Search Results (244)

Background: Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment disorder and a leading cause of pain, sensory disturbances, and functional impairment of the hand. Although carpal tunnel release (CTR) is an established treatment, the influence of demographic characteristics on symptom severity and postoperative functional recovery remains incompletely understood. Aim: This study assessed short-term functional improvement following carpal tunnel release and explored associations between demographic characteristics and patient-reported outcomes before and after surgery. Materials and Methods: Thirty-two adults with electrophysiologically and ultrasonographically confirmed CTS underwent minimally invasive carpal tunnel release. Functional outcomes were assessed preoperatively and three months postoperatively using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire and the Boston Carpal Tunnel Questionnaire (BCTQ). Demographic variables, including sex, education, occupation, place of residence, symptom duration, dominant hand, and primary presenting complaint, were analysed using non-parametric statistical methods. Results: Significant postoperative improvement was observed in both outcome measures. Mean QuickDASH scores improved by approximately 54.2%, while total BCTQ scores improved by approximately 42% (both p < 0.001). Most demographic variables showed no statistically significant association with postoperative outcomes. Sex was significantly associated with both preoperative and postoperative QuickDASH scores, while the symptomatic hand was significantly associated with preoperative QuickDASH scores. No statistically significant associations were identified between the analysed demographic variables and BCTQ scores. Twenty-six patients (81.2%) reported clinical improvement. Conclusions: Minimally invasive carpal tunnel release was associated with substantial short-term improvement in symptoms and hand function at three months. Exploratory analyses identified statistically significant associations between selected demographic characteristics and patient-reported outcomes; however, the limited subgroup sizes preclude definitive conclusions regarding independent demographic effects. Larger cohorts with longer follow-up and multivariable analysis are required to confirm these findings. Full article

Ultrasound-guided hydrodissection and dextrose prolotherapy have evolved into anatomically explicit but mechanistically distinct strategies for musculoskeletal pain. This State-of-the-Art narrative review aimed to synthesize major recent clinical and technical developments and to interpret them within a target-based framework. PubMed and Embase via Ovid were searched for English-language publications from 1 January 2021 through 29 July 2026, supplemented by selected pre-2021 landmark studies identified through backward citation tracking. After initial deduplication, 1662 records entered Title/Abstract screening. The final narrative synthesis cited 67 publications, including selected landmark and methodological sources. One author performed screening, and a second author reviewed the final publication selection; study selection was purposive and designed for a narrative synthesis rather than exhaustive systematic inclusion. Four questions guided the review: recent refinements in hydrodissection technique and indications; increasing condition specificity of prolotherapy evidence; areas of overlap and distinction between the two procedures; and the evidentiary status of emerging applications. Hydrodissection research remains concentrated in carpal tunnel syndrome and increasingly addresses injectate, volume, tissue-plane spread, and procedural configuration, whereas evidence beyond the carpal tunnel remains incompletely replicated. Prolotherapy research has shifted from broad claims toward condition-specific studies in tendinopathy, plantar fasciopathy, knee osteoarthritis, periarticular disorders, and temporomandibular joint pathology. Across both fields, variations in concentration, volume, anatomical site, session number, comparator, rehabilitation, and procedural expertise limit generalization. Hydrodissection is defined by observable, fluid-mediated separation of a tissue interface, whereas prolotherapy involves dextrose delivery to a symptomatic connective-tissue target without requiring immediate tissue-plane separation. The proposed framework is intended to standardize terminology, organize evidence maturity, and guide future comparative research rather than prescribe a validated treatment algorithm. Full article

This study provides a comprehensive bibliometric analysis of photobiomodulation (PBM) research in peripheral nervous system (PNS) disorders, aiming to characterize its structural features and developmental trends. Using a bibliometric workflow, a final dataset of 191 unique publications across 24 standardized PNS disease entities was identified through MeSH- and ICD-11-based classification from 14,670 records retrieved from the Web of Science Core Collection. The results show that PBM research has grown steadily since 2010 but remains concentrated in specific clinical conditions, particularly carpal tunnel syndrome (CTS). Keyword co-occurrence network analysis and functional classification identified three primary domains of PBM research: (1) pain modulation, (2) nerve regeneration and structural repair, and (3) biological/mechanistic regulation. The relative emphasis of these domains differed across disease groups, with compression and entrapment neuropathies emphasizing intervention parameters and assessment, nerve injury/regeneration research showing greater representation of structural repair and biological regulation, and neuropathic pain/neuropathy research showing a prominent pain-related component. Temporal analysis indicated diversification toward a broader range of neuropathic conditions and increasing representation of pain-related and biological themes. In conclusion, PBM research exhibits distinct functional patterns across PNS disease contexts. The function-oriented classification framework provides a structured basis for identifying research gaps and disease-specific research priorities. Full article

