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Carpal Tunnel Syndrome (CTS) vs Pronator Teres Syndrome (PTS): What's the Difference?

In this day and age of typing and other repetitive work, it seems as if more and more people are complaining of numbness and tingling in their hands. As such it is likely that these same people have heard talk of Carpal Tunnel Syndrome—either from their healthcare provider, a friend or associate with a similar issue, or even good 'ol WebMD. Let me stop right here and emphasize that it is never a good idea to just self-diagnose willy-nilly ala the WebMD Symptom Checker. It is a seriously slippery slope, people. One minute you're trying to figure out why your eye is itchy and the next minute you've been self-diagnosed with lupus. One thing I've learned from watching TV dramas of the early 2000's: it's NEVER lupus. Dr. House said so. It must be true. While an online symptom checker is indeed a wealth of informationfor all us curious folk, it is no substitute for a consult with a human that has successfully completed medical school. There are too many things that present with the same or similar symptoms as other things. Case in point, the lovely title at the top of this page.


Median nerve compression site in the carpal tunnel of the wrist and areas of pain, numbness &/or tingling.

What is Carpal Tunnel Syndrome (CTS)?

So, Carpal Tunnel Syndrome or CTS for short. It's a compression of the median nerve as it passes through the carpal tunnel in the wrist, resulting in pain, numbness &/or tingling in the wrist and the first 3 1/2 fingers, reduced dexterity, wrist pain at night, weakness in the muscles of the hand (especially in the thumb), and muscle wasting (atrophy) near the thumb. Office and assembly line workers are the first people that come to mind when one thinks of CTS, but it can really affect anyone that does activities or jobs involving repetitive finger use. (I'm looking at you, gamers.) Heredity, age, and past medical history all factor in, too.

Muscle wasting (atrophy) at the base of the thumb on the left hand.

What is Pronator Teres Syndrome (PTS)?

Pronator Teres Syndrome (PTS) on the other hand (Ha! Hand. I did it again.) is compression of the same median nerve, but higher up at the elbow. This manifests as forearm pain, burning, numbness &/or tingling in the first 3 1/2 fingers, and weakness in the muscles of the hand. It is often found in those with well-developed forearms—athletes, weightlifters, blacksmiths, massage therapists, & Popeye.

Site of median nerve compression in Pronator Teres Syndrome (PTS).

What's the difference?

As any realtor will tell you: location, location, location. Where the nerve ends-up getting compressed (read: squished) is key: CTS=wrist, PTS=elbow. But that's not all… This table should help clarify things:

Median Nerve Entrapment Symptoms

Carpal Tunnel Syndrome (CTS)

Pronator Teres Syndrome (PTS)

Numbness/tingling over the first 3 1/2 fingers



Forearm pain


Wrist pain at night


Weakness in the muscles of the hand



Muscle wasting near the thumb


Is it really that big of a deal?

Absolument, mon ami. According to a 2000 report by the National Institutes of Health (NIH), the rate of a licensed healthcare practitioner diagnosing a patient's symptoms as Carpal Tunnel Syndrome when it is something else is 83%. This often leads to unnecessary, invasive, and largely unsuccessful procedures, such as carpal tunnel release surgery. Both NIH and the American Academy of Orthopedic Surgeons (AAOS) now advise the use of more specific diagnostic measures to identify and treat hand problems before considering surgery.

Massage therapy falls under the designation of Complementary and Alternative Medicine (CAM), but massage therapists are not doctors. While we CANNOT diagnose a disease, we CAN treat the symptoms reported by our clients. Knowing all the little details, the minutiae if you will, determines how we treat those symptoms. Each technique we use during your session will cause a documented physiological response, so it's important to be accurate. That's why the intake process performed at the onset of each treatment session is so important—the information relayed by the client and the knowledge amassed by the massage therapist using a combination of orthopedic assessments as outlined by NIH and AAOS ensures that you are getting the most appropriate care each time you're on our table.

If you feel that you are experiencing symptoms from either CTS or PTS, contact us: / 954-605-1882 or schedule a Therapeutic or Focus massage treatment session here.


Mireles, Matthew C. PhD, MPH; Miller, Jerry A. PhD; Paske, William C. PhD Misdiagnosis of Carpal Tunnel Syndrome, Journal of Clinical Engineering: April 2009 - Volume 34 - Issue 2 - p99-102

doi: 10.1097/JCE.0b013e3181a0c43f


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