Commentary: severe carpal tunnel syndrome

Abstract

There is a general perception in the United States that the rate of carpal tunnel syndrome (CTS) is increasing. Although carpal tunnel release is one of the most commonly performed surgeries in this country, it is still unclear whether there is an epidemic of this disease. Several studies have estimated the prevalence of CTS in the general population (prevalence identifies current existing cases and incidence points to new cases). The prevalence of CTS (confirmed clinically and electrodiagnostically) from a region in Sweden was estimated at 2.7% (95% confidence interval, 2.1% to 3.4%).1 In the U.S., the prevalence of CTS estimated from a regional health care system was 3.7% (95% confidence interval, 0.9% to 4.7%).2 By using the population register at Maastricht, the Netherlands, deKrom et al3 estimated the prevalence at 5.8% (95% confidence interval, 3.5% to 8.1%). Because all these surveys were not based on national samples using strict survey methodology, the prevalence estimates were only extrapolated estimates of the general population. The consistency in the data presented by these 3 studies, however, provided a reasonably valid estimate of CTS prevalence. One of the reasons that the prevalence of CTS is so difficult to establish lies in the lack of a confirmatory study for this disease; provocative tests are notoriously inaccurate, and false-positive and negative findings in electrodiagnostic studies do occur, depending on the prevalence of CTS in the study sample and the cut-off criteria used in the studies.