Background: Carpal tunnel syndrome is the most common entrapment neuropathy of the upper limb and an important cause of pain, sensory disturbance, and hand dysfunction. Open and endoscopic carpal tunnel release are effective, but they may be associated with scar-related pain, wound complications, and delayed return to work. Ultrasound-guided techniques have been developed to reduce soft-tissue trauma, enable real-time visualization of neurovascular structures, and facilitate faster recovery. Methods: A systematic search of PubMed, PubMed Central, and Scopus was conducted according to PRISMA guidelines for English-language studies published over the last 14 years. Eligible studies reported ultrasound-guided carpal tunnel release techniques and/or compared them with open, mini-open, or endoscopic procedures. Data on procedural technique, study population, follow-up, clinical outcomes, complications, and methodological characteristics were extracted and qualitatively synthesized. Results: Twenty-eight studies were included. Sample sizes ranged from 14 to 152 patients, and follow-up ranged from 3 to 74 months. The most frequently reported ultrasound-guided approaches were device-assisted carpal tunnel release, thread carpal tunnel release, and percutaneous carpal tunnel release. Most studies reported clinically meaningful improvement in symptoms and hand function, small incisions, rapid return to daily activities, and low rates of serious complications. Reported adverse events were mostly minor and transient. However, the evidence was limited by small samples, heterogeneous outcomes, single-center designs, limited long-term follow-up, and potential conflicts of interest. Conclusions: Ultrasound-guided carpal tunnel release appears to be a promising, minimally invasive alternative to traditional surgery, though current evidence is of low certainty. Larger independent comparative trials with standardized outcomes and long-term follow-up are needed. Full article

Background/Objectives: Carpal tunnel syndrome (CTS) is a prevalent neuropathy often associated with repetitive wrist movements, sustained wrist postures, and external compression. Although cycling offers numerous health benefits, prolonged handlebar contact may contribute to hand/wrist discomfort and cycling-related neuropathies. As a pilot study, the aim of this work was intended to (1) evaluate the feasibility of using pressure mapping to quantify glove-related pressure redistribution during cycling; (2) identify key confounding variables requiring improved control in future studies, including comfort/discomfort, posture, cycling experience, hand position, and anthropometric variability; and (3) provide preliminary estimates of pressure variability and effect magnitude between bare hands, conventional biking gloves, and Shock·Tek™ gloves to inform a larger confirmatory study. Methods: Thirteen right-handed adults were tested during low-intensity cycling using a stationary bike equipped with a pliance^®-x pressure sensor wrapped around the handlebar under three conditions: no gloves, traditional padded gloves, and Shock·Tek™ gloves. Results: This exploratory pilot study (1) demonstrated the feasibility of using pressure mapping, (2) identified confounding variables, and (3) showed that while traditional gloves did not significantly reduce surface pressure in the projected median nerve region as we hypothesized, the Shock·Tek™ gloves yielded a 61% reduction in pressure (mean: 20.23 kPa vs. 51.96 kPa with no gloves). Conclusions: These preliminary findings suggest that glove design can influence surface pressure distribution over the projected median nerve region at the hand–glove–handlebar interface during short-duration stationary cycling. Full article

Background/Objectives: Idiopathic Carpal Tunnel Syndrome (CTS) can be an early manifestation of systemic amyloidosis, particularly transthyretin cardiac amyloidosis (ATTR-CA). The primary purpose of this retrospective case series was to describe the presence of amyloid deposits in tenosynovial tissue and explore potential cardiac involvement in patients undergoing carpal tunnel release surgery. Methods: From a cohort of 54 patients diagnosed with bilateral idiopathic CTS with surgical indication, 12 patients were selected for tenosynovial tissue samples, which were subsequently evaluated using Congo red staining and proteomic confirmation via mass spectrometry. Before the procedure, patients underwent a clinical assessment of medical history, electrocardiogram, and cardiac scintigraphy with Technetium-99 m 3,3-diphosphono-1,2-propanodicarboxylic acid (^99mTc-DPD). Transthoracic echocardiogram and cardiac magnetic resonance were subsequently performed in all patients with positive scintigraphy, while a subset of scintigraphy-negative patients underwent an echocardiogram. Results: Congo red staining identified amyloid deposits in 3 of the 12 patients (25%). Proteomic analysis confirmed ATTR amyloidosis deposits in 2 of these patients (17%). One of these 2 patients presented Perugini grade 3 uptake on cardiac scintigraphy, suspicious for ATTR-CA. Complete concordance across histology, proteomics, and cardiac imaging was observed in only 1 patient (8.3%). Three discordances were noted: one case of tenosynovial ATTR without evident cardiac disease, one patient with a discordant Congo red result likely reflecting low amyloid burden or tissue heterogeneity, and one with imaging findings suspicious for ATTR-CA despite a negative tenosynovial biopsy. Conclusions: Tenosynovial biopsy obtained during CTS surgery can reveal early amyloid deposition, which may precede overt cardiac involvement. The variability observed across findings underscores the need for a multimodal diagnostic approach that integrates histological, proteomic, and imaging data, thereby mitigating the risk of amyloidosis misclassification. Full article

