POTENTIAL CONTRIBUTIONS OF NECK MUSCLE DYSFUNCTIONS TO INITIATION ANDMAINTENANCE OF CARPAL-TUNNEL SYNDROME

A biomechanical perspective of the carpal tunnel (CT) is reviewed that lends itself to an understanding of carpal tunnel syndrome (CTS) from a broader pathophysiological perspective than focusing narrowly or so lely opt nerve disturbance in the extremity. A wider integration of ph ysiological systems in the etiology and maintenance of CTS is proposed that links muscular dysfunction in the neck and possibly elsewhere to dysfunction at the CT A significant subset of individuals who develop CTS have a primary contribution from muscular dysfunctions rather dis tal to the CT itself Neurophysiological dysregulation of normal inhibi tory feedback at the level of the motoneuron pool specifically involvi ng gamma motoneuron impulses may be a primary contributing mechanism. Empirical demonstration of amelioration cf CTS symptoms by means of su rface electromyography (sEMG) retraining of dysfunctional neck muscle patterns is reviewed as support for the hypothesized link. The specifi c retraining techniques are described Future conceptual and research d irections are noted.