Carpal tunnel syndrome: diagnosis, treatment, rehabilitation (review)

Carpal tunnel syndrome (CTS) is one of the most common compression mononeuropathies. The disease is widespread among the working population in Russia and worldwide and has a distinct clinical picture. Currently, there are effective international diagnostic and treatment algorithms. However, the awareness of doctors and patients about the initial manifestations of the CTS remains low. The frequency of erroneous diagnosis and difficulties in the differential diagnosis lead to untimely beginning of a specific therapy and early disability among working population, which decreases the efficacy of subsequent treatment. This article gives a detailed description of the gold standard of disease diagnosis. It describes the peculiarities of nerve conduction studies (NCS), analyzes the results obtained, and gives the hints for interpretation. The use of ultrasound examination, as a method which allows to visualize the nerve, surrounding structures and to identify the causes of compression is also described. It should be noted that the method has not only a diagnostic value, but is also used to navigate the surgical treatment and monitor the effectiveness of the treatment in the postoperative period. It is also very important to know about different options of rehabilitation and justify their use in the early postoperative period, analyze the effectiveness of physical therapy in the conservative treatment of CTS. A thorough acquaintance with modern trends of clinical and instrumental diagnosis of the disease will help to develop an effective algorithm for treatment and rehabilitation, as well as to implement a methodology for a personalized approach to each patient individually.