Carpal Tunnel Syndrome is a common painful condition of the hand and wrist.  It is caused by compression of the median nerve as it travels under a ligamentous channel in the wrist.  There are several causes of carpal tunnel syndrome including rheumatoid arthritis, pregnancy, collagen vascular diseases and repetitive strain. Diabetes and alcoholism can affect the function of the nerves and contribute to the problem.  Any disease that alters the amount of fluid in the body can worsen the symptoms such as obesity, kidney failure or thyroid disease.   The symptoms include pain, numbness and weakness of the hand and wrist.  The pain and numbness radiates to the thumb, index finger, middle finger and half of the ring finger.  Repetitive motion of the hand and wrist, such as in typing, will worsen the problem.  There may be wasting of the muscles of the thumb pad.  Electromygraphy and nerve conduction studies will delineate the problem.  Other diseases that can be confused with carpal tunnel syndrome include cervical disc disease (herniated disc) and diabetic nerve disease.  Treatment begins with conservative therapy which includes, heat, ice, non-steroidal anti-inflammatory medications and physical therapy.  Splinting of the wrist is also useful.  Injection of the carpal tunnel with a dilute solution of a local anesthetic and a steroid may also help.  In severe cases, surgery to release the compression of the nerve is necessary.