Tunnel Syndromes - Peripheral Nerve Compression Syndromes

Tunnel syndromes occur when nerves pass through bony, fibrous, osteofibrous and fibromuscular tunnels, impairing nerve function. Patients with tunnel syndromes can present with motor, sensory or autonomic findings, although they present most often with motor and sensory complaints. This third edition of Tunnel Syndromes does a good job of categorizing and describing these syndromes.

The first section uses two chapters to introduce the reader to the body of knowledge encompassing tunnel syndromes. Chapter one reviews the general etiology of these conditions, along with clinical findings, diagnosis and treatment. Chapter two addresses neurophysiology and how electrodiagnostic tests are used to determine the location of specific tunnel syndromes.

The second section is devoted to the syndromes of the upper extremity, discussing 26 different tunnel syndromes affecting this area. Conditions covered include thoracic outlet syndrome; suprascapular nerve syndrome; long thoracic nerve compression; supinator syndrome; ulnar tunnel syndrome; and, of course, carpal tunnel syndrome. The authors review the relevant anatomy, etiology, clinical findings and treatment options for each condition.

The third section covers the tunnel syndromes that affect the trunk, while the fourth section deals with the lower extremity, addressing 17 different tunnel syndromes, from lumbosacral tunnel syndrome to Morton's metatarsalgia. Each syndrome is covered in the same detail as in previous sections. There is a short fifth section that discusses these tunnel syndromes as they relate to athletes. Variations in etiology and treatment in such cases are presented.

The book contains numerous illustrations and photographs, although the majority of the former are black-and-white drawings. This edition includes expanded references and nine syndromes not found in prior editions. Discussion of the anatomy associated with tunnel syndromes is well-supported both by text and illustrations, and clinical findings are presented clearly. The sections on treatment address the range of treatments available, from conservative to surgical intervention. Although chiropractic care is not mentioned specifically, the various therapeutic modalities employed by chiropractors are most certainly to be found.

Overall, I found this a useful and well-thought-out text. Generally, this material is not covered to this depth in college curricula, so it makes an excellent reference for students and field practitioners alike.

Dr. Savoie's rating:

9 out of 10

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