Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) develops when the median nerve is compressed within the carpal tunnel at the wrist. The tunnel is a confined passage containing the median nerve and flexor tendons. Swelling of its contents or a relatively narrow tunnel raises pressure around the nerve; prolonged pressure interferes first with nerve conduction and later with axonal function. The sensory pattern is the quickest clinical clue: tingling, numbness, burning, or reduced sensation in the thumb, index finger, middle finger, and radial half of the ring finger. The little finger is usually spared because its sensation is supplied by the ulnar nerve. Symptoms often worsen at night or with sustained wrist flexion because these positions further increase pressure in the tunnel. Patients may describe shaking or “flicking” the hand to obtain relief. Motor involvement affects the thenar muscles, which control thumb opposition and other fine movements. Dropping objects, difficulty fastening clothing, or reduced pinch strength suggests that compression is no longer purely sensory. Persistent sensory loss, thenar weakness, or visible thenar wasting indicates more advanced nerve dysfunction. Risk is multifactorial. Repetitive or...