Background: To compare the clinical and ultrasonographic effects of pulsed therapeutic ultrasound (US) and pulsed shortwave diathermy (SWD) in patients with mild-to-moderate carpal tunnel syndrome (CTS). Methods: In this randomized controlled trial, 40 patients with electrophysiologically confirmed mild-to-moderate CTS were randomly allocated into two groups. Both groups received wrist splinting and tendon–nerve gliding exercises. The US group received 15 sessions of pulsed ultrasound therapy (3 MHz, 0.8 W/cm²), whereas the SWD group received 15 sessions of pulsed shortwave diathermy (80 Hz, 19.2 W). Outcomes were assessed at baseline, 1 month, and 3 months using ultrasonographic median nerve cross-sectional area (MNCSA) (primary outcome), Boston Carpal Tunnel Questionnaire (BCTQ), Visual Analog Scale (VAS) for pain, Douleur Neuropathique 4 (DN4), and handgrip strength. Results: Baseline demographic characteristics, including age (mean ± SD) and sex distribution, were comparable between groups (p > 0.05), although BCTQ Functional Status and Total scores differed significantly at baseline. Repeated-measures analyses demonstrated significant time effects for MNCSA and all secondary clinical outcomes, including BCTQ scores, VAS pain, DN4 scores, and grip strength (all p < 0.001; partial η² range: 0.51–0.75), indicating moderate-to-large effect sizes. Both the US and SWD groups showed sustained improvements at the 1- and 3-month follow-ups, with no significant differences between treatment modalities (all group × time interaction p > 0.05). Conclusions: In patients with mild-to-moderate CTS, both US and SWD administered alongside splinting and exercise were associated with significant clinical and ultrasonographic improvements over 3 months. No significant difference was observed between the two modalities. Both treatments may be considered adjunctive options within conservative management, although further controlled studies are needed to clarify modality-specific effects. Full article

Peripheral neuropathy constitutes a prevalent, albeit underrecognized, extraglandular manifestation of Sjögren’s disease (SjD). Carpal tunnel syndrome (CTS) commonly coexists with SjD; however, the efficacy of standard CTS treatments in this population remains insufficiently characterized. This study evaluated the clinical and biological response to local corticosteroid injection in CTS patients with and without SjD and explored factors potentially associated with treatment outcomes. Twenty patients with SjD and CTS diagnosed based on typical clinical symptoms and supportive ultrasonographic findings and 19 control subjects with idiopathic CTS underwent ultrasound-guided corticosteroid injection. Median nerve cross-sectional area (CSA), the Boston Carpal Tunnel Questionnaire (BCTQ), and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were assessed before treatment and 4 weeks after injection. Patients with SjD additionally underwent comprehensive clinical, laboratory, neurophysiological, and patient-reported outcome assessments. Patients with SjD appeared to demonstrate a significantly greater reduction in median nerve CSA following corticosteroid injection compared with controls (mean reduction: 0.46 vs. 0.31 mm²; p = 0.006, Cohen’s d = 0.96, CI90% [0.51, 1.49]). Despite this favorable biological response, clinical improvement was significantly smaller in the SjD group. Patients without SjD exhibited greater improvement in both the BCTQ Symptom Severity Scale (p = 0.021) and Functional Status Scale (p = 0.033), whereas changes in DASH scores did not differ significantly between groups. Patients with concomitant peripheral neuropathies experienced significantly poorer BCTQ improvement than those with isolated CTS, suggesting that neurological comorbidity may contribute to treatment resistance. No significant associations were identified between treatment response and fibromyalgia status or ESSPRI domains. Among quality-of-life measures, only the SF-36 General Health domain differed significantly between neuropathy types. Patients with SjD and CTS exhibit a dissociation between structural improvement of the median nerve and subjective symptom relief after corticosteroid injection. These findings suggest that mechanisms beyond local nerve compression, including coexisting peripheral neuropathy and potentially altered pain processing, may contribute to persistent symptoms. Comprehensive neurological assessment and multidimensional outcome evaluation may improve identification of SjD patients at risk of suboptimal response to conventional CTS therapies. Full article

