Editing Carpal tunnel syndrome (section)

== Symptoms ==
The characteristic symptom of CTS is numbness, tingling, or burning sensations in the thumb, index, middle, and radial half of the ring finger. These areas process sensation through the median nerve.<ref>{{cite journal | vauthors = Aroori S, Spence RA | title = Carpal tunnel syndrome | journal = The Ulster Medical Journal | volume = 77 | issue = 1 | pages = 6–17 | date = January 2008 | pmid = 18269111 | pmc = 2397020 }}</ref> Numbness or tingling is usually worse with sleep. People tend to sleep with their wrists flexed, which increases pressure on the nerve. Ache and discomfort may be reported in the [[forearm]] or even the [[upper arm]].<ref>{{Cite web|url=http://www.nhs.uk/Conditions/Carpal-tunnel-syndrome/Pages/Symptoms.aspx|title=Carpal tunnel syndrome – Symptoms|website=[[National Health Service (England)#Internet information service|NHS Choices]] | access-date=2016-05-21|url-status=live|archive-url=https://web.archive.org/web/20160524081418/http://www.nhs.uk/Conditions/Carpal-tunnel-syndrome/Pages/Symptoms.aspx|archive-date=2016-05-24}} Page last reviewed: 18/09/2014</ref> Symptoms that are not characteristic of CTS include [[wrist pain|pain in the wrists]] or hands, loss of grip strength,<ref name=Atroshi_1999>{{cite journal | vauthors = Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I | title = Prevalence of carpal tunnel syndrome in a general population | journal = JAMA | volume = 282 | issue = 2 | pages = 153–158 | date = July 1999 | pmid = 10411196 | doi = 10.1001/jama.282.2.153 | doi-access = free }}</ref> minor loss of sleep,<ref>{{Cite web| vauthors = Boyko T |date=January 24, 2022|title=Carpal Tunnel Syndrome|url=https://txosa.com/carpal-tunnel-syndrome/|url-status=live|website=TXOSA|archive-url=https://web.archive.org/web/20220124185447/https://txosa.com/carpal-tunnel-syndrome/ |archive-date=2022-01-24 }}</ref> and loss of manual dexterity.<ref name="CTS_2009">{{Cite web |title=Carpal Tunnel Syndrome Information Page |date=December 28, 2010 |publisher=[[National Institute of Neurological Disorders and Stroke]] | url=http://www.ninds.nih.gov/disorders/carpal_tunnel/carpal_tunnel.htm |url-status=live |archive-url=https://web.archive.org/web/20101222221850/http://www.ninds.nih.gov/disorders/carpal_tunnel/carpal_tunnel.htm |archive-date=December 22, 2010 }}</ref>

As the median neuropathy gets worse, there is loss of sensibility in the thumb, index, middle, and thumb side of the ring finger. As the neuropathy progresses, there may be first weakness, then to atrophy of the muscles of [[thenar eminence]] (the [[flexor pollicis brevis]], [[opponens pollicis]], and [[abductor pollicis brevis]]). The sensibility of the palm remains normal because the superficial sensory branch of the median nerve branches proximal to the [[transverse carpal ligament]] (TCL) and travels superficial to it.<ref name="Norvell_2009">{{Cite web |date=September 10, 2009 |title=Carpal Tunnel Syndrome |url=http://emedicine.medscape.com/article/822792-overview |url-status=live |archive-url=https://web.archive.org/web/20100803005746/http://emedicine.medscape.com/article/822792-overview |archive-date=August 3, 2010 |publisher=[[eMedicine]] |vauthors=Norvell JG, Steele M}}</ref>

Median nerve symptoms may arise from [[Nerve compression syndrome|nerve compression]] at the level of the [[thoracic outlet]] or the area where the median nerve passes between the two heads of the pronator teres in the forearm,<ref>{{Cite book| vauthors = Netter F |title=Atlas of Human Anatomy|year=2011|publisher=Saunders Elsevier|location=Philadelphia, PA|isbn=978-0-8089-2423-4|pages=412, 417, 435|edition=5th}}</ref> although this is debated.