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Cell Calcium Feb 2010Abnormal neuronal calcium (Ca2+) homeostasis has been implicated in numerous diseases of the nervous system. The pathogenesis of two increasingly common disorders of the... (Review)
Review
Abnormal neuronal calcium (Ca2+) homeostasis has been implicated in numerous diseases of the nervous system. The pathogenesis of two increasingly common disorders of the peripheral nervous system, namely neuropathic pain and diabetic polyneuropathy, has been associated with aberrant Ca2+ channel expression and function. Here we review the current state of knowledge regarding the role of Ca2+ dyshomeostasis and associated mitochondrial dysfunction in painful and diabetic neuropathies. The central impact of both alterations of Ca2+ signalling at the plasma membrane and also intracellular Ca2+ handling on sensory neurone function is discussed and related to abnormal endoplasmic reticulum performance. We also present new data highlighting sub-optimal axonal Ca2+ signalling in diabetic neuropathy and discuss the putative role for this abnormality in the induction of axonal degeneration in peripheral neuropathies. The accumulating evidence implicating Ca2+ dysregulation in both painful and degenerative neuropathies, along with recent advances in understanding of regional variations in Ca2+ channel and pump structures, makes modulation of neuronal Ca2+ handling an increasingly viable approach for therapeutic interventions against the painful and degenerative aspects of many peripheral neuropathies.
Topics: Animals; Calcium; Calcium Signaling; Diabetic Neuropathies; Humans; Mononeuropathies; Neurons; Peripheral Nervous System
PubMed: 20034667
DOI: 10.1016/j.ceca.2009.11.008 -
BMC Musculoskeletal Disorders Aug 2023Our objective was to summarize, synthesize, and integrate the evidence evaluating the effectiveness of biophysical agents compared to other conservative treatments, for... (Review)
Review
BACKGROUND
Our objective was to summarize, synthesize, and integrate the evidence evaluating the effectiveness of biophysical agents compared to other conservative treatments, for the management of carpal tunnel syndrome (CTS).
METHODS
This was an overview of systematic reviews (SRs). We searched several online databases and obtained SRs relating to managing CTS using biophysical agents. Two independent researchers screened and appraised the quality of the SRs using the A MeaSurement Tool to Assess systematic Reviews-2 appraisal tool. We extracted information related to study characteristics as well as the effectiveness of biophysical agents for CTS, the effect sizes, and between-group significances. We categorized the information based on the type of biophysical agent. We also performed a citation mapping and calculated the corrected covered area index.
RESULTS
We found 17 SRs addressing 12 different biophysical agents. The quality of the SRs was mainly critically low (nā=ā16) or low (nā=ā1). The evidence was inconclusive for the effectiveness of Low-level Laser therapy and favorable for the short-term efficacy of non-thermal ultrasound in improving symptom severity, function, pain, global rating of improvement, satisfaction with treatment, and other electrophysiological measures compared to manual therapy or placebo. Evidence was inconclusive for Extracorporeal Shockwave therapy, and favorable for the short-term effectiveness of Shortwave and Microwave Diathermy on pain and hand function. The corrected covered area index was lower than 35% indicating a low overlap of the SRs.
CONCLUSIONS
The findings were based on low-quality primary studies, with an unclear or high risk of bias, small sample sizes, and short follow-ups. Therefore, no recommendations can be made for the long-term effectiveness of any biophysical agents. High-quality evidence is needed to support evidence-based recommendations on the use of biophysical agents in the management of CTS.
PROSPERO REGISTRATION NUMBER
CRD42022319002, registered on 17/04/2022.