Background: Minimally invasive carpal tunnel release (CTR) approaches, including endoscopic and ultrasound-guided, encompass a range of distinct techniques. These approaches have been increasingly adopted across both surgical and non-surgical specialties. However, the literature frequently groups the techniques into broad categories, obscuring clinically meaningful differences in transection mechanism, safety profile, and learning curve. Methods: This narrative review organizes minimally invasive CTR into eight distinct techniques, two endoscopic and six ultrasound-guided, classified by their primary transection mechanism. Results: Single-portal endoscopic CTR has the largest evidence base, with network meta-analysis data demonstrating significant early functional advantages over open CTR. Among ultrasound-guided techniques, the retractable retrograde blade is the most widely adopted, with randomized trial data supporting comparable outcomes to mini-open CTR. Hook-knife retrograde and thread-loop techniques have demonstrated feasibility and durable outcomes, though experience is concentrated among a few high-volume operators. The antegrade cutting, pinhole scalpel, and needle-knife have more limited evidence. Earlier return to work is the most reproducible benefit across all minimally invasive approaches. Endoscopic CTR carries a modestly higher revision rate, while long-term data for ultrasound-guided techniques remain lacking. Conclusions: This mechanism-based classification highlights important differences between techniques in safety features, evidence maturity, and learning curves. Head-to-head trials comparing endoscopic and ultrasound-guided techniques and device-specific registries with standardized outcome reporting are needed to inform evidence-based adoption. Full article

Background: Thumb pain frequently arises from multiple conditions—de Quervain’s tenosynovitis, carpometacarpal (CMC) osteoarthritis, carpal tunnel syndrome, intersection syndrome, and myofascial pain syndrome—that often coexist yet are traditionally managed as separate entities. Fascial abnormalities, including hyaluronic acid-related densification and impaired interlayer gliding, have been proposed to constitute a shared pathological substrate underlying these conditions. Ultrasound-guided fascia hydrorelease (US-FHR) targeting fascial pathology has been used clinically for thumb–wrist pain; however, the anatomical targets and treatment regions have not been systematically described. Aim: This article presents a fifteen-point US-FHR clinical protocol for five converging thumb pain conditions, based on shared fascial abnormalities—densification and impaired interlayer gliding—that these conditions may have in common. It further provides a shared practical framework for pain physicians, orthopedic specialists, hand therapists, and acupuncturists. Methods: The protocol was organized based on a focused literature review on fascial biology, thumb–wrist anatomy, and the five converging conditions, combined with long-term clinical experience at Kimura Pain Clinic. For each POINT, the anatomical rationale, associated pain pattern, procedural concept, and major safety considerations were summarized. A four-direction screening test (thumb flexion, extension, abduction, and adduction) assessed in three modes (active contraction, resistance loading, and passive stretch), combined with nine established clinical tests, was integrated to identify the affected fascial structures. A diagnostic ultrasound finding characterized by multi-layered hyperechoic bands with reduced interlayer gliding—the sonographic appearance termed “stacking fascia” (a hyperechoic, stripe-shaped lesion), a previously described morphological sign that may reflect fascial densification—is described. Results: The protocol comprises 15 POINTs distributed across two approaches: nine POINTs via a dorsal approach and six POINTs via a palmar approach. The dorsal approach (9 POINTs) covers the first and third extensor compartments, their intersections (1st–2nd and 2nd–3rd), the two radial-artery crossing points (Points 5 and 6, where the radial artery passes deep to the first-compartment and EPL/ECRB–ECRL tendons, respectively), Gokoku (Hegu), the adductor pollicis, and the deep palmar arch. The palmar approach (6 POINTs) covers the thenar muscles, transverse carpal ligament, paraneural sheath and interfascicular epineurium of the median nerve, the median-nerve/FPL/FCR interface, the median nerve within the carpal tunnel, and the deeper palmar ligamentous structures adjacent to the median nerve. Periarterial release around the radial artery is proposed as a hypothesis-generating approach to CMC osteoarthritis, in which fascial constriction of periarterial tissue may contribute to subchondral vascular compromise. For each POINT, the anatomical rationale, associated pain patterns, procedural concept, and safety considerations are integrated and described. Conclusions: The proposed fifteen-point protocol represents an expanded, structured, and clinical-experience-based framework for US-FHR in five converging thumb pain conditions sharing common fascial abnormalities. It may serve as a practical basis for the standardization, education, and broader dissemination of US-FHR in this population. Prospective observational studies, randomized controlled trials, and imaging validation studies are needed to evaluate its clinical effectiveness and to test the underlying mechanistic hypotheses, including potential periarterial vascular contributions to CMC osteoarthritis. Full article

