Factors For Carpal Tunnel Syndrome Research Articles

Demographical, Anatomical, Disease-Related, and Occupational Risk Factors for Carpal Tunnel Syndrome

Background: Carpal tunnel syndrome (CTS) is the most common focal mononeuropathy. It causes characteristic symptoms, including numbness and paresthesia in the hand due to median nerve compression at the wrist. Objectives: We aimed to investigate CTS prevalence and personal, psychosocial, biomedical, and occupational factors related to it comprehensively, according to scattered publications, without the simultaneous evaluation of all CTS risk factors. Methods: A total of 345 patients referred to a hand clinic with a complaint of paresthesia in upper extremities and suspected CTS. The patients underwent neurological assessment and electrodiagnostic (EDX) tests to confirm the diagnosis. The demographic information, past medical history, past trauma history, and occupational history of all the patients were recorded and finally analyzed with SPSS software. Results: Of the patients, 213 (67.1%) met the criteria for CTS, of whom 160 (75%) were female. Females were significantly more affected by CTS than males (P < 0.05). The mean age was higher in the CTS patients (53.80 ± 11.57 years) than in non-patients (42.39 ± 12.31 years, P < 0.001). No statistical relevance was found between CTS prevalence with occupational history, underlying medical conditions, positive Tinel’s and Phalen's tests, and muscle atrophy. Conclusions: We recognized age and gender as main determinants in developing CTS. We also found that older age was related to higher CTS intensity.

The relation between body mass index with severity level of carpal tunnel syndrome at RSUP DR. M. Djamil Padang period 2017–2018

Body Mass Index (BMI) is a measuring instrument in determining of a person's nutritional status. Obesity and Overweight are the risk factors for Carpal Tunnel Syndrome (CTS). This study was conducted to determine the relationship between BMI and the severity level of CTS at RSUP Dr. M. Djamil Padang Period 2017–2018.

Effect of Functional Hand Use on Compression and Displacement of the Median Nerve

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Repetitive wrist and hand movement is a risk factor for carpal tunnel syndrome. During daily functional hand use, some people develop carpal tunnel syndrome. However, the exact mechanism of injury remains unknown. We evaluated the effect of functional hand use on the median nerve and assessed the compression and displacement of the median nerve using state-of-the-art sonography. Primary Author and Speaker: Buwen Yao Contributing Authors: Shawn C. Roll

Evaluation of Diabetes Mellitus as a Risk Factor for Carpal Tunnel Syndrome (1666)

Evaluation of Diabetes Mellitus as a Risk Factor for Carpal Tunnel Syndrome (1666)

Ultrasonographic Measurement of Mean Cross-sectional Area of the Median Nerve in Pregnant Women in a Tertiary Level Hospital of Nepal: A Descriptive Cross-sectional Study.

Pregnancy is one of the predisposing factors for carpal tunnel syndrome, which may manifest as swelling of the median nerve. The purpose of this study was to obtain the mean cross-sectional area of median nerve using ultrasound in pregnant females at carpal tunnel inlet and its variations with different trimesters. A total of 102 pregnant females at first, second and third trimesters were evaluated for median nerve with ultrasonography. Mean cross sectional area of median nerve was calculated in both hands by using two methods- direct and indirect. The study was conducted after obtaining ethical clearance from Institutional Review Board of Institute of Medicine, and after obtaining the written informed consent from the subjects. Convenience sampling technique was used. Data obtained were compiled and analyzed using Statistical Package for the Social Sciences version 20. The overall mean cross-sectional area was 6.84±1.09 mm2 using direct method and 7.09±1.19 mm2 using indirect method. The values obtained with indirect method were greater than that obtained with direct method. Mean cross-sectional area of the median nerve were higher at third trimester in both hands and by both direct and indirect methods. From the study conducted, the normal value of mean cross-sectional area of median nerve in pregnant females was established.

Incidence and Reappraisal of Known Risk Factors Associated with Carpal Tunnel Syndrome: A Nationwide, 11-Year, Population-Based Study in South Korea.

