Pathophysiology and diagnosis of Carpal tunnel syndrome

Background: Carpal tunnel syndrome (CTS) is a common medical condition, which causes pain, numbness, and tingling in the hand, arm, or forearm of the affected individual. CTS occurs when the median nerve is squeezed or compressed as it travels through the wrist.Despite CTS being an idiopathic syndrome, there are still existing risk factors associated with the prevalence of this medical condition. Notable ecological risk factors include extended positions in excesses of wrist flexion or extension, monotonous use of the flexor muscles, and exposure to vibration.The pathophysiology of CTS involves a combination of mechanical trauma, increased pressure, and ischemic damage to the median nerve within the carpal tunnel. Concerning increased pressure, normal pressure is recorded to vary between 2 mmHg and 10 mmHg. In the carpal tunnel, the change in the position of the wrist may result in dramatic shifts in the fluid pressure. As such, the extension increases the pressure to more than 10 times its initial level, while flexion of the wrist causes an eight times increase in the pressure.The characteristic symptoms of CTS are numbness and tingling in the median nerve distribution. This classic distribution will typically include the palmar aspect of the thumb, index, middle, and half of the ring finger. The remaining half of the ring finger and small finger should be excluded, as they are usually innervated by the ulnar nerve. The palm should be excluded, as it is typically innervated by the palmar cutaneous branch of the median nerve arising proximal to the carpal tunnel.The diagnosis of CTS is based on clinical symptoms and strengthened by several examinations and workup