Carpal tunnel syndrome

When the intracarpal canal interstitial pressure rises above a critical threshold pressure, capillary blood flow is reduced below the level required for median nerve function, then viability. The associated symptoms include pain, paræsthesiæ and altered sensation, or a combination of these. While primary carpal tunnel syndrome can result from direct trauma to the contents of the carpal tunnel or surrounding tissues, the more common type is idiopathic and multi-factorial, with a multitude of risk factors. There is considerable confusion in the literature between risk factors and factors that provoke the symptoms. This paper analyses the published evidence for the rôle that each of the risk factors plays in the ætiology of carpal tunnel syndrome.