Background and PurposePrevious studies have revealed various risk factors for carpal tunnel syndrome (CTS), but few large-scale studies have been conducted. We used data from the 11-year, longitudinal, nationwide population-based National Health Insurance Service–National Health Screening cohort to identify the actual risk factors for CTS.MethodsWe collected patients with CTS newly diagnosed using electrodiagnostic studies while excluding radiculopathy, plexopathy, or polyneuropathy, which can be confused with CTS. The crude and standardized incidence rates of CTS were calculated. Univariate and multivariate Cox analyses and the incidence of CTS were used to identify the risk factors for newly diagnosed CTS.ResultsThe standardized incidence was 130.8/100,000 person-years based on the World Health Organization World Standard Population as a reference. Multivariate Cox analysis identified that the risk factors for CTS were being middle-aged, female, and obese, and having rheumatoid arthritis and Raynaud's syndrome, whereas gout and hypothyroidism were not risk factors. Diabetes and end-stage renal disease did not show a significant hazard ratio, although it is implicit that the durations of these diseases affect the development of CTS.ConclusionsThis study calculated the incidence of CTS and reappraised the associated risk factors found in previous studies. This information will be helpful for determining the pathophysiology of CTS, and hence aid the establishment of effective new public health policies.

Association of the role of personal variables and nonoccupational risk factors for work-related carpal tunnel syndrome.

The purpose of this study was to identify personal variables and nonoccupational risk factors for carpal tunnel syndrome and to analyse the strength of association of these factors. We performed a case-control study with 162 cases and 300 controls. We studied consecutive patients with an electrophysiologically confirmed diagnosis of symptomatic carpal tunnel syndrome. Univariate analysis was performed in the case group and control comparing them for presence of various risk factors. Multivariate analysis was carried out through logistic regression. The mean BMI and age were greater in the case group than in the control. Multivariate analysis showed that BMI (OR = 1.05, 95% CI = 1.01-1.11) and arterial hypertension (OR = 4.63, 95% CI = 2.88-7.44) were the only factors significantly associated with carpal tunnel syndrome. The age, cigarette smoking and alcohol drinking were at the edge of significance. Carpal tunnel syndrome is the most common peripheral neuropathy and has been related to occupational activities in some but not all studies. Clarifying this relationship has important implications for workers' compensation systems. Based on our findings, BMI and arterial hypertension are considered to be the most significant risk factors of carpal tunnel syndrome in our study.

WORKLOAD, REPETITIVE WRIST MOVEMENTS, YEARS OF SERVICE WITH CARPAL TUNNEL SYNDRO

Carpal Tunnel Syndrome (CTS) is an occupational disease caused by disruption of the hand position which is constantly and is often associated with activities that use the hands for a long time can affect nerves, blood supply to the hands and wrists. This study aims to determine the relationship between workload, repetitive wrist movements and work time with carpal tunnel syndrome in cantel eyelash workers. The results of this study are there is no relationship between workload and the incidence of CTS (p=1,000), there is a relationship between repetitive wrist movements with the incidence of CTS (p=0.031) and There is a relationship between years of service and the incidence of CTS (p=0.007). The conclusion is repetitive wrist movements performed by workers during years of work are a risk factor for carpal tunnel syndrome. So that to reduce this risk, it is necessary to stretch your hands before working, every two hours of work and finish working.

Effect of Force, Posture, and Repetitive Wrist Motion on Intraneural Blood Flow in the Median Nerve.

Pinching, deviated wrist postures, and repetitive motion are risk factors for carpal tunnel syndrome. Hypervascularization of the median nerve and increased intraneural blood flow proximal to the carpal tunnel result in finger force and deviated wrist postures. The purpose of this study was to determine the effects of pinching with and without force, wrist posture, and repetitive wrist motion on intraneural blood flow in the median nerve. Eleven healthy and 11 carpal tunnel syndrome-symptomatic individuals completed 3 sections of this study: 15 pinch posture force trials, 3 repetitive wrist motion trials, and 3 static wrist posture trials. Intraneural blood flow (centimeters per second) was measured with pulsed wave Doppler ultrasound during each trial. Transverse B-mode images obtained from static trials were used to calculate the median nerve cross-sectional area and circumference. An analysis of variance statistical analysis revealed significant main effects of pinch posture force (F4,80 = 21.397; P < .001) and wrist posture (F2,40 = 14.545; P < .001). Intraneural blood flow velocities were significantly greater when 6 N of force was applied by the thumb, finger, or pinch compared to no applied force in the same postures. Intraneural blood flow velocities were higher at 30° wrist flexion (mean ± SD, 2.24 ± 0.42 cm/s) than neutral (2.06 ± 0.45 cm/s) and 30° wrist extension (1.97 ± 0.46 cm/s). No changes were found in response to repetitive wrist motion. Flexed wrists as well as applied finger and thumb forces increase median nerve blood flow at the entry to the carpal tunnel, which may negatively affect the median nerve.

