Carpal tunnel syndrome: An overview

Carpal Tunnel Syndrome (CTS) is the most common upper extremity neuropathy, accounting for 90% of all entrapment neuropathies. The prevalence of CTS varies from 0.125% to 5.8% of population and the incidence in United States has been estimated to be from 1-3 cases per 1,000. Patients usually present with numbness, and weakness in the hand, with or without the wrist pain, which may radiate up to the forearm, resulting from compression of the median nerve at the wrist beneath the transverse carpal ligament. The diagnosis is mostly clinical and electrodiagnostic studies are usually performed to confirm the diagnosis and to grade the severity. The most important risk factor for CTS recognized over the years is environmental including repetitivemovements of wrist or prolonged positioning of the wrist in extreme flexion or extension position and exposure to vibration. Besides the environmental factors, compression of the nerve can be due to external compression such as a tumor or osteoarthritic changes. Other medical factors that affect the volume of the tunnel also are important risk factors. Treatment of CTS falls under two categories: conservative or surgical. The objective of this review is to provide an overview of carpal tunnel syndrome with emphasis on the risk factors, clinical symptoms and evidence-based overview of treatments options for this common and disabling condition.