Obesity and Carpal Tunnel Syndrome

A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. How do calculate your BMI index
BMI= weight (kg)/ height (m2)

C. Carpal Tunnel Syndrome is defined as a condition of numbness, tingling, weakness, or muscle damage in the hand and fingers, as a result of the pressure on the median nerve.

D. How Obesity associates Carpal Tunnel Syndrome
1. According to the study of|The relationship of obesity, age, and carpal tunnel syndrome: more complex than was thought?" by Bland JD., posted in PubMed, researchers found that increased BMI is a significant independent risk factor for CTS in patients under the age of 63 years, but is less important in older patients. Patients over the age of 63 years have a different pattern of risk factors for CTS than younger patients. This suggests that CTS in the elderly population may have different underlying pathogenetic mechanisms.

2. In study of "Carpal tunnel syndrome" by Aroori S, Spence RA., posted in PubMed, researchers indicated that Carpal tunnel syndrome is one of the most common peripheral neuropathies. It affects mainly middle aged women. In the majority of patients the exact cause and pathogenesis of CTS is unclear. Although several occupations have been linked to increased incidence and prevalence of CTS the evidence is not clear. Occupational CTS is uncommon and it is essential to exclude all other causes particularly the intrinsic factors such as obesity before attributing it to occupation.

3. According to the study of "Hand syndromes associated with diabetes: impairments and obesity predict disability" by Redmond CL, Bain GI, Laslett LL, McNeil JD., posted in PubMed, researchers found that In adults with hand syndromes associated with diabetes, disability was related to impaired muscle function and carpal tunnel syndrome. Obesity and overall physical functioning influenced hand disability, particularly in women.

4. In abstract of the study of "Assessment of body mass index and hand anthropometric measurements as independent risk factors for carpal tunnel syndrome" by Sharifi-Mollayousefi A, Yazdchi-Marandi M, Ayramlou H, Heidari P, Salavati A, Zarrintan S, Sharifi-Mollayousefi A., posted in PubMed, researchers found that The mean values of BMI, wrist ratio and shape index were significantly higher in all CTS patients and females compared to controls, whereas in males only BMI and wrist ratio were higher. The patients in the mild severity subgroup had a significantly lower age and wrist ratio. BMI, wrist ratio and shape index were found to be independent risk factors of CTS development in all patients and females. Our study showed BMI, wrist ratio and shape index as independent risk factors for CTS. These findings are of potential anatomical and clinical importance and outline the risk factors of anatomical malfunction of the wrist in CTS.

5. According to the study of "Individual risk factors for carpal tunnel syndrome: an evaluation of body mass index, wrist index and hand anthropometric measurements" by Boz C, Ozmenoglu M, Altunayoglu V, Velioglu S, Alioglu Z., posted in PubMed, researchers concluded that Differences in the hand length/height ratio were not statistically significant in female and male CTS patients compared to their controls and it was not found to be an independent risk factor for CTS. Our study confirmed BMI as an independent risk factor for CTS in both genders. Hand and wrist anthropometrics were found to be independent risk factors for CTS in females, but not in males.

6. In abstract of the study of "Epidemiology of carpal tunnel syndrome in women of childbearing age. Findings in a large cohort study" by Vessey MP, Villard-Mackintosh L, Yeates D., posted in PubMed, researchers indicated that The most significant positive association between an existing disease and CTS was menstrual disorders (p=.001). Additional similar associations existed for orthopedic conditions and gastrointestinal tract symptoms. The relationships between CTS and OC use, menstrual disorders, and obesity may be related to pressure on the median nerve due to fat or edema near the carpal tunnel.

7. Etc.

E. Treatments of Obesity and Carpal Tunnel Syndrome
1. According to the study of "Medical and non-medical correlates of carpal tunnel syndrome in a Taiwan cohort of one million" by Tseng CH, Liao CC, Kuo CM, Sung FC, Hsieh DP, Tsai CH., posted in PubMed, researchers found that Patients were predominantly women (65.6% vs. 47.7% in the control group) and older (40 and above, 62.6% vs. 36.2%). Rheumatoid arthritis was found to be the most significant comorbidity associated with CTS, followed by gout, hypertension, diabetes, obesity, uremia, and acromegaly. For younger group age ≤39, the association of these comorbidities was stronger, and hypothyroidism and vitamin B(6) deficiency were additional comorbidities...., these disorders may aid in removing possible causes of CTS. This is the first report on the effect of aging on probable CTS risk factors. How factors associated with aging contribute to the development of CTS remains to be determined.

2. In a study of "Concurrent medical disease in work-related carpal tunnel syndrome" by, Atcheson SG, Ward JR, Lowe W., posted in PubMed, researchers concluded that Routine patient histories and record reviews are inadequate for proper evaluation of work-related CTS. Unrecognized medical diseases capable of causing CTS are common. Studies asserting an association between occupational hand usage and CTS are of questionable validity unless they prospectively account for confounding disease and obesity.

3. Etc.
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