Age and Body Anthropometry as Predicting Factors for Carpal Tunnel Syndrome among Egyptian Obese Women

BACKGROUND: Carpal tunnel syndrome (CTS) is the most prevalent entrapment neuropathy in the upper limb. The most consistent risk factors are female gender, age, and obesity. The results of previous studies are conflicting, and moreover, data from studies regarding obesity and nerve conduction velocity are not available for our Egyptian population.&#x0D; AIM: This study was designed to investigate the contribution of age and body anthropometry as predictor factors to the CTS and to identify patients at high risk for CTS among Egyptian obese women.&#x0D; METHODS: The study included 120 obese women grouped according to the clinical and electrodiagnostic (EDX) findings into two groups: 60 with CTS and 60 without CTS (non-CTS). EDX study was used in the diagnosis of median nerve entrapment at the level of the wrist, according to the American Association of Neuromuscular and EDX Medicine. Body weight and height were measured and then body mass index (BMI) was calculated. Waist-to-hip ratio (WHR) was determined from the measured waist circumference (WC) and hip circumference (HC). Mid upper arm circumference (MUAC) was measured as well. The receiver operating characteristic (ROC) curve was used to assess the power of age and body anthropometry as predictor factors for CTS.&#x0D; RESULTS: CTS obese cases showed significantly lower values of both median motor nerve conduction velocity (MMNCV) and median sensory nerve conduction velocity compared to those without CTS. Significantly higher median sensory latency and median motor latency have been found in CTS cases compared to non-CTS group. Significant differences in the mean age have been found between the two groups and a tendency for higher body anthropometry measures in the CTS cases relative to those without CTS. Moreover, there were negative correlations between MMNCV and obesity indices. Age showed the highest area under the ROC curve, followed by BMI, WHR WC, HC, and MUAC.&#x0D; CONCLUSION: Age and obesity indices are important risk factors that can be used as predictors to CTS in obese women. Age is a more powerful diagnostic tool relative to the anthropometric measurements. Women of age above 40 years and suffering from a high degree of obesity are at risk of developing CTS.

Diagnostic Value of Ultrasound in CTS in Diabetic Versus Nondiabetic Populations

PurposeDiabetes mellitus (DM) is a well-known risk factor for carpal tunnel syndrome (CTS). However, few studies have compared differences in the cross-sectional area (CSA) of the median nerve in patients with and without DM. The purpose of this study was to compare the utility of ultrasound for the diagnosis of CTS in diabetic versus nondiabetic patients.MethodA total of 248 hands of 155 patients were evaluated: 154 hands belonged to non-DM patients with CTS, 80 to DM patients with CTS, 13 patients with DM but no CTS, and 51 patients without DM or CTS. All hands underwent ultrasonography of the median nerve at the wrist for determination of CSA; patients completed a CTS Symptom Severity Scale and Functional Status Scale for each hand.ResultsAverage CSA (mm2) of non-DM patients with CTS was 11.25 whereas the average in DM patients with CTS was 12.23 (P = .17). Cross-sectional area of 9.5 or greater was the most powerful predictor of CTS in patients without DM, and CSA of 10.5 or greater in patients with DM.ConclusionsCross-sectional area of the median nerve was similar for patients with and without DM; however, cutoff values for positive diagnosis may need to be adjusted in patients with DM. Ultrasonography of the wrist is a valuable resource for diagnosing CTS in patients with and without DM.Type of study/level of evidenceDiagnostic II.

Risk factors for carpal tunnel syndrome or trigger finger following distal radius fracture: a nationwide study

New-onset carpal tunnel syndrome (CTS) and trigger finger after distal radius fractures (DRFs) with or without open reduction and internal fixation (ORIF) have been reported inconsistently across different studies. This study assessed the incidence of CTS and trigger finger after DRFs using Taiwan National Health Insurance Research Database. In total, 1454 patients in the case (ORIF) cohort and 1454 patients in the control (non-ORIF) cohort were included in this retrospective study. The mean age was approximately 55 years old, and the female to male ratio was approximately 3/2. Nine patients underwent carpal tunnel release (CTR) surgery after diagnosis of CTS in the case group, and no patients did in the control group; whereas 19 cases of CTS were diagnosed without CTR in the case group, and 4 such cases were observed in the control group. Five cases of trigger finger were diagnosed in the case group, and 3 cases were diagnosed in the control group. CTS were significantly associated with ORIF for DRFs within 9 months after the fracture, whereas trigger finger was not significantly different between groups. Diabetes mellitus was a significant risk factor for CTS and trigger finger within 9 months after the incidence of DRFs.