Background: High-resolution ultrasound is increasingly used as a complementary tool in carpal tunnel syndrome (CTS), but the value of median nerve cross-sectional area (CSA) for severity stratification remains uncertain. This study evaluated whether median nerve CSA measured at the pisiform level can distinguish severe from moderate CTS classified according to the Bland grading scale. Methods: This prospective cross-sectional study included 72 participants: moderate CTS (n = 34), severe CTS (n = 24), and healthy controls (n = 14). Nerve conduction studies, abductor pollicis brevis needle electromyography, and ultrasound examinations were performed on the same day. CSA was measured three times by a blinded examiner, and the mean value was used for analysis. Correlation, age-adjusted linear regression, and receiver operating characteristic curve analyses were performed. Results: Median nerve CSA increased progressively from controls to moderate and severe CTS groups (8.0 ± 1.1, 16.5 ± 4.6, and 19.8 ± 3.4 mm², respectively; p < 0.001), with significant pairwise differences. Intraobserver and interobserver reliability were excellent (ICC = 0.95 and 0.91, respectively). CSA correlated positively with distal motor and sensory latencies and inversely with compound muscle action potential and sensory nerve action potential amplitudes. CSA also showed a weak positive association with neurogenic motor unit action potentials. In age-adjusted regression analysis, distal motor latency remained independently associated with CSA (B = 0.873, p = 0.002). A CSA cut-off of 18.5 mm² distinguished severe from moderate CTS with an area under the curve (AUC) of 0.728, sensitivity of 66.67%, and specificity of 79.41%. Conclusions: Median nerve CSA measured at the pisiform level may provide useful adjunctive structural information for CTS severity assessment and may show moderate discriminatory performance for differentiating severe from moderate CTS. CSA should be interpreted in conjunction with clinical and electrodiagnostic findings rather than as a stand-alone severity marker. Full article

Transthyretin cardiac amyloidosis (ATTR-CA) is an increasingly recognized cause of cardiac dysfunction in adults, resulting from extracellular deposition of misfolded transthyretin fibrils and progressive myocardial impairment. Clinical expression and diagnostic yield differ substantially between sexes, contributing to systematic underdiagnosis in women, who often present with subtler myocardial remodeling, heart failure with preserved ejection fraction (HFpEF)–dominant phenotypes, and nonspecific systemic manifestations that fall below conventional diagnostic thresholds, particularly in early disease stages. Female patients, particularly those with ATTRwt, tend to present at older ages and more frequently show HFpEF-dominant phenotypes and nonspecific extracardiac manifestations. Carpal tunnel syndrome (CTS) is an important extracardiac red flag for ATTR-CM, but its interpretation in women requires caution because of the high background prevalence of idiopathic CTS in the general population. Evidence also suggests sex-related differences in diastolic function, right ventricular involvement, and overall progression. Despite these biological and phenotypic distinctions, women are markedly underrepresented in trials of disease-modifying therapies, limiting conclusions about sex-specific treatment effects and leaving uncertainty about whether current pharmacologic interventions provide comparable benefit. Hormonal influences, genetic background, and age-related mechanisms, comorbidities, and diagnostic pathways may contribute to the distinctive female phenotype, but underlying mechanisms remain insufficiently defined. This narrative review examines sex-associated differences in ATTR-CA, focusing on mechanisms of underdiagnosis, principal clinical and imaging features, and implications for therapeutic response, with the goal of improving diagnostic accuracy, guiding individualized management, and ultimately enhancing outcomes for women and all affected patients worldwide in clinical practice. Full article

