Ultrasonographic Measurements of the Median Nerve Before and After Splinting for Carpal Tunnel Syndrome

High Resolution Ultrasonographic Measurements of the Median Nerve Before and After Wrist Splinting for Carpal Tunnel Syndrome

A prospective cohort follow-up study design is undertaken. Both males and females with mild to moderate carpal tunnel syndrome will receive standard-of-care wrist splint for 6 weeks and undergo follow up studies for data collection. Controls will also be seen for a one time visit.

Inclusion Criteria:

• 18 years or older and;
• Diagnosis of mild to moderate CTS with median motor latency at 8 cm is greater than 4.5 milliseconds or Combined Sensory Index > 0.9 where first line therapy is indicated to include nocturnal wrist bracing
• Control subjects without symptoms of carpal tunnel syndrome.

Exclusion Criteria:

• Evidence of severe CTS as seen with electromyographic changes in the body of the muscle
• Untreated hypothyroidism, Rheumatologic disorders
• Diagnosed Severe CTS or Chronic symptoms of carpal tunnel, greater than 1 year, this includes wasting of the hand muscles
• Undergoing or previously treated for carpal tunnel on affected side. This includes surgery (carpal tunnel release), corticosteroid injections, bracing within the last 3 months while wearing the brace consistently every night, or any other intervention.
• Currently pregnant or < 3 months post partum
• History of wrist, hand fracture or severe trauma to affected hand and/or wrist
• Known tumor, mass or deformity of the hand/wrist
• Inflammatory articular disease of the joints or tendons Existing cervical radiculopathy or previous surgeries to the neck for radicular symptoms
• History of electrodiagnostic evidence of generalized polyneuropathy or evidence of denervation
• Diagnosed neuromuscular disorders which may complicate CTS diagnosis
• Implanted electronic device (pacemaker, intrathecal pump/stimulator)
• Any illness that makes it unsafe for the patient to participate in the study
• Not fluent in English as NeuroQOL and other subjective information is limited to the English language interpretation