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Isam Atroshi, MD; Christina Gummesson, MS; Ragnar Johnsson, MD, PhD; Ewald Ornstein, MD; Jonas Ranstam, PhD; Ingmar Rosén, MD, PhD

JAMA. 1999;282:153-158.

Context  Carpal tunnel syndrome (CTS) is a cause of pain, numbness, and tingling in the hands and is an important cause of work disability. Although high prevalence rates of CTS in certain occupations have been reported, little 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 symptoms of pain, numbness, and tingling in any part of the body, followed 2 months later by clinical examination and nerve conduction testing of responders reporting symptoms in the median nerve distribution in the hands, as well 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 symptomatic responders, 81% underwent clinical examination.

Main Outcome Measures  Population prevalence rates, calculated as the number of symptomatic responders diagnosed on examination as having clinically certain CTS and/or electrophysiological median neuropathy divided by the total number of responders.

Results  Of the 2466 responders, 354 reported pain, numbness, and/or tingling in the median nerve distribution in the hands (prevalence, 14.4%; 95% confidence interval [CI], 13.0%-15.8%). On clinical examination, 94 symptomatic 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 electrophysiologically confirmed CTS (prevalence, 2.7%; 95% CI, 2.1%-3.4%). Of 125 control 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 electrophysiologic testing.

Author Affiliations: Department of Orthopedics, Hässleholm-Kristianstad Hospital, Kristianstad, Sweden (Drs Atroshi and Ornstein); Lund University, Lund, Sweden (Ms Gummesson); Departments of Orthopedics (Dr Johnsson) and Clinical Neuroscience, Division of Clinical Neurophysiology (Dr Rosén), Lund University Hospital, Lund; and Department of Health and Society, Malmö University, Malmö, Sweden (Dr Ranstam).

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