Carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is a nerve compression syndrome caused by compression of the median nerve as it goes through the carpal tunnel of the wrist.

It’s the most common nerve syndrome where a nerve gets caught and accounts for 90% of all nerve syndromes.

Early symptoms include pain, tingling and paraesthesia (burning/prickling).

Symptoms usually occur (but can vary to a degree) in the thumb, forefinger, middle finger and thumb side of the ring finger.

Pain sometimes spreads up the entire arm. In later stages, hands may get weaker, fine-motor coordination may be reduced, hand movements may become clumsy and the base of the thumb may start to wane.

Patients can get diagnosed quickly and respond well to treatment.

The carpal tunnel (CT) is made up of a rigid osteofibrous wall which forms a tunnel that protects the median nerve and the flexor tendon.

The so-called transverse carpal ligament makes up the upper boundary and the carpal bones make up the lower boundary.


The carpal tunnel includes the median nerve and 9 flexor tendons.

Flexor tendons comprise:

  • Four tendons of the flexor digitorum profundus muscle
  • Four tendons of the flexor digitorum superficialis
  • One tendon of the flexor pollicis longus.