Personal, biomechanical, psychosocial, and organizational risk factors for carpal tunnel syndrome: a structural equation modeling approach.

This longitudinal study aimed at exploring the direct and indirect relationships between organizational, psychosocial, biomechanical, and personal factors and carpal tunnel syndrome (CTS) in French workers. Between 2002 and 2005, 3710 workers were included in the Cosali cohort. Between 2007 and 2010, 1611 workers were re-examined using the same standardized clinical protocol. Subjects free from CTS at baseline were studied (804 men and 563 women). We used structural equation models to examine the relationships between incident CTS cases and organizational (machine-paced work or work pace dependent on customers' demand), psychosocial (job strain model), biomechanical (Borg's rating perceived exertion, wrist bending, pinching, and hand-transmitted vibrations), and personal factors at baseline. Symptomatic CTS risk was directly increased by biomechanical factors (standardized coefficient = 0.19, P = 0.011), female gender (0.25, P < 0.001), and age (0.15, P = 0.042). No psychosocial factors had a direct impact on CTS, but decision authority and skill discretion had an indirect impact by influencing biomechanical exposure. Exposure to machine-paced work had an indirect impact on increasing CTS, either by raising biomechanical exposure (0.19, P < 0.001) or by lowering decision authority (-0.18, P < 0.001) and skill discretion (-0.20, P < 0.001), which in turn increased biomechanical exposure. Similar complex relationships were observed between risk factors and CTS defined by a more strict case definition. Biomechanical exposure had a direct impact on CTS, while organizational factors and psychosocial factors had an indirect impact on CTS. The findings support conceptual models linking work organization to CTS.

Smoking as risk factor for carpal tunnel syndrome: A birth cohort study.

Our aim was to determine whether maternal smoking and offspring's own smoking affect the offspring's risk for carpal tunnel syndrome (CTS). The study sample consisted of the Northern Finland Birth Cohort 1966 (N = 8703). Information on maternal smoking was collected from the participants' mothers. At 31 years, information on smoking, body mass index, socioeconomic status, and long-term illnesses were collected, combined with data of CTS diagnoses from the Care Register for Health Care (1997-2016). Maternal smoking was not associated with increased risk of CTS in offspring. Before the age of 31 years, smoking ≤10 pack years (hazard ratio [HR] = 1.54, 95% confidence interval [CI] = 1.11-2.15) and >10 pack years (HR = 1.90; 95% CI = 1.20-3.01) among women, and >10 pack years (HR = 1.89; 95% CI = 1.14-3.12) among men was associated with CTS compared with nonsmokers. In this birth cohort, offsprings' own smoking was associated with CTS; however, maternal smoking was not.

Does the use of electronic devices provoke the carpal tunnel syndrome (CTS) symptoms and functional impairment? A cross-sectional study

IntroductionAs electronic devices usage escalates, public's concerns are raised on whether specific hand activities while using electronics can lead to median nerve problems. Aim of the workThis study was conducted to assess the association, prevalence and risk factors for carpal tunnel syndrome (CTS) symptoms among electronic devices users. Patients and methodsThis study was conducted among a general population of Riyadh, Saudi Arabia with a total of 800 distributed Arabic self-administered questionnaire including the socio-demographic, patterns of electronic devices use and a standardized questionnaire “Boston Carpal Tunnel Questionnaire (BCTQ).” Common risk factors were excluded, such as diabetes mellitus, rheumatoid arthritis, thyroid disease, gout, current pregnancy, cervical and hand problems. ResultsThe response rate was 88.9% and the male: female was 0.5:1. Data analysis revealed that nearly 50% of all participants were moderately sever symptomatic. Out of which 42.4% were medically free with no apparent risk factors for CTS, and the rest had severe symptoms. Symptoms suggestive of CTS were significantly associated with younger age, female gender, higher body mass index (BMI) and occupation. However, there was no proven association with the patterns of electronic devices use. The functional status was significantly associated with age, gender, BMI and occupation. ConclusionThere was no significant association between the patterns of electronic devices use and CTS symptoms. The high prevalence of CTS symptoms necessitates awareness programs, especially among the young population. Although this work did not prove the association, further studies with confirmatory clinical testing are recommended.

