Date: Thu, 21 Jan 1999 10:05:06 1100
From: Mary Westbrook
Subject: Re: [PPM] Bulbar polio & carpal tunnel
> I am also experiencing currently, carpal tunnel in both wrists. Could this be related to my Post-polio syndrome?
Research by R.Warner,W.Waring and G.Davidoff (" Risk factors for median mononeuropathy of the wrist in postpoliomyelitis patients - (Abstract)", Archives of Physical Medicine and Rehabilitation, Volume 70, pages 464-467, June 1989) investigated 148 consecutive patients at a post-polio clinic. Those who used mobility aids were much more likely to have carpal tunnel syndrome..22% prevalence versus 1% in the general population.
The authors cite several other studies of disabled people showing high rates of CTS among those using wheelchairs, crutches, walking sticks etc. Polio survivors often use their hands/wrists to push themselves up from chairs etc. Thus CTS is often a late effect of polio in terms of the broad definition which includes wear and tear on a compromised body but CTS would not be included in most definitions of Post-polio syndrome.
In a follow-up article W.Waring and R. Werner (" Clinical management of carpal tunnel syndrome in patients with long-term sequelae of poliomyelitis - (Abstract)" The Journal of Hand Surgery,Volume 14A,pages 865-869, 1989) caution against wrist surgery for polio survivors with CTS particularly for those who use canes or crutches regularly. In a study of 33 polios with CTS they found "There was no significant long-term resolution of symptoms in the patients who had surgery (N=9) or were currently using wrist orthoses (N=11) compared with patients without such treatment(N=13)..These data does not imply that previous poliomyelitis is an absolute contraindication to CTsurgery. Rather a cautious approach needs to be used when evaluating this population, especially those who use canes or crutches constantly. Management strategies need to be designed that will permit patients who use canes and crutches to continue their use of assistive devices while decreasing the risk of exacerbating their condition or more hopefully to prevent its initial occurrence".
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