Table 1.

History of Present Illness in Carpal Tunnel Syndrome

Clinical Question	Classic Presentation of CTS	Clinical Significance
Duration	Variable	Unclear whether duration of symptoms correlates with amount of nerve injury. This should be correlated with physical exam and diagnostic findings.
Location/Radiation	Along the median nerve distribution	Location and/or radiation of symptoms outside of this distribution may prompt the physician to consider diagnosis other than CTS. If there are symptoms within the median nerve distribution in addition to other distributions (eg, The ulnar nerve distribution) the physician may consider other diagnosis (ie, proximal nerve compression syndrome) that mimics CTS.
Association Symptoms	Decreased strength with pinching or grip	Due to atrophy of the thenar muscles
Timing of Symptoms	Increased symptoms at night when sleeping	It is common for patients to sleep with their elbows and wrist fully flexed, leading to an increase pressure in the carpal canal. Therefore, it is common for patients to report increased symptoms at night or when first waking up.
Lifestyle Activities	Activities that fully extend the wrist (driving, holding a telephone) or fully flex the wrist. Also, occupational hazards such as use of vibratory tools.	See Risk Factors in text.
Comorbidities	Obesity Diabetes	See Risk Factors in text.