Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a topic covered in the 5-Minute Emergency Consult.

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  • Carpal tunnel syndrome is caused by compression of the median nerve as it passes through the carpal tunnel.
  • The carpal tunnel is the area bound by the carpal bones and the transverse carpal ligament.
  • The median nerve, flexor digitorum profundus, flexor digitorum superficialis (FDS), and flexor pollicis longus are located in the carpal tunnel.
  • Carpal tunnel syndrome can be classified as acute or chronic.


  • Acute:
    • Trauma
    • Infection
    • Snake bite
    • Hemorrhage
    • High-pressure injection injury
  • Chronic:
    • Occupational/overuse syndromes—high impact, repetitive motion
    • Pregnancy, birth control pills
    • Granulomatous disease: Tuberculosis, sarcoidosis
    • Mass lesions with median nerve compression
    • Osteophytes
    • Amyloid
    • Multiple myeloma
    • Rheumatoid arthritis
    • Endocrine disorders: Hypothyroidism, diabetes mellitus, acromegaly
    • Chronic hemodialysis
    • Idiopathic

Pediatric Considerations
Idiopathic causes are rare in children; most cases have a correctable cause including:
  • Trauma
  • Mucolipidosis
  • Hamartoma of the median nerve
  • Anomalous FDS
  • Hemophilia with hematoma

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