Patients typically complain of intermittent pins and needles or a burning pain in the median nerve distribution of the hand.

Pain is generally worse at night than during the day, and may be relieved if the patient shakes their hands.

CTS normally affects at least two of a combination of the thumb, index finger and middle finger on the palmar surface of the hand.

Symptoms affecting the ring and little fingers, wrist pain and radiation of pain proximal to the wrist may occur, but are uncommon.

CTS is unlikely if there are no symptoms present in any of the first three digits.

Symptoms are usually bilateral and progressive with an insidious onset.

In the later stages of the disease, an aching sensation may radiate to the forearm and elbow.

The image illustrates the dermatomal distribution of sensory changes in CTS. The blue area indicates the area of sensory loss.