U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Carpal tunnel syndrome(CTS)

MedGen UID:
2856
Concept ID:
C0007286
Disease or Syndrome
Synonym: CTS
SNOMED CT: Distal median nerve compression (57406009); Distal median nerve entrapment (57406009); Carpal tunnel (57406009); Carpal canal (57406009); CTS - Carpal tunnel syndrome (57406009); Carpal tunnel syndrome (57406009)
 
Related gene: TTR
 
Monarch Initiative: MONDO:0007275
OMIM®: 115430
OMIM® Phenotypic series: PS115430
Orphanet: ORPHA50838

Definition

Carpal tunnel syndrome is a disorder caused by disturbances in nerve function (neuropathy), leading to pain and numbness or tingling (paresthesia) primarily in the wrist and hand. While carpal tunnel syndrome can occur at any age, it most often affects people between the ages of 40 and 60. In more than half of cases, both hands are affected; however, the severity may vary between hands. When only one hand is affected, it is most often the hand used for writing (the dominant hand).

In carpal tunnel syndrome, the pain or paresthesia is usually felt in the wrist, the palm, and the first four fingers of the hand. These signs and symptoms often develop during sleep and are noticeable upon waking. Affected individuals typically shake their hand to get rid of the pain and numbness, a characteristic move known as the flick sign. As the condition advances, the signs and symptoms begin to occur during the day as well. Affected individuals may have difficulty performing manual tasks such as turning doorknobs, fastening buttons, or opening jars. The symptoms of carpal tunnel syndrome may be triggered by certain activities that flex or extend the wrist, such as driving, typing, or holding a telephone.

Over time, people with carpal tunnel syndrome can have muscle and nerve wasting (atrophy) in the affected hand and a reduced ability to detect sensations, which can be mistaken for an improvement of symptoms. [from MedlinePlus Genetics]

Term Hierarchy

Professional guidelines

PubMed

Wang L
Phys Med Rehabil Clin N Am 2018 Nov;29(4):751-760. Epub 2018 Sep 17 doi: 10.1016/j.pmr.2018.06.009. PMID: 30293628
Wipperman J, Goerl K
Am Fam Physician 2016 Dec 15;94(12):993-999. PMID: 28075090
Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, Caliandro P, Hobson-Webb LD
Lancet Neurol 2016 Nov;15(12):1273-1284. Epub 2016 Oct 11 doi: 10.1016/S1474-4422(16)30231-9. PMID: 27751557

Recent clinical studies

Etiology

Ijaz MJ, Karimi H, Ahmad A, Gillani SA, Anwar N, Chaudhary MA
Biomed Res Int 2022;2022:2155765. Epub 2022 Jun 22 doi: 10.1155/2022/2155765. PMID: 35782066Free PMC Article
Calandruccio JH, Thompson NB
Orthop Clin North Am 2018 Apr;49(2):223-229. Epub 2018 Feb 1 doi: 10.1016/j.ocl.2017.11.009. PMID: 29499823
Franklin GM, Friedman AS
Phys Med Rehabil Clin N Am 2015 Aug;26(3):523-37. Epub 2015 Jun 19 doi: 10.1016/j.pmr.2015.04.003. PMID: 26231963
Aboonq MS
Neurosciences (Riyadh) 2015 Jan;20(1):4-9. PMID: 25630774Free PMC Article
Kim PT, Lee HJ, Kim TG, Jeon IH
Clin Orthop Surg 2014 Sep;6(3):253-7. Epub 2014 Aug 5 doi: 10.4055/cios.2014.6.3.253. PMID: 25177448Free PMC Article

Diagnosis

Osiak K, Elnazir P, Walocha JA, Pasternak A
Folia Morphol (Warsz) 2022;81(4):851-862. Epub 2021 Nov 16 doi: 10.5603/FM.a2021.0121. PMID: 34783004
Wang L
Phys Med Rehabil Clin N Am 2018 Nov;29(4):751-760. Epub 2018 Sep 17 doi: 10.1016/j.pmr.2018.06.009. PMID: 30293628
Wipperman J, Goerl K
Am Fam Physician 2016 Dec 15;94(12):993-999. PMID: 28075090
Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, Caliandro P, Hobson-Webb LD
Lancet Neurol 2016 Nov;15(12):1273-1284. Epub 2016 Oct 11 doi: 10.1016/S1474-4422(16)30231-9. PMID: 27751557
Middleton SD, Anakwe RE
BMJ 2014 Nov 6;349:g6437. doi: 10.1136/bmj.g6437. PMID: 25378457