Topics: Humans; Carpal Tunnel Syndrome; Extracorporeal Shockwave Therapy; Low-Level Light Therapy; Pain Management; Systematic Reviews as Topic
PubMed: 37563725
DOI: 10.1186/s12891-023-06778-z -
CMAJ : Canadian Medical Association... Aug 2014
Topics: Carpal Tunnel Syndrome; Humans; Immobilization; Occupational Diseases; Occupational Therapy; Risk Factors
PubMed: 24566652
DOI: 10.1503/cmaj.131177 -
The Journal of Emergency Medicine 1999Chronic carpal tunnel syndrome was initially described by James Jackson Putnam in 1880. A number of medical luminaries have also contributed to our understanding of the... (Review)
Review
Chronic carpal tunnel syndrome was initially described by James Jackson Putnam in 1880. A number of medical luminaries have also contributed to our understanding of the syndrome, including Paget, Marie, Ramsay Hunt, Phalen. and Osler. Carpal tunnel syndrome is the most common peripheral compression neuropathy. Most cases are idiopathic, with nonspecific tenosynovitis leading to median nerve compression. A number of diseases and other conditions are also associated with chronic carpal tunnel. Patients characteristically complain of nocturnal paresthesias or burning pain. Motor complaints relate to thenar muscular weakness and atrophy. Bedside diagnostic tests include Tinel's and Phalen's signs, and application of pressure over the median nerve by inflating a sphygmomanometer over the wrist. Tinel's sign is the induction of paresthesias by tapping over the site of the median nerve at the wrist. In Phalen's sign, symptoms are reproduced by maximum flexion of the wrist for 60 s. The classically described patients are middle-aged women. In addition, another distinct population is receiving increased attention, the relatively young male and female workers who experience symptoms performing repetitive manual labor.
Topics: Adult; Carpal Tunnel Syndrome; Female; History, 19th Century; History, 20th Century; Humans; Male; Middle Aged; Occupational Diseases
PubMed: 10338251
DOI: 10.1016/s0736-4679(99)00030-x -
Neurosciences (Riyadh, Saudi Arabia) Jul 2017One of the most common referrals to the electrodiagnostic (EDX) laboratory is to confirm a clinical impression of carpal tunnel syndrome (CTS). The EDX studies are... (Review)
Review
One of the most common referrals to the electrodiagnostic (EDX) laboratory is to confirm a clinical impression of carpal tunnel syndrome (CTS). The EDX studies are valuable in localizing median nerve abnormalities to the wrist, grading its severity, and excluding other condition that can mimic or coexist with CTS. However, there are many clinical and EDX pitfalls that can lead to misdiagnosis. Careful clinical assessment and attention to technical factors and details of the EDX techniques are fundamental for the quality and accurate interpretation of the study. This review aims to discuss the clinical and the EDX approaches to the diagnosis of CTS with emphasis on the commonly encountered pitfalls.
Topics: Carpal Tunnel Syndrome; Diagnostic Techniques, Neurological; Humans; Median Nerve
PubMed: 28678210
DOI: 10.17712/nsj.2017.3.20160638 -
BMJ (Clinical Research Ed.) Aug 2007
Review
Topics: Carpal Tunnel Syndrome; Clinical Laboratory Techniques; Humans; Referral and Consultation; Splints; Steroids
PubMed: 17703044
DOI: 10.1136/bmj.39282.623553.AD -
Best Practice & Research. Clinical... Feb 2011Carpal tunnel syndrome (CTS) is a fairly common condition in working-aged people, sometimes caused by physical occupational activities, such as repeated and forceful... (Review)
Review
Carpal tunnel syndrome (CTS) is a fairly common condition in working-aged people, sometimes caused by physical occupational activities, such as repeated and forceful movements of the hand and wrist or use of hand-held, powered, vibratory tools. Symptoms may be prevented or alleviated by primary control measures at work, and some cases of disease are compensable. Following a general description of the disorder, its epidemiology and some of the difficulties surrounding diagnosis, this review focusses on the role of occupational factors in causation of CTS and factors that can mitigate risk. Areas of uncertainty, debate and research interest are emphasised where relevant.
