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Carpal tunnel syndrome.

C arpal tunnel syndrome is the most common entrapment neuropathy, with a prevalence in the general adult population ranging from 2.7 to 5.8 percent. Although the prevalence of bilateral symptoms is uncertain, one study in the United Kingdom reported bilateral symptoms in more than 50 percent of cases. The mean annual crude incidence of carpal tunnel syndrome was found to be 329 cases per 100,000 person-years, and the standardized incidence was 276. Although the etiology is often unknown, certain conditions are commonly associated with carpal tunnel syndrome (Table 1). In addition, carpal tunnel syndrome is often associated with overuse-type injuries caused by repetitive motion, usually work-related. Because many other conditions produce symptoms similar to those of carpal tunnel syndrome (Table 2), an accurate history and physical examination are essential to establishing the diagnosis.