Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel. The main symptoms are pain, numbness and tingling in the thumb, index finger, middle finger and the thumb side of the ring finger. Symptoms typically start gradually and during the night. Pain may extend up the arm.  Weak grip strength may occur, and after a long period of time the muscles at the base of the thumb may waste away.  In more than half of cases, both hands are affected.  Risk factors include obesity, repetitive wrist work, pregnancy, genetics, and rheumatoid arthritis.  There is tentative evidence that hypothyroidism increases the risk. Diabetes mellitus is weakly associated with CTS. The use of birth control pills does not affect the risk. Types of work that are associated include computer work, work with vibrating tools and work that require a strong grip.  Diagnosis is suspected based on signs, symptoms and specific physical tests and may be confirmed with electro diagnostic tests. If muscle wasting at the base of the thumb is present, the diagnosis is likely. Being physically active can decrease the risk of developing CTS.  Symptoms can be improved by wearing a wrist splint or with corticosteroid injections.