Ccs. Donaldson et al., POTENTIAL CONTRIBUTIONS OF NECK MUSCLE DYSFUNCTIONS TO INITIATION ANDMAINTENANCE OF CARPAL-TUNNEL SYNDROME, Applied psychophysiology and biofeedback, 23(1), 1998, pp. 59-72
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.