Therapy

Ijaz MJ, Karimi H, Ahmad A, Gillani SA, Anwar N, Chaudhary MA
Biomed Res Int 2022;2022:2155765. Epub 2022 Jun 22 doi: 10.1155/2022/2155765. PMID: 35782066Free PMC Article
Shem K, Wong J, Dirlikov B
J Hand Ther 2020 Jul-Sep;33(3):272-280. Epub 2020 May 1 doi: 10.1016/j.jht.2019.12.002. PMID: 32362377
Huisstede BM, Hoogvliet P, Franke TP, Randsdorp MS, Koes BW
Arch Phys Med Rehabil 2018 Aug;99(8):1623-1634.e23. Epub 2017 Sep 20 doi: 10.1016/j.apmr.2017.08.482. PMID: 28942118
Jiménez Del Barrio S, Bueno Gracia E, Hidalgo García C, Estébanez de Miguel E, Tricás Moreno JM, Rodríguez Marco S, Ceballos Laita L
Neurologia (Engl Ed) 2018 Nov-Dec;33(9):590-601. Epub 2016 Jul 22 doi: 10.1016/j.nrl.2016.05.018. PMID: 27461181
Page MJ, O'Connor D, Pitt V, Massy-Westropp N
Cochrane Database Syst Rev 2012 Jun 13;(6):CD009899. doi: 10.1002/14651858.CD009899. PMID: 22696387

Prognosis

Hofer M, Ranstam J, Atroshi I
JAMA Netw Open 2021 Oct 1;4(10):e2130753. doi: 10.1001/jamanetworkopen.2021.30753. PMID: 34677593Free PMC Article
Fernández-de-Las-Peñas C, Arias-Buría JL, Cleland JA, Pareja JA, Plaza-Manzano G, Ortega-Santiago R
Phys Ther 2020 Oct 30;100(11):1987-1996. doi: 10.1093/ptj/pzaa150. PMID: 32766779
Calandruccio JH, Thompson NB
Orthop Clin North Am 2018 Apr;49(2):223-229. Epub 2018 Feb 1 doi: 10.1016/j.ocl.2017.11.009. PMID: 29499823
Hanewinckel R, Ikram MA, Van Doorn PA
Handb Clin Neurol 2016;138:263-82. doi: 10.1016/B978-0-12-802973-2.00015-X. PMID: 27637963
Fernández-de-Las Peñas C, Ortega-Santiago R, de la Llave-Rincón AI, Martínez-Perez A, Fahandezh-Saddi Díaz H, Martínez-Martín J, Pareja JA, Cuadrado-Pérez ML
J Pain 2015 Nov;16(11):1087-94. Epub 2015 Aug 15 doi: 10.1016/j.jpain.2015.07.012. PMID: 26281946

Clinical prediction guides

Siddiqi OK, Ruberg FL
Trends Cardiovasc Med 2018 Jan;28(1):10-21. Epub 2017 Jul 13 doi: 10.1016/j.tcm.2017.07.004. PMID: 28739313Free PMC Article
Geler Külcü D, Bursali C, Aktaş İ, Bozkurt Alp S, Ünlü Özkan F, Akpinar P
Turk J Med Sci 2016 Jun 23;46(4):1042-9. doi: 10.3906/sag-1503-4. PMID: 27513402
Chang YW, Hsieh SF, Horng YS, Chen HL, Lee KC, Horng YS
BMC Musculoskelet Disord 2014 Nov 26;15:399. doi: 10.1186/1471-2474-15-399. PMID: 25428566Free PMC Article
Werner RA, Andary M
Muscle Nerve 2011 Oct;44(4):597-607. doi: 10.1002/mus.22208. PMID: 21922474
Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S
Spine (Phila Pa 1976) 2003 Jan 1;28(1):52-62. doi: 10.1097/00007632-200301010-00014. PMID: 12544957

Recent systematic reviews

Jiménez-Del-Barrio S, Cadellans-Arróniz A, Ceballos-Laita L, Estébanez-de-Miguel E, López-de-Celis C, Bueno-Gracia E, Pérez-Bellmunt A
Int Orthop 2022 Feb;46(2):301-312. Epub 2021 Dec 3 doi: 10.1007/s00264-021-05272-2. PMID: 34862562Free PMC Article
Hernández-Secorún M, Montaña-Cortés R, Hidalgo-García C, Rodríguez-Sanz J, Corral-de-Toro J, Monti-Ballano S, Hamam-Alcober S, Tricás-Moreno JM, Lucha-López MO
Int J Environ Res Public Health 2021 Feb 28;18(5) doi: 10.3390/ijerph18052365. PMID: 33671060Free PMC Article
Jiménez Del Barrio S, Bueno Gracia E, Hidalgo García C, Estébanez de Miguel E, Tricás Moreno JM, Rodríguez Marco S, Ceballos Laita L
Neurologia (Engl Ed) 2018 Nov-Dec;33(9):590-601. Epub 2016 Jul 22 doi: 10.1016/j.nrl.2016.05.018. PMID: 27461181
Basson A, Olivier B, Ellis R, Coppieters M, Stewart A, Mudzi W
J Orthop Sports Phys Ther 2017 Sep;47(9):593-615. Epub 2017 Jul 13 doi: 10.2519/jospt.2017.7117. PMID: 28704626
Ballestero-Pérez R, Plaza-Manzano G, Urraca-Gesto A, Romo-Romo F, Atín-Arratibel MLÁ, Pecos-Martín D, Gallego-Izquierdo T, Romero-Franco N
J Manipulative Physiol Ther 2017 Jan;40(1):50-59. Epub 2016 Nov 11 doi: 10.1016/j.jmpt.2016.10.004. PMID: 27842937

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Recent activity

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...