An avid cyclist notes recurrent aching pain and paresthesias in the hands after a day of road cycling, especially affecting the thumb, palm, and first two fingers. Sometimes he awakens from sleep with the same symptoms, which can be relieved after a few minutes of shaking the hands.
Which of the following is NOT a risk factor for developing this condition? Scroll down for the answer.
- Marfan syndrome
- Female gender
The condition described above is carpal tunnel syndrome. The only option listed above which does not increase the risk of CTS is 1) Marfan syndrome. Women have a 3x risk of developing CTS. The condition is caused by compression of the median nerve beneath the transverse carpal ligament in the wrist, and repetitive wrist movements or bending the wrist – as happens to road cyclists, or when the wrists are bent while sleeping – can worsen the compression. Any condition which causes neuropathy, such as diabetes, can increase the frequency of CTS as well.
Definitive treatment of CTS is surgical release of the transverse carpal ligament, although conservative measures include wrist splints to reduce nerve compression from flexion/extension of the wrists.
For more information, including a diagram of median nerve sensory distribution & exam tips, see page 39 in the Medical Student review book.