Carpal tunnel syndrome (CTS) has long been one of the most common work-related disorders as well as the most widespread peripheral neuropathy. The syndrome is characterized by weakness of the thumb, index and middle fingers, numbness, tingling and even paralysis due to muscle atrophy. These symptoms result from compression of the median nerve. There are many causes traditionally associated with the disorder, including trauma, overuse, and systemic conditions. Although a great deal of information is known about the disorder and many strides have been made and successful in reducing the disorder in recent years, the prevalence and costs to society are still very high. By reviewing the data using an evolutionary perspective to understand why carpal tunnel is susceptible to the disorder compared to other species and what current human patterns increase an individual's chance of developing CTS, the causes of the disorder can be better understood and analyzed . further preventive actions can be taken. The wrist consists of eight carpal bones that articulate proximally with the radius and ulna of the forearm and distally with the metacapals of the hand. The carpal bones are aligned in two rows. The proximal row contains the scaphoid, lunate, triquetral, and pisiform and the distal row which consists of the trapezius, trapezium, capitate, and hamate. The ventral side of the carpal bones creates a concave cavity. This cavity is known as carpal tunnel. The tunnel is formed by the transverse carpal ligament (TCL) which extends across the top of the carpal bones (Fig.1.).http://www.ortho-md.com/images/proceduresImg/Wrist1.jpgFig.1 .The TCL is a thick, inflexible connective tissue that...... middle of paper ......l Sci. 2014 March 15; 338(1-2): 207-13.Patel JN, McCabe SJ, Meyers J. Characteristics of sleep disturbances in patients with carpal tunnel syndrome. Hand. March 2012; 7(1): 55-8.Patel A, Culberson MD, Patel A, Hashem J, Jacob J, Edelstein D, Choueka J. The adverse effect of carpal tunnel syndrome on sleep quality. Sleep disorder. 2014; 2014: 962746.McCabe SJ, Gupta A, Tate DE, Myers J. Preferred side sleeping position is associated with carpal tunnel syndrome. Hand. 2011 June: 6(2): 132-7.Bhattacharya A. Cost of Occupational Musculoskeletal Disorders (MSD) in the United States. Int J Ind Ergonomics. May 2014; 44(3):448-54.Jerosch-Herold C, Shepston L, Wilson ECF, Dyer T, Blake J. Clinical course, cost, and predictive factors for treatment response in carpal tunnel syndrome: the PALMS study protocol. Diord Musculoskeletal BMC. February 2014 7; 15: 35.