Probably a hand surgeon or orthopedist see this a lot more. Although it is very rare, I have The other thing to remember is that carpal tunnel syndrome, like ulnar entrapment or tarsal tunnel syndrome, can be associated with certain underlying medical conditions. Diabetes is a big one. I have picked up a few patients with hypothyroidism that were before undiagnosed. These patients have severe problems and often don t even respond to surgery.
Amyloidosis is another one that can be very resistant.
Chronic renal failure on hemodialysis they can get amyloid deposits with Beta 2 microglobulin as opposed to The treatment includes, if they have an underlying condition like thyroid disease or diabetes, treat the hypothyroidism, that will often help. Rheumatoid arthritis, treating the synovitis with an injection in the wrist or maybe systemic treatment. That may help. Antiinflammatory drugs may help. Wrist splinting will help, particularly at nighttime.