Prevalence of carpal tunnel syndrome in a general population

Context Carpal tunnel syndrome (CTS) is a cause of pain, numbness, and ting ling in the hands and is an important cause of work disability. Although hi gh prevalence rates of CTS in certain occupations have been reported, littl e is known about its prevalence in the general population. Objective To estimate the prevalence of CTS in a general population. Design General health mail survey sent in February 1997, inquiring about sy mptoms of pain, numbness, and tingling in any part of the body, followed 2 months later by clinical examination and nerve conduction testing of respon ders reporting symptoms in the median nerve distribution in the hands, as w ell as of a sample of those not reporting these symptoms (controls). Setting A region in southern Sweden with a population of 170 000. Participants A sex- and age-stratified sample of 3000 subjects (age range, 25-74 years) was randomly selected from the general population register and sent the survey, with a response rate of 83% (n = 2466; 46% men). Of the s ymptomatic responders, 81% underwent clinical examination. Main Outcome Measures Population prevalence rates, calculated as the number of symptomatic responders diagnosed on examination as having clinically ce rtain CTS and/or electrophysiological median neuropathy divided by the tota l number of responders. Results Of the 2466 responders, 354 reported pain, numbness, and/or tinglin g in the median nerve distribution in the hands (prevalence, 14.4%; 95% con fidence interval [CI], 13.0%-15.8%). On clinical examination, 94 symptomati c subjects were diagnosed as having clinically certain CTS (prevalence, 3.8 %; 95% CI, 3.1%-4.6%). Nerve conduction testing showed median neuropathy at the carpal tunnel in 120 symptomatic subjects (prevalence, 4.9%; 95% CI, 4 .1%-5.8%), Sixty-six symptomatic subjects had clinically and electrophysiol ogically confirmed CTS (prevalence, 2.7%; 95% CI, 2.1%-3.4%). Of 125 contro l subjects clinically examined, electrophysiological median neuropathy was found in 23 (18.4%; 95% CI, 12.0%-26.3%). Conclusion Symptoms of pain, numbness, and tingling in the hands are common in the general population. Based on our data, 1 in 5 symptomatic subjects would be expected to have CTS based on clinical examination and electrophys iologic testing.