Carpal tunnel syndrome

Carpal tunnel syndrome (CTS) results from compression of the median nerve in the carpal tunnel and is characterised by painful paraesthesiae of the hand, wrist, or forearm.

• described as a mononeuropathy or radiculopathy, it is caused by tight packing of tendons and the median nerve in the carpal tunnel such that any swelling is likely to cause ischaemia and compression of the nerve
  • syndrome is characterized by pain in the hand, numbness, and tingling in the distribution of the median nerve
  • sensations may be felt in the thumb, index finger, middle finger, and the radial side of the ring finger
  • painful feelings may result in a reduction in grip strength and hand function
• most commonly diagnosed compression neuropathy of the upper limb (1,2)
• pathophysiology of CTS involves a combination of mechanical trauma, increased pressure, and ischaemic damage to the median nerve within the carpal tunnel (3)
• more common in females than in males
• peak age ranges from 40 to 60 years
• risk factors for CTS include obesity, monotonous wrist activity, pregnancy, genetic heredity, and rheumatoid inflammation (3)
• diagnosis of CTS is conducted through medical assessments and electrophysiological testing

Reference:

• (1) Middleton SD, Anakwe RE Carpal tunnel syndrome. BMJ. 2014;349:g6437
• (2) I Ibrahim et al. Carpal Tunnel Syndrome: A Review of the Recent Literature. Open Orthop J. 2012; 6: 69-76
• (3) Genova A, Dix O, Saefan A, Thakur M, Hassan A. Carpal Tunnel Syndrome: A Review of Literature. Cureus. 2020 Mar 19;12(3):e7333.