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Carpal tunnel syndrome occurs due to compression of the median nerve at the flexor retinaculum in the wrist and can present with pain and numbness in the palmar aspect of the first 3 digits. Risk factors include diabetes, obesity, pregnancy, hypothyroidism, rheumatoid arthritis, and ESRD on hemodialysis. Treatment initially involves a trial with a wrist brace. If not improvement is noted, a nerve conduction study should be performed to assess the severity and possible need for decompression surgery.