• Journal of Korean Neurosurgical Society
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• v.52 no.5
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• pp.472-475
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• 2012

Objective : The aim of this study is to establish the value of hand elevation test as a reproducible provocative test for the diagnosis of carpal tunnel syndrome (CTS). Methods : We had a prospective study of 45 hands of 38 patients diagnosed with CTS between April 2005 and February 2009. The diagnosis of CTS was based on the American Academy of Neurology clinical diagnostic criteria. Experimental and control group patients underwent Tinel's test, Phalen's test, carpal compression test and hand elevation test as provocative tests for CTS. Results : We used chi-square analysis to compare Tinel's test and Phalen's test, carpal compression test with hand elevation test. The sensitivity and specificity of the hand elevation test is 86.7% and 88.9% each. Tinel's test had 82.2% sensitivity and 88.9% specificity. Phalen's test had 84.4% sensitivity and 86.7% specificity. Carpal compression test had 84.4% sensitivity 82.2% specificity. Comparisons of sensitivity and specificity between hand elevation test and Tinel's test, Phalen's test, and carpal compression test had no statistically significant differences. To compare the diagnostic accuracies of four tests, the area under the non-parametric receiver operating character curve was applied. Conclusion : The hand elevation test has higher sensitivity and specificity than Tinel's test, Phalen's test, and carpal compression test. Chi-square statistical analysis confirms the hand elevation test is not ineffective campared with Tinel's test, Phalen's test, and carpal compression test.

• Journal of Korean Neurosurgical Society
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• v.55 no.5
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• pp.296-299
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• 2014

We report a rare case of pronator teres syndrome in a young female patient. She reported that her right hand grip had weakened and development of tingling sensation in the first-third fingers two months previous. Thenar muscle atrophy was prominent, and hypoesthesia was also examined on median nerve territory. The pronation test and Tinel sign on the proximal forearm were positive. Severe pinch grip power weakness and production of a weak "OK" sign were also noted. Routine electromyography and nerve conduction velocity showed incomplete median neuropathy above the elbow level with severe axonal loss. Surgical treatment was performed because spontaneous recovery was not seen one month later.

• Journal of Acupuncture Research
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• v.35 no.1
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• pp.4-10
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• 2018

The aim of this report was to show the effects of acupotomy in patients with carpal tunnel syndrome. Four patients were treated with acupotomy twice. Visual analogue scale (VAS), Tinel's sign, Phalen's test, Boston carpal tunnel syndrome questionnaire (BCTQ), muscular strength test, and a cross-sectional area of median nerve was measured using ultrasound before and after treatment. In all 4 cases, the VAS score, BCTQ score and cross-sectional area of median nerve, all decreased and muscular strength test score increased. Tinel's sign and the Phalen's test changed from a positive to a negative in most cases. This report shows that acupotomy is an effective treatment for carpal tunnel syndrome. Further larger are needed to fully evaluate the beneficial effects of this treatment.

• The Journal of Korean Obstetrics and Gynecology
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• v.28 no.4
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• pp.65-76
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• 2015

Objectives : This study is to report the effect of Korean medical treatment on a patient suffered from carpal tunnel syndrome (CTS) occurred in pregnancy and worsened after birth. Methods : We treated the patient diagnosed as carpal tunnel syndrome by Korean medical treatment such as acupuncture, pharmacopuncture and herbal medicine at ⃝⃝Hospital of Korean Medicine from July 31th 2015 to August 6th 2015. And we evaluated changes of symptoms by Visual Analog Scale (VAS), Tinel sign, Phalen’s test, and Digital Infrared Thermographic Imaging (DITI). Results : 1. Through Korean medical treatment, postpartum carpal tunnel syndrome was significantly improved. VAS was decreased from 4 to 2, Phalen’s test was manifested from 10 seconds to 26 seconds and Tinel sign was changed from positive to negative. 2. We compared the gap of temperature between palm and forearm before and after Korean medical treatment through DITI. The temperature on the right side was changed from 0.74℃ to 1.01℃ and the left one from 0.63℃ to 1.01℃. Conclusions : This case report shows that Korean medical treatment is useful to treat pregnancy-related carpal tunnel syndrome worsened after birth.

• Journal of Preventive Medicine and Public Health
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• v.29 no.3 s.54
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• pp.507-519
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• 1996

The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry : to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome : and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity (NCV). The study group was divided into exposed group(39 cases) and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exsist. 1. There are stastically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were comfirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram , sensitivity 88.9%, specificity 84.2% Tinel's sign ; sensitivity 55.6%, specificity 72.8% Phalen's sign ; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.

• Journal of Acupuncture Research
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• v.19 no.6
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• pp.61-66
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• 2002

Objective : Carpal tunnel syndrome has gained increasing attention and acceptance as a significant cause of peripheral neuropathy, since it was first reported in 1836. The purpose of this study is to inspect the effect of oriental medical treatment on Carpal tunnel syndrome patients who is not come under surgical decompession. Methods : 20 patients who visited Won-Kwang University Hospital during the period from January 1998 to May 2000 were analysed for clinical manifestations. Results : 1. Among 20 patients, 3 were male and 17 were female. 2. The syndrome occurred on the right side in 5 patients, on the left side in 0 patients, and on both 15 patients 3. The most of causes were overwork. 4. Numbness was the most common symptom followed by night pain, paresthesis, morning stiffness, puffiness and resting pain 5. Among 20 patients, 12 were Tinel's sign positive, 16 were Phalen's test positive Conclusions : When the symptom is mild and duration is short, conservative treatment is effetive, but when neurological deficit is prominent and conservative treatment is not effective, surgical decompession is indicated. We treated 19 among 20 cases of the patients which Carpal Tunnel syndrome. We achieved effective results.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.1
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• pp.53-60
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• 2002

