Carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is a compressive neuropathy of the median nerve as it passes through the carpal tunnel — a rigid, narrow passage at the base of the hand formed by the carpal bones and the transverse carpal ligament. The syndrome occurs when increased pressure within this confined space compresses the median nerve, producing numbness, tingling, pain, and weakness in the thumb, index, middle, and radial half of the ring finger. It is the most common form of repetitive strain injury and the most frequent reason for work-related hand surgery.

CTS is not exclusively caused by keyboard use — pregnancy, diabetes, and rheumatoid arthritis are significant risk factors — but keyboard work is the most modifiable risk factor in the modern office environment. The wrist position required by standard flat keyboards, combined with sustained contact pressure against desk surfaces, elevates carpal tunnel pressure to levels that impair nerve conduction within minutes. The split keyboard and tenting were developed specifically to address this mechanism by returning the wrist to a neutral position.