CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Carpal tunnel syndrome - Management
What underlying contributory factors should I exclude?
- Family history: one in four people with carpal tunnel syndrome have a positive family history in first degree relatives.
- Inflammatory conditions: rheumatoid arthritis, gout, pseudogout, non-specific tenosynovitis of the flexor tendons, connective tissue disease (e.g. systemic lupus erythematosis).
- Metabolic causes: hypothyroidism, diabetes mellitus, acromegaly.
- Increased canal volume: congestive heart failure, oedema, pregnancy, obesity in younger people.
- Fractures: Colles' fracture; fracture dislocation of the radiocarpal, carpal, and carpometacarpal joints.
- Abnormal anatomy: ganglion, lipoma, haemangioma, neurofibromas, median artery aneurysm or arteriovenous malformation, xanthoma, congenitally small carpal canal.
- Tumours: of the median nerve.
- Amyloidosis: (e.g. secondary to renal failure).
- Infections: Lyme disease, mycobacterial infection, septic arthritis.
- Use of hand-held vibrating tools.
- Do not routinely request laboratory tests to screen for underlying causes or contributory factors.
© NHS Institute for Innovation and Improvement