Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • numbness of hand(s)
  • numbness confined to palmar aspect of the first 4 fingers
  • nighttime worsening
  • numbness in median nerve distribution

Other diagnostic factors

  • symptoms are intermittent
  • onset is gradual
  • weakness of hand
  • clumsiness
  • aching and pain in arm
  • weakness of thenar muscles (abductor pollicis brevis, or APB, in particular)
  • normal reflexes
  • finger stiffness
  • cold sensitivity
  • atrophy of thenar eminence

Risk factors

  • age over 30 years
  • high BMI
  • female sex
  • smoking cigarettes
  • white ethnicity
  • alterations in carpal tunnel space
  • fractured wrist/carpal bones
  • square wrist
  • rheumatoid arthritis
  • diabetes
  • thyroid disorders
  • dialysis
  • pregnancy
  • HRT and/or oophorectomy
  • congenital carpal tunnel stenosis
  • occupation involving exposure to repetitive bending, twisting, or vibration of the hands or wrists
  • occupational keyboard/computer use
  • physical inactivity
  • sports and activities
  • mobility aids

Diagnostic investigations

Treatment algorithm

Contributors

Authors VIEW ALL

Nigel Ashworth

Professor

Division of Physical Medicine & Rehabilitation

Faculty of Medicine & Dentistry

University of Alberta

Edmonton

Canada

Disclosures

NA is an author of a number of references cited in this monograph.

Peer reviewers VIEW ALL

Associate Professor

University of Ottawa

Ottawa

Ontario

Canada

Disclosures

SM declares that he has been primary author and co-author of Cochrane systematic reviews of nonsurgical interventions for treatment of carpal tunnel syndrome.

Associate Professor

The University of Western Ontario

London

Ontario

Canada

Disclosures

TJD declares that he has no competing interests.

Consultant Rheumatologist

The James Cook University Hospital

South Tees Hospitals NHS Foundation Trust

Middlesbrough

UK

Disclosures

MP declares that he has no competing interests.

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