CTS is a peripheral neuropathy of the median nerve. It causes compression of the median nerve in carpel tunnel at wrist. It causes pain, numbness, paresthesia in the distribution of the median nerve (Thumb, index and middle finger). Some of the predisposing factors include: diabetes, obesity, pregnancy, hypothyroidism and heavy manual work or work with vibrating tools.
The main symptom of CTS is intermittent numbness of the thumb, index, long and radial half of the ring finger. The numbness often occurs at night, with the hypothesis that the wrists are held flexed during sleep. It can be relieved by manual massaging of wrist and wearing of wrist splint that prevents flexion. Long-standing CTS leads to permanent nerve damage with constant numbness and weakness of the muscles.
The concern in carpal tunnel syndrome is primarily numbness that is so intense that it wakes one from sleep.
Conservative treatment include use of night splints and corticosteroid injection. The only scientifically established disease modifying treatment is surgery done by decompression of the carpel tunnel.