Work-related risk factors for Carpal Tunnel Syndrome among Majmaah University female touchscreen users.

Objectives:This study aimed to explore the prevalence of carpal tunnel syndrome symptoms among female touchscreen users at Majmaah University, Saudi Arabia and to make a comparison for the wrist range of motion between probable CTS and non-CTS female touchscreen users.Methods:Two hundred and twenty-two female touchscreen users were enrolled in the present study. Among this cohort, fifty-two were academic members, 40 were employees and 130 were undergraduates. A Digital Inclinometer device was used to assess ROM of the wrist movements. A computer-based questionnaire, Phalen’s test, and Tinel’s sign were used to investigate the presence of CTS symptoms. The study was conducted between November 2018 and February 2019 at Majmaah University.Results:The prevalence of probable CTS was 34.2% among touchscreen users; the percent of probable CTS was significantly higher in undergraduates compared to other touchscreen users. There was a significant reduction in wrist flexion between the tested groups.Conclusion:Female touchscreen users at Majmaah University tended to have a high-risk for CTS. Wrist ROM measurements, particularly wrist flexion, could be a beneficial indicator for anticipating deviations in wrist posture after long-term touchscreen use. It is necessary to consider the job nature, age, BMI, and duration of using touchscreen as risk factors for CTS symptoms.

Body, wrist, and hand anthropometric measurements as risk factors for carpal tunnel syndrome

AimThe aim of this study was to identify cut-off values for body, hand, and wrist measurements in order to correctly identify individuals with increased risk of carpal tunnel syndrome (CTS).Patients and methodsThis study included 30 patients with clinically diagnosed and electrophysiologically confirmed idiopathic CTS and 30 age-matched and sex-matched healthy volunteers as the control group. Both groups performed sensory and motor conduction studies of the median nerve. Body, hand, and wrist anthropometric measurements were taken including weight, height, waist circumference, hip circumferences, wrist depth/width, third digit length, palm length/width, and hand length. Obesity indicators and hand/wrist ratios were calculated. Area under the ROC curve (AUC), confidence intervals, cut-off values, sensitivity, and specificity were calculated separately for each measured parameter.ResultsThere were statistically significant differences among the studied participants regarding all measured anthropometric parameters (P<0.001). As a result, all studied patients had squarer wrists and shorter hands than healthy participants. The AUC values for all studied measurements showed high accuracy (AUC<95) except for hip circumference, waist-to-hip ratio, palm length, third digit length, and digit index which showed moderate accuracy. In the studied patients there were positive significant correlations between BMI, wrist depth, wrist ratio, and shape index with an electrophysiological severity grading of CTS of the studied patients; on the other hand, there were negative significant correlations between palm length, hand length, and hand ratio with electrophysiological severity grading of CTS.ConclusionThe cut-off values for body, wrist, and hand anthropometric measurements are useful tools to assess the risk factors for CTS.

High wrist ratio is a risk factor for carpal tunnel syndrome.

Carpal tunnel syndrome (CTS) is the most common upper extremity entrapment neuropathy and various risk factors have been implicated in the etiology. In this study, we aimed to determine whether anthropometric measurements are independent risk factors for CTS. Patients with symptoms of CTS (n = 27) and asymptomatic controls (n = 27) were enrolled following electrophysiological confirmation. Body mass index (BMI) was recorded and anthropometric measurements of the hand were made by a digital caliper. BMI, wrist width, wrist depth, palm length, hand width, wrist ratio, wrist/palm ratio, and wrist/hand ratio were significantly higher in the CTS group. BMI, wrist ratio, wrist/palm ratio, and wrist/hand ratio were independent variables in the logistic regression analysis; wrist ratio was the only significant predictor of CTS. Patients with a wrist ratio higher than 0.69 were 8.2 times more likely to have CTS. This study suggests that wrist ratio may be considered as an independent risk factor for CTS. Clin. Anat. 31:698-701, 2018. © 2018 Wiley Periodicals, Inc.

