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CTS is the most common of all the nerve entrapment syndromes (Miller & Reinus, 2010). Estimates of the rate of CTS have been reported to range from 2.3 to 7.5 cases per 100 person‐years (Cardona et al., 2019). In a study of 4,321 primarily industrial workers, CTS was observed to afflict 7.8% of the cohort (Dale et al., 2013). Estimates of the prevalence of CTS are generally around 2% of the population (Descatha et al., 2010), with a lifetime incidence of approximately 10–15% (Miller & Reinus, 2010). The higher end of these incidence estimates is generally seen in those having significant occupational exposure (Palmer, Harris, & Coggon, 2007). Women generally exhibit 3–5 times greater incidence rates than men, and cases in women are typically seen between the ages of 30 and 60 years (Miller & Reinus, 2010). Pregnancy is a notable risk factor for CTS in females, thought to be due to increased pressure in the carpal tunnel due to swelling of the structures running through the canal from the additional water retention associated with pregnancy. Cases in men are usually seen between the ages of 35 and 40 years, and men’s CTS cases are often occupationally related (Palmer et al., 2007). Overall, the dominant hand is the most often affected; however, up to 50% of cases involve bilateral symptoms (Miller & Reinus, 2010).

Figure 2.8 Location of the carpal tunnel and path of the median nerve in the hand.

Medical treatment of CTS has been estimated to cost over $2 billion annually (Dale et al., 2013; Falkiner & Myers, 2002; Stapleton, 2006). Indirect costs such as lost work time and job change may be substantially greater (Faucett, Blanc, & Yelin, 2000; Foley, Silverstein, & Polissar, 2007). Exposure to physical risk factors such as high force, non‐neutral working postures, and repetition are well‐known risk factors for MSDs (da Costa & Vieira, 2010; National Research Council – Institute of Medicine, 2001; NIOSH, 1997). Recent evidence from a prospective study of 2,474 service and production workers suggests that interactions of these risk factors demonstrate a strong association with incident CTS (Harris‐Adamson et al., 2015).