Page 706 - medicina-integrativa_compress

CAPÍTULO 66 SÍNDROME DEL TÚNEL CARPIANO 719

• Puede ser costosa y no suele estar cubierta modalidades. El clínico debe tener certeza del
por los seguros médicos. diagnóstico y optar por un cirujano que haya
practicado numerosas intervenciones de STC.
Se recomienda la derivación a un especialista
■ Cirugía
en STC para que efectúe una evaluación antes
Es probable que la cirugía sea lo más útil en de proponer la cirugía al paciente. La cirugía
los pacientes con dolor o entumecimiento A A 3 3 no se recomienda en las embarazadas con
intratable, atrofia de la eminencia tenar o STC, que probablemente se resolverá después
fracaso del tratamiento con otras del parto.

BIBLIOGRAFÍA 21. Lombardi A, Quirke T, Rauscher G: Acute median nerve
compression associated with tumescent fluid administration.
1. Stevens J, Sun S, Beard C, et al: Carpal tunnel syndrome in Plast Reconstr Surg 102:235-237, 1998.
Rochester, Minnesota, 1961 to 1980. Neurology 38:134-138, 1988. 22. Ly-Pen D, Andreu J, de Blas G, et al: Surgical decompression versus
2. Andreoli, T, Carpenter C, Griggs C, et al: Cecil Essentials of local steroid injection in carpal tunnel syndrome. Arthritis Rheum
Medicine, 6th ed. Philadelphia, WB Saunders, 2004. 52:612-619, 2005.
3. Bernard B (ed): Musculoskeletal disorders and workplace factors: 23. Armstrong T, Devor W, Borschel L, et al: Intracarpal steroid
a critical review of epidemiologic evidence for work-related injection is safe and effective for short-term management of carpal
musculoskeletal disorders of the neck, upper extremity, and low tunnel syndrome. Muscle Nerve 29:82-88, 2004.
back. DHHS (NIOSH) publication no. 97-141. Cincinnati, National 24. Chang M, Ger L, Hsieh P, et al: A randomized clinical trial of oral
Institute for Occupational Safety and Health, July 1997. steroids in the treatment of carpal tunnel syndrome: A long term
4. Silverstein B, Kalat J: Work related disorders of the back and upper follow up. J Neurol Neurosurg Psychiatry 73:710-714, 2002.
extremity in Washington State, 1990-1997. SHARP Technical Report 25. Sloboda D, Challis J, Moss T, et al: Synthetic glucocorticoids:
40-2, 1999. Olympia, Wash, SHARP Program, 1999. Antenatal administration and long-term implications. Curr Pharm
5. Katz J, Simmons B: Carpal tunnel syndrome. N Engl J Med Des 11:1459-1472, 2005.
346:1807-1812, 2002. 26. Akarca U: Gastrointestinal effects of selective and non-selective
6. Solomon D, Katz J, Bahn R, et al: Nonoccupational risk factors for non-steroidal anti-inflammatory drugs. Curr Pharm Des 11:
carpal tunnel syndrome. J Gen Intern Med 14:310-314, 1999. 1779-1793, 2005.
7. Stevens J, Beard C, O’Fallon W, et al: Conditions associated with 27. U.S. Food and Drug Administration, Center for Disease Evaluation
carpal tunnel syndrome. Mayo Clin Proc 67:541-548, 1992. and Research: COX-2 Selective (includes Bextra, Celebrex, and
8. Pryse-Phillips W: Validation of a diagnostic sign in carpal tunnel Vioxx) and Non-Selective Non-Steroidal Anti-Inflammatory Drugs
syndrome. J Neurol Neurosurg Psychiatry 47:870-872, 1984. (NSAIDs): http://www.fda.gov/cder/drug/infopage/COX2/default.htm/
9. Sheon R, Moskowitz R, Goldberg V: Soft Tissue Rheumatic Pain: 28. United States Pharmacopeia. USP-Verified Dietary Supplements:
Recognition, Management, Prevention, 3rd ed. Baltimore, http://www.usp.org/USPVerified/dietarySupplements/
Williams & Wilkins, 1996. supplements.html/
10. Occupational disease surveillance: carpal tunnel syndrome. 29. Fajardo M, Di Cesare P: Disease-modifying therapies for
Morb Mortal Wkly Rep 38:485, 1989. osteoarthritis: Current status. Drugs Aging 22:141-161, 2005.
11. Sheon RP: Clinical manifestations and diagnosis of carpal tunnel 30. Natural Medicines Comprehensive Database:
syndrome. Up to Date April, 2005. www.naturaldatabase.com/
12. Nathan P, Wilcox A, Emerick P, et al: Effects of an aerobic 31. Bliddal H, Rosetzsky A, Schlichting P, et al: A randomized, placebo-
exercise program on median nerve conduction and symptoms controlled, cross-over study of ginger extracts and ibuprofen in
associated with carpal tunnel syndrome. J Occup Environ Med osteoarthritis. Osteoarthritis Cartilage 8:9-12, 2000.
43:840-843, 2001. 32. Biegert C, Wagner I, Ludtke R, et al: Efficacy and safety of willow
13. O’Connor D, Marshall S, Massy-Westropp N: Non-surgical bark extract in the treatment of osteoarthritis and rheumatoid
treatment (other than steroid injection) for carpal tunnel arthritis: Results of 2 randomized double-blind controlled trials.
syndrome. Cochrane Database Syst Rev (1):CD003219, 2003. J Rheumatol 31:2121-2130, 2004.
14. Sachs C: Oral analgesics for acute nonspecific pain. Am Fam 33. Lyss G, Schmidt T, Merfort I, et al: Helenalin, an anti-inflammatory
© Elsevier. Es una publicación MASSON. Fotocopiar sin autorización es un delito.
Physician 71:913-918, 2005. sesquiterpene lactone from Arnica, selectively inhibits transcription
15. Baumann T: Pain management. In Dipiro JT, Talbert RL, Yee GC, factor NF-kappaB. Biol Chem 378:951-961, 1997.
et al: Pharmacotherapy: A Pathophysiologic Approach, 5th ed. 34. Jeffrey S, Belcher H: Use of Arnica to relieve pain after carpal-tunnel
New York, McGraw-Hill, 2002, pp 1103-1117. release surgery. Altern Ther Health Med 8:66-68, 2002.
16. Clinical Pharmacology: Monographs accessed: aspirin, salsalate, 35. O’Conner D, Marshall S, Massy-Westropp N: Non-surgical
diflunisal, choline magnesium salicylate, ibuprofen, naproxen treatment (other than steroid injection) for carpal tunnel
sodium, ketoprofen, fenoprofen, flurbiprofen, oxaprozin, syndrome. The Cochrane Collaboration. Cochrane Database Syst
indomethacin, diclofenac, etodolac, nabumetone, meloxicam, Rev (3):003219, 2005.
piroxicam, celecoxib, acetaminophen, methylprednisolone acetate, 36. Field T, Diego M, Cullen C, et al: Carpal tunnel syndrome
prednisolone: www.clinicalpharmacology.com/ symptoms are lessened following massage therapy. J Bodywork Mov
17. Gerritsen A, deKrom M, Struijs M, et al: Conservative treatment Ther 8:9-14, 2004.
options for carpal tunnel syndrome: A systematic review of 37. Garfinkel M, Singhal A, Katz W, et al: Yoga-based intervention for
randomized controlled trials. J Neurol 249:272-280, 2002. carpal tunnel syndrome. A randomized trial. JAMA 280:1601-1603,
18. Chang M, Chiang H, Lee S, et al: Oral drug of choice in carpal 1998.
tunnel syndrome. Neurology 51:390-393, 1998. 38. Sevim S, Dogu O, Camdeviren H, et al: Long-term effectiveness of
19. MICROMEDEX Healthcare Series: Drugdex Evaluations accessed: steroid injections and splinting in mild and moderate carpal tunnel
aspirin, salsalate, diflunisal, choline magnesium salicylate, ibuprofen, syndrome. Neurol Sci 25:48-52, 2004.
naproxen sodium, ketoprofen, fenoprofen, flurbiprofen, oxaprozin, 39. Ebenbichler G, Resch K, Nicolakis P, et al: Ultrasound treatment for
indomethacin, diclofenac, etodolac, nabumetone, meloxicam, treating the carpal tunnel syndrome: Randomised “sham” controlled
piroxicam, celecoxib, acetaminophen, methylprednisolone acetate, trial. BMJ 316:731-735, 1998.
prednisolone: www.thomsonhc.com/home/dispatch/ 40. Davis P, Hulbert J, Kassak K, et al: Comparative efficacy of
20. Radecki P: Personal factors and blood volume movement in conservative medical and chiropractic treatments for carpal tunnel
causation of median neuropathy at the carpal tunnel: A syndrome: A randomized clinical trial. J Manipulative Physiol Ther
commentary. Am J Phys Med Rehabil 75:235-238, 1996. 21:317-326, 1998.