EMG vs. Thermography in Severe Carpal Tunnel Syndrome

Abstract

Carpal tunnel syndrome (CTS) is one of the most common compressive neuropathies in the upper extremities (Bland, 2007) and a frequent cause of pain, paresthesias and impaired hand function. A syndrome is, by definition, a collection of signs and symptoms. Its clinical symptoms depend on duration and degree of the compression of the median nerve (MN). At first the sensory nerve fibres are affected, but as the compression persists, large calibre myelinated nerve fibres (sensory and motor) undergo damage as well. Clinical symptoms and signs alone are not sufficient to confirm the diagnosis and surgical release, electrodiagnostic methods are needed for this purpose (Rosenbaum & Ochoa, 2002). Within the last decades, CTS reached epidemic proportions in many occupations and industries. It represents a large expense because of absence from work and wage compensation due to temporary incapacity for work. For this reason numerous researches, not only in the field of medicine, are looking for a non-invasive diagnostic method for determining those loads in workplaces that facilitate the development of CTS (Ammer, 1999, 2003; R.T. Herrick & S.K. Herrick, 1987; Schartelmuller & Ammer, 1996; Tchou et al., 1992). Intelligent systems have turned out to be useful and successful aids in medicine for determining, classifying, sample searching, data analysis, and new knowledge discovery (Haas & Burnham, 2008). But thermography, on the contrary, did not receive due attention (American Academy of Neurology, 1990) in the area of determining entrapment neuropathies, despite its advantages (completely safe, passive investigation, without contact, painless and can be easily repeated with low costs of use) (Hackett, 1976).