Topics: Carpal Tunnel Syndrome; Humans; Occupational Diseases; Risk Factors
PubMed: 21663847
DOI: 10.1016/j.berh.2011.01.014 -
Neurologia Medico-chirurgica Apr 2017Idiopathic carpal tunnel syndrome (CTS) is a common complaint, reflecting entrapment neuropathy of the upper extremity. CTS produces symptoms similar to those of other... (Review)
Review
Idiopathic carpal tunnel syndrome (CTS) is a common complaint, reflecting entrapment neuropathy of the upper extremity. CTS produces symptoms similar to those of other conditions, such as cervical spondylosis or ischemic or neoplastic intracranial disease. Because of these overlaps, patients with CTS are often referred to a neurosurgeon. Surgical treatment of CTS was started recently in our department. Through this experience, we realized that neurosurgeons should have an increased awareness of this condition so they can knowledgeably assess patients with a differential diagnosis that includes CTS and cervical spinal and cerebral disease. We conducted a literature review to gain the information needed to summarize current knowledge on the clinical, pathogenetic, and therapeutic aspects of CTS. Because the optimal diagnostic criteria for this disease are still undetermined, its diagnosis is based on the patient's history and physical examination, which should be confirmed by nerve conduction studies and imaging modalities such as magnetic resonance imaging and ultrasonography. Treatment methods include observation, medication, splinting, steroid injections, and surgical intervention. Understanding the clinical features and pathogenesis of CTS, as well as the therapeutic options available to treat it, is important for neurosurgeons if they are to provide the correct management of patients with this disease.
Topics: Carpal Tunnel Syndrome; Humans; Neurosurgery
PubMed: 28154344
DOI: 10.2176/nmc.ra.2016-0225 -
American Family Physician Jul 2003Carpal tunnel syndrome affects approximately 3 percent of adults in the United States. Pain and paresthesias in the distribution of the median nerve are the classic... (Review)
Review
Carpal tunnel syndrome affects approximately 3 percent of adults in the United States. Pain and paresthesias in the distribution of the median nerve are the classic symptoms. While Tinel's sign and a positive Phalen's maneuver are classic clinical signs of the syndrome, hypalgesia and weak thumb abduction are more predictive of abnormal nerve conduction studies. Conservative treatment options include splinting the wrist in a neutral position and ultrasound therapy. Orally administered corticosteroids can be effective for short-term management (two to four weeks), but local corticosteroid injections may improve symptoms for a longer period. A recent systematic review demonstrated that nonsteroidal anti-inflammatory drugs, pyridoxine, and diuretics are no more effective than placebo in relieving the symptoms of carpal tunnel syndrome. If symptoms are refractory to conservative measures or if nerve conduction studies show severe entrapment, open or endoscopic carpal tunnel release may be necessary. Carpal tunnel syndrome should be treated conservatively in pregnant women because spontaneous postpartum resolution is common.
Topics: Carpal Tunnel Syndrome; Glucocorticoids; Humans; Ultrasonic Therapy
PubMed: 12892346
DOI: No ID Found -
Proceedings of the National Academy of... Dec 2007Chemokines and chemokine receptors are widely expressed by cells of the immune and nervous systems. This review focuses on our current knowledge concerning the role of... (Review)
Review
Chemokines and chemokine receptors are widely expressed by cells of the immune and nervous systems. This review focuses on our current knowledge concerning the role of chemokines in the pathophysiology of chronic pain syndromes. Injury- or disease-induced changes in the expression of diverse chemokines and their receptors have been demonstrated in the neural and nonneural elements of pain pathways. Under these circumstances, chemokines have been shown to modulate the electrical activity of neurons by multiple regulatory pathways including increases in neurotransmitter release through Ca-dependent mechanisms and transactivation of transient receptor channels. Either of these mechanisms alone, or in combination, may contribute to sustained excitability of primary afferent and secondary neurons within spinal pain pathways. Another manner in which chemokines may influence sustained neuronal excitability may be their ability to function as excitatory neurotransmitters within the peripheral and central nervous system. As is the case for traditional neurotransmitters, injury-induced up-regulated chemokines are found within synaptic vesicles. Chemokines released after depolarization of the cell membrane can then act on other chemokine receptor-bearing neurons, glia, or immune cells. Because up-regulation of chemokines and their receptors may be one of the mechanisms that directly or indirectly contribute to the development and maintenance of chronic pain, these molecules may then represent novel targets for therapeutic intervention in chronic pain states.
Topics: Chemokines; Humans; Mononeuropathies; Neuralgia; Neuroglia; Peripheral Nerve Injuries; Receptors, Chemokine
PubMed: 18083844
DOI: 10.1073/pnas.0709250104