Carpal Tunnel Syndrome

In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan.


Carpal tunnel syndrome (CTS) occurs when the median nerve is compressed as it traverses the carpal tunnel. The primary factor contributing to the onset of CTS is the elevated pressure within the carpal tunnel. The typical initial signs of CTS include pain, numbness, and paresthesias, which affect the first 3 digits and the lateral half of the fourth digit. Symptoms of CTS can exhibit variability, with pain manifesting at the wrist, involving the entire hand, and potentially radiating up the forearm or extending beyond the elbow. Pain associated with CTS does not typically extend to the neck. As the condition advances, individuals may experience hand weakness, diminished fine motor coordination, clumsiness, and eventual atrophy of the thenar muscles.

Initially, symptoms associated with CTS frequently manifest at night while lying down and tend to improve during the daytime. Over time, the majority of patients begin to encounter symptoms during the day, particularly when engaged in repetitive activities such as drawing, typing, or playing video games. In advanced cases, these symptoms may become persistent or constant.

Occupations involving frequent computer use, exposure to vibrating equipment, or repetitive movements significantly elevate the risk of developing CTS for individuals. Obesity, genetic predisposition, diabetes, rheumatoid arthritis, hypothyroidism, and pregnancy also contribute to the risk of developing CTS.

Treatment options for CTS depend on the severity of the disease. In most cases, patients should undergo an initial trial of conservative treatment. Individuals with severe disease or who do not respond to traditional treatment measures should consider surgical intervention.

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