunnel Syndrome

Carpal Tunnel Syndrome


Related Terms


  • Compression Neuropathy
  • CTS
  • Median Nerve Compression
  • Median Nerve Mononeuropathy

Differential Diagnoses


Specialists


  • Ergonomist
  • Hand Surgeon
  • Neurologist
  • Neurosurgeon
  • Occupational Therapist
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist
  • Physical Therapist

Comorbid Conditions


  • Diabetes mellitus
  • Obesity
  • Thyroid illness
  • Toxic exposures

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Factors Influencing Duration


The ability (or lack thereof) to stop activities that increase the symptoms, the response to conservative treatment, and the ability to perform tasks while wearing adaptive splints may influence disability time. The endoscopic form of carpal tunnel release surgery, which involves smaller incisions, has a shorter recovery period but a higher complication rate, and final outcomes are the same, regardless of whether surgery is done by open "mini-palm" or by endoscopic technique.

Duration Trends from Reference Data


DURATION TRENDS
 ICD-9-CM: 354  
CasesMeanMinMaxNo Lost TimeOver 6 Months
97855102550.2%0.4%
 
  
 
Percentile:5th25thMedian75th95th
Days:12274367123
 
  
 

DURATION TRENDS
 ICD-9-CM: 354.0  
CasesMeanMinMaxNo Lost TimeOver 6 Months
61615502170.1%2.7%
 
  
 
Percentile:5th25thMedian75th95th
Days:11274472147
 
  
 

Differences may exist between the duration tables and the reference graphs. Duration tables provide expected recovery periods based on the type of work performed by the individual. The reference graphs reflect the actual experience of many individuals across the spectrum of physical conditions, in a variety of industries, and with varying levels of case management. Selected graphs combine multiple codes based on similar means and medians.

Medical Codes


ICD-9-CM:
354 - Mononeuritis of Upper Limb and Mononeuritis Multiplex
354.0 - Carpal Tunnel Syndrome; Median Nerve Entrapment; Partial Thenar Atrophy

Treatment


Conservative treatment may include eliminating or greatly reducing movements or tasks that seem to cause or exacerbate the symptoms, such as repetitive motion of the wrist and fingers or wrist-bending extremes (flexion and extension). Other treatment may include use of nonsteroidal anti-inflammatory drugs (NSAIDs such as aspirin and ibuprofen), wearing protective splints while working and/or sleeping, stretching and strengthening exercises, diuretics to reduce excess fluids, and possible corticosteroid injections into the carpal tunnel. An electrical current may be used to deliver medication (usually corticosteroids) through the skin into the area requiring treatment (iontophoresis). Studies have shown that vitamin B6 (pyridoxine) supplements help reduce symptoms of CTS only in those who are deficient in this vitamin; yoga has been shown to reduce pain and increase grip strength (NINDS).

In chronic or severe cases unrelated to fluid buildup in pregnancy or menopause, surgery may be required. The procedure (open carpal tunnel release) involves cutting the transverse carpal ligament (roof of the carpal tunnel) to relieve pressure on the median nerve. This is generally done on an outpatient basis with local or regional anesthesia. In some cases, surgery can be performed endoscopically by inserting a fiberoptic endoscope through a small incision to observe the inside of the carpal tunnel while incising the transverse carpal ligament (endoscopic carpal tunnel release).

Source: Medical Disability Advisor






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