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Karpaltunnelsyndrom

Sist revidert:
Sist revidert av:


Definisjon:
Skyldes kompresjon av nervus medianus i canalis carpi. Repeterende håndbevegelser i yrket og hevelser i håndleddet disponerer
Forekomst:
Hyppigst forekommende perifere nevropati med prevalens 3-4% i den voksne befolkning. Vanligst blant kvinner, prevalensen øker med alderen
Symptomer:
Typiske symptom er smerter, nummenhet og prikking i håndflaten og i de radiale fingrene
Funn:
Diagnosen kan stilles klinisk. Tinels og Phalens tegn kan styrke mistanken
Diagnostikk:
Klinikk sammen med nevrografisk diagnostikk gir mest pålitelig informasjon om tilstanden
Behandling:
Tilstanden kan spontanhelbrede, og konservativ behandling er som regel førstevalg. Ved alvorlige sympom og/eller store plager kan operativ behandling være et godt alternativ
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  3. American Academy of Orthopaedic Surgeons: Management of Carpal Tunnel Syndrome. Evidence-Based Clinical Practice Guideline 2016. www.aaos.org  
  4. Rosario NB, De Jesus O. Electrodiagnostic Evaluation of Carpal Tunnel Syndrome. StatPearls (Internet). Last Update: February 12, 2023. www.ncbi.nlm.nih.gov  
  5. Ljøstad U, Mygland Å. Karpaltunnelsyndrom. Nevro-NEL. Sist oppdatert: 28. okt. 2020. nevrologi.legehandboka.no  
  6. Muller M, Tsui D, Schnurr R, Biddulph-Deisroth L, Hard J, MacDermid JC. Effectiveness of hand therapy interventions in primary management of carpal tunnel syndrome: a systematic review. J Hand Ther 2004; 17: 210-28. PubMed  
  7. Todnem K, Lundemo GH. Symptomer og kliniske forløp ved karpaltunnelsyndrom. Tidsskr Nor Lægeforen 2001; 121: 1489-92. PubMed  
  8. Silver S, Ledford CC, Vogel KJ, Arnold JJ. Peripheral Nerve Entrapment and Injury in the Upper Extremity. Am Fam Physician. 2021;103(5):275-285. PubMed  
  9. Vaught MS, Brismée JM, Dedrick GS, et al.. Association of disturbances in the thoracic outlet in subjects with carpal tunnel syndrome: a case-control study. Journal of hand therapy 2011; 24: 44-52. PubMed  
  10. McDonagh C, Alexander M, Kane D. The role of ultrasound in the diagnosis and management of carpal tunnel syndrome: a new paradigm. Rheumatology (Oxford). 2015;54(1):9-19. PMID: 25118315 PubMed  
  11. Atthakomol P, Manosroi W, Phanphaisarn A, et al. Comparison of single-dose radial extracorporeal shock wave and local corticosteroid injection for treatment of carpal tunnel syndrome including mid-term efficacy: a prospective randomized controlled trial. BMC Musculoskelet Disord. 2018 Jan 25;19(1):32. doi: 10.1186/s12891-018-1948-3. PMID: 26610183 PubMed  
  12. Wu YT, Ke MJ, Chou YC, et al.. Effect of radial shock wave therapy for carpal tunnel syndrome: A prospective randomized, double-blind, placebo-controlled trial. J Orthop Res 2016 Jun; 34(6): 977-84. pmid:26610183 PubMed  
  13. Karimzadeh A, Bagheri S, Raeissadat SA, et al. The comparison of the effectiveness between different doses of local methylprednisolone injection versus triamcinolone in Carpal Tunnel Syndrome: a double-blind clinical trial. J Pain Res. 2019; 12: 579-84. PMID: 30787634 PubMed  
  14. Wu IX, Lam VC, Ho RS, et al. Acupuncture and related interventions for carpal tunnel syndrome: systematic review. Clin Rehabil 2019. pmid:31556315 PubMed  
  15. Chesterton LS, Blagojevic-Bucknall M, Burton C, et al. The clinical and cost-effectiveness of corticosteroid injection versus night splints for carpal tunnel syndrome (INSTINCTS trial): an open-label, parallel group, randomised controlled trial. Lancet 2018; 392: 1423-33. pmid:30343858 PubMed  
  16. Ashworth NL, Bland JD P, Chapman KM, et al. Local corticosteroid injection versus placebo for carpal tunnel syndrome. Cochrane Database of Systematic Reviews 2023, Issue 2. The Cochrane Library  
  17. Atroshi I, Flondell M, Hofer M, et al. Metyhylprednisolone injections for the carpal tunnel syndrome: A randomized, placebo-controlled trial. Ann Intern Med 2013; 159: 309-17. Annals of Internal Medicine  
  18. Hofer M, Ranstam J, Atroshi I. Extended Follow-up of Local Steroid Injection for Carpal Tunnel Syndrome: A Randomized Clinical Trial. JAMA Netw Open. 2021;4(10):e2130753. doi:10.1001/jamanetworkopen.2021.30753 DOI  
  19. Rankin IA, Sargeant H, Rehman H, Gurusamy KS. Low-level laser therapy for carpal tunnel syndrome. Cochrane Database of Systematic Reviews 2017, Issue 8. Art. No.: CD012765. DOI: 10.1002/14651858.CD012765. DOI  
  20. Li Y, Luo W, Wu G, Cui S, Zhang Z, Gu X. Open versus endoscopic carpal tunnel release: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord. 2020;21(1):272. PubMed  
  21. Fatami T, Kobayashi A, Utika T, Endoh T, Fujita T. Carpal tunnel syndrome; its natural history. Hand Surgery 1997; 2 (2): 129-30.
  • Terje Johannessen, professor dr. med.

Tidligere fagmedarbeidere

  • Tor Ansved, docent och specialist, Neurology clinic, Sophiahemmet, Stockholm (Medibas)
  • Trond Sand, professor, overlege seksjon for klinisk nevrofysiologi, Nevrologisk avdeling, Norges teknisk-naturvitenskapelige universitet og Regionsykehuset i Trondheim
  • Espen Dietrichs, professor og avdelingsoverlege, Universitetet i Oslo og Nevrologisk avdeling, Rikshospitalet, Oslo