Science Letters

Risk Factors, Diagnosis, and Treatments for Carpal Tunnel Syndrome: A Review

Abdul Azeez Alsharif 1, Furqan Nasir 2, Yachen Shi 1, Xiuxiu Tian 1, Ahsan Ali Khan3, Yi Jing Guo 1*

1 Department of Neurology, Southeast University Affiliated Zhong Da Hospital, No. 87 Dingjiaqiao, Nanjing, 210009, China

2 Department of Pediatrics and Neonatal Intensive Care Unit, Southeast University Affiliated Zhong Da Hospital, No. 87 Dingjiaqiao, Nanjing, 210009, China

3 Department of Neurosurgery, Southeast University affiliated Zhong Da Hospital, No. 87 Dingjiaqiao, Nanjing, 210009, China

Abstract

Carpal tunnel syndrome (CTS) is a common medical condition that is usually caused by the compression of the median nerve at the level of the carpal tunnel. The mechanism leading to carpal tunnel syndrome is not completely understood. In general, CTS develops when the tissues around the median nerve swell and exert pressure on the median nerve. Symptoms present as tingling and numbness in the thumb, index, middle fingers and lateral half of the ring finger, pain in the anterior part of forearm and wrist, and awkwardness of hand. In early stages, the process leading to CTS is usually reversible. However, with the passage of time, the insulation over the surface of median nerve branches may wear away, and permanent damage to the nerve may develop. Several risk factors such as age >30 years, female sex, fractured carpal bones, rheumatoid arthritis, diabetes, high BMI, specific occupations involving repetitive twisting, bending or vibrations of wrists, congenital carpal tunnel stenosis, dialysis, pregnancy, etc. are responsible for CTS. The incidence of CTS in the US has been reported to be 3.5/1000 person-years, with a prevalence rate up to 3.7%. Rates of CTS have risen remarkably and rapidly over the recent years, but it is uncertain whether this is due to rising risk factors or a better awareness of the disease. CTS is uncommon in developing countries and has a different propensity for different ethnic groups. The purpose of this review article is to provide up-to-date information about the risk factors, diagnosis, and treatment strategies of CTS.