Carpal tunnel syndrome usually occurs between ages 30 and 60, and it poses a serious occupational health problem. Keyboard workers, assembly-line workers and packers, and persons who repeatedly use poorly designed tools are most likely to develop this disorder. Some disorders such as diabetes, hypothyroidism, and rheumatoid arthritis sometimes contribute to the condition. The patient with carpal tunnel syndrome usually complains of weakness, pain, burning, numbness, or tingling in one or both hands. This affects the thumb, forefinger, and middle finger, but not the fourth or fifth finger.
Symptoms are often worse at night and in the morning.
The pain may spread to the forearm and, in severe cases, as far as the shoulder. The patient can usually relieve such pain by shaking her hands vigorously or dangling her arms at her side. Physical examination of a patient with carpal tunnel syndrome reveals decreased sensation to light tough or pinpricks in the affected fingers. X-rays can reveal bony abnormalities and EMG detects a median nerve conduction delay. If symptoms have been present for less than 2 months, conservative treatment should be tried first.