Background and Objectives: Carpal tunnel release (CTR) has evolved toward increasingly less invasive techniques, with the aim of reducing procedural trauma and accelerating recovery. While ultrasound-guided and microinvasive approaches have demonstrated safety and technical precision, prospective data describing Return-to-Work (RTW) and early functional recovery remain limited. Materials and Methods: This prospective cohort study included adults undergoing office-based ultrasound-guided microinvasive CTR (Micro-CTR) under local anaesthesia using a retractable needle-mounted blade system. Patient-reported outcomes were collected using the Comprehensive Carpal Tunnel Recovery Questionnaire. The primary outcome was time to RTW. Secondary outcomes included change in pain score, analgesic duration, and time to return to driving and household tasks. Continuous outcomes were non-normally distributed and are reported as medians with interquartile ranges (IQRs). Recovery outcomes were compared by structured self-reported postoperative-event status using non-parametric and time-to-event analyses, and an exploratory distributional analysis assessed the influence of longer self-reported RTW intervals on the overall recovery distribution. Results: Sixty-seven patients were included. Median RTW was 9 days (IQR, 30.5; n = 48), with a median return to driving at 5 days (IQR 6) and household tasks at 7 days (IQR 7). Median pain decreased from 8/10 preoperatively to 0/10 postoperatively (p < 0.0001). Participants reporting at least one structured postoperative event had longer RTW intervals than those selecting no structured event (median 35 vs. 5 days; HR 0.42, 95% CI 0.22–0.80; p = 0.0079). Exploratory distributional analysis showed that longer RTW intervals had a substantial influence on the overall RTW distribution; the full RTW responder cohort remained the primary analysis. Conclusions: Ultrasound-guided Micro-CTR was associated with rapid early functional recovery in most patients in this prospective cohort. Recovery was heterogeneous, with longer RTW intervals observed among participants reporting structured postoperative events. These findings support RTW as a pragmatic functional endpoint in evaluating emerging CTR techniques. Full article

Background: Carpal tunnel release (CTR) surgery may have an impact on the speed and accuracy of handwriting and digital typing using a computer or mobile devices. Methods: In this prospective cohort study, patients undergoing CTR surgery of the dominant hand, between 18 and 70 years of age, with frequent use of a QWERTY keyboard and smartphone were included. A baseline Visual Analog Scale (VAS) for subjective alteration of writing and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) were collected at a maximum 3-month follow-up. Digital typing speed (word per minute, wpm) and accuracy (number of mistakes) were tested. Handwriting was assessed by means of direct supervision of one investigator. Results: Of the 30 enrolled patients, 23 (76.7%) completed the 3-month follow-up and were included in the final analysis (mean age 55 ± 12.3 years). Pre- and post-surgery improvements in keyboard typing speed (14.8 ± 6.8 wpm to 17.6 ± 5 wpm) and mobile texting speed (16.7 ± 5.9 wpm to 21.7 ± 6.5 wpm) were significantly improved over time. Accuracy improved significantly only in keyboard typing, where the mean number of errors was reduced (13.1 ± 8.2 to 9.9 ± 5.6). QuickDASH scores decreased significantly (39.1 ± 9.1 to 17 ± 6). Conclusions: CTR surgery was associated with improved typing speed and reduced the number of errors (19% and −24%, respectively) as well as texting speed (30%). This improvement may be relevant in daily and occupational activities, as reported in the previous literature. Full article

Objectives: This systematic review and meta-analysis aimed to assess whether serum inflammatory markers are associated with Carpal Tunnel Syndrome (CTS), moving beyond the traditional mechanical explanation. Methods: Seven observational studies involving a total of 609 adult participants (CTS patients and matched healthy controls) were included. Studies were selected through comprehensive searches of PubMed and Embase databases up to April 2025. Data extraction and quality assessment were independently performed by two reviewers using the Newcastle–Ottawa Scale. Standardized mean differences (SMDs) and 95% confidence intervals were calculated using random-effects meta-analysis. Results: CTS patients exhibited significantly elevated serum levels of CCL2, CCL5, CXCL10, CXCL8, IL-4, VEGF, and TGF-β compared to controls. CCL4 was increased in the fixed-effect model but showed high heterogeneity; however, it was not statistically significant in the random-effects model and demonstrated extreme heterogeneity. No significant or consistent differences were observed for IL-1β, IL-6, IL-9, IL-10, TNF-α, or IFN-α. Conclusions: CTS is associated with a systemic pro-inflammatory and pro-fibrotic profile. CCL2, CCL5, IL-4, VEGF, and TGF-β may serve as promising biomarkers. Further large-scale, standardized studies are needed to validate these findings. Full article