In carpal tunnel syndrome (CTS) (synonyms: Brachialgia paraesthetica nocturna; carpal tunnel syndrome (CTS); KTS [carpal tunnel syndrome]; carpal tunnel syndrome; median nerve compression; median nerve compression syndrome; neuropathy due to median nerve constriction; ICD-10-GM G56. 0: Carpal tunnel syndrome) is a compression syndrome (narrowing syndrome) of the median nerve in the region of the carpal canal. Usually, the syndrome occurs on both sides.
The median nerve is a nerve that partially innervates the forearm motor and sensory. Through the carpal tunnel, the median nerve travels to the palm of the hand. There it innervates some of the short finger muscles. In addition, the median nerve is responsible for sensitive innervation of the palm from the thumb to the inside of the ring finger.
Carpal tunnel syndrome is the most common narrowing syndrome of a peripheral nerve. It often occurs bilaterally (80% of cases). Cubital tunnel syndrome (KbTS; synonym: ulnar nerve neuropathy at the elbow; formerly also sulus ulnaris syndrome, SUS) is the second most common nerve compression syndrome (13 times less frequent than KTS).
Sex ratio: males to females is 1: 3-4.
Peak incidence: the condition occurs predominantly between the ages of 40 and 70. It is rare in children.
The prevalence (disease incidence) is 3-6% (in Germany). In southern Sweden, the prevalence for the typical symptoms of carpal tunnel syndrome is 14.8% of the population. In gravidity (pregnancy), the prevalence is reported to be 17%. In diabetics, it ranges from 3 to 20%. In patients with rheumatoid arthritis, the prevalence is particularly high.
The incidence (frequency of new cases) of carpal tunnel syndrome is approximately 300 cases per 100,000 population per year. Physical workers have a 3 to 7 times higher incidence of carpal tunnel syndrome than non-physical workers.
Course and prognosis: In mild forms of the disease, conservative therapy (mainly pharmacotherapy/medicinal therapy, physical measures) is usually sufficient. In advanced stages, muscle atrophy (muscle atrophy) may occur in the area of the thumb ball. In severe cases, surgical intervention is usually required. The more time that elapses between symptom onset and surgery, the worse the prognosis. After surgery, the nocturnal pain improves immediately and the sensory disturbance also resolves within days to a few weeks.
Comorbidities (concomitant diseases): Common comorbidity is diabetic polyneuropathy/diseases of the peripheral nervous system affecting multiple nerves due to diabetes mellitus (prevalence with 30% without diabetic polyneuropathy 14%). Patients with carpal tunnel syndrome are 12 times more likely to be diagnosed with amyloidosis and half as likely to develop heart failure: carpal tunnel syndrome should thus be taken seriously as a warning sign of future amyloidosis or amyloidosis-associated cardiomyopathy.
