Carpal Tunnel Syndrome (CTS) is a common cause of median nerve entrapment. The tunnel itself lies between the transverse carpal ligament and the bones of the wrist. Along with several tendons, the median nerve must travel through this tunnel. When this space becomes compromised and the nerve is affected it is known as CTS.
The thumb, index, and middle finger on the palm side can become symptomatic. Symptoms could include numbness, 
tingling, pain, and weakness. Early signs may include a feeling of having to shake the hand to “wake it up”. The nerve can become permanently damaged if left untreated.
The most common cause of CTS is overuse of the hands and wrist. This can include things like computer work, sewing, and playing a musical instrument. Other risk factors can include age, obesity, pregnancy, and diabetes.
Although we are discussing the carpal tunnel, the median nerve can also be compromised at other locations. When treating a patient with median nerve symptoms, we also have to consider the neck, shoulder, elbow, forearm, and thumb, along with the carpal tunnel, as possible entrapment sites.
The most common treatment for median nerve entrapment used in the office is manual therapy which includes soft tissue and nerve release, and in some cases joint mobilization. Other considerations may include naturally reducing inflammation, splinting, and ergonomics.
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