What is Carpal Tunnel Syndrome?

Carpal Tunnel Anatomy and Compression Dynamics

The carpal tunnel is an inelastic fibro-osseous canal on the volar wrist bounded deeply by carpal bones and roofed by the transverse carpal ligament. Within this tight passage, nine flexor tendons and the median nerve travel. Elevated hydrostatic pressure within the canal causes ischemic microvascular distress to median nerve sensory and motor axons.

Predisposing Risk Factors

Repetitive wrist flexion-extension, vibratory tool exposure, pregnancy fluid shifts, rheumatoid arthritis, hypothyroidism, and diabetes mellitus represent established etiologic catalysts.

Classic Presentation

• Paresthesia and numbness in the thumb, index, middle, and radial half of the ring finger
• Nocturnal symptom exacerbation awakening patients, relieved by hand shaking (Flick sign)
• Thenar muscle weakness and loss of fine motor dexterity leading to dropped objects
• Visible thenar eminence muscle atrophy in longstanding chronic disease

Frequently Asked Questions

How is carpal tunnel diagnosed definitively?

Diagnosis combines provocative clinical maneuvers (Phalen's maneuver, Tinel's sign) with objective electrodiagnostic nerve conduction studies (EMG/NCS).

What is endoscopic carpal tunnel release?

Endoscopic release divides the transverse carpal ligament through a miniature incision under local anesthesia in 15 minutes, preserving palmar skin integrity and accelerating return to work.