Neurosensory dysfunction of the injured inferior alveolarnerve(IAN) is a common and distrssing consequence of traumatic or iatrogenic injury. Conventional neurosensory testing has been used to detect and monitor sensory impairments of the injured IAN. However, these tests had low reliability and are not qualitative at best because they are based on solely on the patient's subjective assesment of symptoms. Consequently, there is need for more reliable, sensitive, and objective test measures to document and to monitor sensory dysfunction of the trigeminal nerve. This study was to investigate DITI's (digital infrared thermographic imaging) potential as a diagnostic alternative for evaluating of the nerve injures and sensory disturbance. Subjects were 30 patients who had been referred to Ewha Medical Center due to sensory disturbance of the lower lip and chin followed after unobserved inferior alveolar nerve injuries. The patients were examined by clinical neurosensory tests as SLTD (static light touch discrimination), MDD (moving direction discrimination), PPN (pin prick nociception) and DITI (digital infrared thermographic imaging). The correlation between clinical sensory dysfunction scores(Sum of SLTD, MDD, PPN, NP, Tinel sign) and DITI were tested by Spearman nonparametric rank correlation anaylsis & Kruskal-Wallis test, Wilcoxon 2-sample test. This study resulted in as follows; (1) The difference of thermal difference between normal side and affected side was as ${\Delta}-3.2{\pm}0.13$. (2) The DITI differences of the subjects presenting dysesthesia of the lip and chin were correlated significantly with the neurosensory dysfunction scores(r=0.419, p=0.021)and SLTD (r=0.429, p<0.05). (3) The MDD, PPN, NP, Tinel sign, duration, gender were not correlated with DITI(p> 0.05). Therefore, the DITI(digital infrared thermographic imaging) can be an option of the useful objective diagnostic methods to evaluate the injured inferior alveolar nerve and sensory dysfunction of trigerminal nerve.

• Journal of Pharmacopuncture
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• v.24 no.2
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• pp.76-83
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• 2021

While carpal tunnel syndrome (CTS) is the most common entrapment neuropathy affecting the wrist, resulting in substantial physical, psychological, and economic effects, there is no gold standard therapy for CTS. In this case series study, we aimed to report CTS patients treated with Carthami Semen Pharmacopuncture (CSP) and electroacupuncture (EA) showing improvements in their symptoms, and the combinatorial effects of CSP and EA. We collected medical records of CTS outpatients who received CSP and EA at Chuku Acupuncture & Moxibustion Korean Medicine Clinic from August 2017 to September 2018. The outcome measures were the visual analog scale (VAS) for pain, paresthesia, the Korean version of the Boston carpal tunnel questionnaire (K-BCTQ) score, and changes in nocturnal pain, Tinel sign, and Phalen's test. We included patient satisfaction at the completion of all treatments. 17 patients were included for this case series study. After treatment, VAS for pain decreased significantly from 50.41 ± 16.19 to 9.59 ± 9.46, VAS for paresthesia also decreased significantly from 63.50 ± 11.49 to 14.75 ± 12.97, and K-BCTQ symptom severity scale decreased from 2.48 ± 0.68 to 1.89 ± 0.70 (all p < 0.001). Nocturnal pain, Tinel signs, and Phalen's test showed improvements after all the treatments. All the patients reported favorable overall satisfaction with the treatments, and 69.23% wanted future pharmacopuncture treatments if CTS recurred. No complications were detected. The combination of CSP and EA could be an effective and safe option in treating CTS.

• Journal of Yeungnam Medical Science
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• v.8 no.1
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• pp.79-85
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• 1991

The author studied 20 healthy adults (20 hands) as a control and 30 patients (40 hands) with carpal tunnel syndrome to evaluate the clinical usefulness of measuring nerve conduction velocity after wrist fiexion in diagnosis of carpal tunnel syndrome. The median nerve conduction velocity over wrist to finger segment was measured before and after wrist flexion for 1, 2 and 5 minutes, using belly-tendon method for motor nerve distal latency(MNDL) and antidromic method for sensory nerve conduction velocity(SNCV). The results were as follows : 1. In control froup, MNDL increased in 1 hand and SNCV decreased in 2 hands after wrist flexion. In patient group, MNDL increased in 2 hands and SNCV decreased in 3 hands after wrist flexion. 2. In both control and patient group, there were no significant changes in mean values of SNCV and MNDL between before and after wrist flexion. 3. Phalen's wrist flexion test was positive in 5 percent of control and 60 percent of patient group. 4. Tinel's sign was present in 10 percent of control and 33 percent of patient group.

• Journal of Physiology & Pathology in Korean Medicine
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• v.29 no.1
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• pp.79-84
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• 2015

The aim of this review is to investigate studies of Korean medical treatment of carpal tunnel syndrome published in Korea and the evidence of it's effects in order to suggest a better research method in the future. Four Korean web databases were searched by using key words such as 'carpal', and checked relevant Korean journals. The papers were classified into the field of study, publish date, diagnostic methods, evaluation methods and analysed the study tendency. There are 9 case studies, 4 controlled studies. The paper was published almost every year more than once. Acupucture, pharmacopuncture, acupotomy, warm needle acupuncture, taping, etc. were used as treatment tools. The two most commonly used diagnostic method for carpal tunnel syndrome are Phalen's test and Tinel's sign. The two most commonly used evaluation method are VAS(Visual Analog Scale) and subjective symptoms. Korean medical treatment of carpal tunnel syndrome was effective in all studies. Korean medical treatment of carpal tunnel syndrome was effective in all studies. So it is possible that Korean medical treatment of carpal tunnel syndrome is useful as therapeutic medicine, but there are not sufficient evidence based papers, so there should be further studies.