The objectives of this study were to determine the point prevalence of neurophysiologically defined median nerve compression and associated carpal tunnel syndrome in a random sample of the general population. The design was a two-stage screening study: (i) a cross-sectional survey to estimate the point prevalence of current hand symptoms; (ii) nerve conduction testing of the median nerve in weighted samples of the survey respondents. The target study population was a random sample of 1000 adults aged between 18 and 75 yr registered with a family practice in the UK. A mailed questionnaire enquired about hand symptoms on the day and included various demographic questions. Weighted random samples were taken based on the hand symptoms reported, and the subjects were invited to attend for motor and sensory median nerve conduction testing. A neurophysiological diagnosis of median nerve compression was made based on a number of different cut-offs using published criteria. Of those receiving a questionnaire, 79% responded. A total of 250 responders were invited to attend for nerve conduction testing, of whom 155 (62%) attended. Non-response to the questionnaire and non-attendance for nerve conduction testing may have biased the prevalence estimates. After adjustment for such biases, a prevalence estimate of between 7 and 16% was obtained, varying with the different cut-offs used to define delayed median nerve conduction. Subjects over 54 yr of age had a higher prevalence than younger participants. There was no difference in prevalence estimates between men and women. The conclusion reached was that carpal tunnel syndrome, as assessed by delayed median nerve conduction, is common in the general population.

Objective. To examine the association between different patterns of hand symptoms and the presence of delayed nerve conduction in the general population.Methods. We performed a 2-stage screening survey involving a questionnaire on current hand symptoms, and nerve conduction testing in samples of subjects with and without symptoms. Of 648 respondents to the symptom questionnaire, 212 reported hand symptoms. In all, 155 were tested for nerve conduction of sensory and motor median nerve latencies, including 40 who had reported no symptoms. Patterns of hand symptoms were compared with nerve conduction results and associations weighted back to the general population.Results. The presence of any hand symptoms had only a 40% sensitivity for delayed nerve conduction on latency testing. The presence of typical symptoms of carpal tunnel syndrome had a much lower sensitivity.Conclusion. In a community setting, the distribution of hand symptoms does not usefully correlate with the presence of delayed nerve conduction in the median nerve.Carpal tunnel syndrome (CTS) is clinically defined as the occurrence of hand and arm symptoms as a

Both carpal tunnel syndrome and Raynaud's phenomonon are common conditions in the general population. These two different conditions frequently cause similar symptoms such as tingling, numbness, and "deadness of the fingers". They may also co-exist for instance in scleroderma or rheumatoid arthritis. In order to study the association, if any, between these two conditions, we studied 93 patients with idiopathic carpal tunnel syndrome confirmed in electro-physiological tests with 57 control subjects, for the presence of Raynaud's phenomenon by means of a previously validated questionnaire. Raynaud's phenomenon was detected significantly more frequently (P = 0.002) in patients with idiopathic carpal tunnel syndrome (36%) compared to control subjects (12%). Thus there appears to be an association between these two conditions. The mechanism for this is not clear. Sympathetic dysfunction may play a part. Practitioners should be aware of the similarity of the symptoms and the possibility that the two conditions may co-exist.

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