S138. Median nerve area and body mass index in carpal tunnel syndrome patients: A retrospective review of 1030 cases

Obesity is a risk factor for carpal tunnel syndrome (CTS), but the association between median nerve cross-sectional area (CSA) and body mass index (BMI) is unclear. This is a retrospective review of patients presenting to the Duke Electromyography (EMG) Laboratory during 2013–2014 with a final diagnosis of CTS. US diagnosis of CTS was based upon median nerve cross-sectional area of >9 mm2 and/or wrist-to-forearm ratio of >1.4. EDx studies were the gold standard for diagnosis. The objective of this study is to determine if median nerve CSA is higher in overweight CTS patients. 1030 consecutive patients presenting to the Duke EMG Laboratory during 2013–2014 with a final electrodiagnostic (EDX) diagnosis of CTS were examined. Median nerve at the wrist (W-CSA), and forearm (F-CSA) were measured, and wrist-forearm ratio (WFR) calculated; patients were classified into BMI groups: I = underweight/normal, II = overweight, III = moderate obesity, IV = severe obesity, V = morbidly obesity. Statistical analysis was performed with ANCOVA test and Bonferroni correction using as covariates: age, gender, pregnancy and handedness. The mean age was 56 ± 14.0 (range from 20 to 90 years). 263 were men (36.8%) and 451 were women (63.2%, 10 women were pregnant). 521 patients were Caucasians, 162 Afro-Americans and 31 other ethnicities (Asians, Indians, Hispanic). 539 were right-handed, 174 left-handed and 1 was ambidextrous. We had 43 bifid median nerves, and 3 with persistent median artery. The mean body mass index (BMI) was 32.2 ± 8.0 (range from 15.5 to 112.1); patients were classified into BMI groups: Group I (underweight and normal weight) = 108; Group II (preobese) = 204; Group III (obese) = 182; Group IV (severely obese) = 102; Group V (morbidly obese) = 113. 5 patients were excluded because were outliers. There was a significant difference between BMI groups for W-CSA - right W-CSA mean 12.8 mm2 p = 0.000 and left W-CSA mean 11.7 mm2 p = 0.002, especially between: (1) underweight/normal and morbidly obese patients: right W-CSA mean 11.8 vs. 14.3 mm2 p = 0.001, left W-CSA mean 11.1 vs. 13.2 mm2 p = 0.004. (2) and between overweight and morbidly obese patients- right W-CSA mean 12.2 vs. 14.3 mm2 p = 0.000, left W-CSA mean 11.3 vs. 13.2 mm2 p = 0.001. There was no difference between BMI groups for forearm-CSA or the WFR. Higher BMI is associated with increased W-CSA in patients with CTS. In the current study, higher BMI is associated with increased W-CSA in patients with CTS.

Preferences in Sleep Position Correlate With Nighttime Paresthesias in Healthy People Without Carpal Tunnel Syndrome.

Carpal tunnel syndrome has been associated with sleep position preferences. The aim of this study is to assess self-reported nocturnal paresthesias and sleeping position in participants with and without carpal tunnel syndrome diagnosis to further clinical knowledge for preventive and therapeutic interventions. A cross-sectional survey study of 396 participants was performed in young adults, healthy volunteers, and a patient population. Participants were surveyed on risk factors for carpal tunnel syndrome, nocturnal paresthesias, and sleep preferences. Binary logistic regression analysis was performed comparing participants with rare and frequent nocturnal paresthesias. Subanalyses for participants without carpal tunnel syndrome under and over 21 years of age were performed on all factors significantly associated with subclinical compression neuropathy in the overall population. Thirty-three percent of the study population experienced nocturnal paresthesias at least weekly. Increased body mass index ( P < .001) and sleeping with the wrist flexed ( P = .030) were associated with a higher frequency of nocturnal paresthesias. Side sleeping was associated with less frequent nocturnal symptoms ( P = .003). In participants without carpal tunnel syndrome, subgroup analysis illustrated a relationship between nocturnal paresthesias and wrist position. In participants with carpal tunnel syndrome, sleeping on the side had a significantly reduced frequency of nocturnal paresthesias. This study illustrates nocturnal paresthesias in people without history of carpal tunnel syndrome including people younger than previously reported. In healthy patients with upper extremity subclinical compression neuropathy, sleep position modification may be a useful intervention to reduce the frequency of nocturnal symptoms prior to developing carpal tunnel syndrome.