 Every branch of the median nerve is affected by CTS. Though the median nerve is primarily sensory, it does have one motor branch innervating the thenar muscle in the palm. CTS sufferers begin to experience weakness in this muscle as the nerve becomes increasingly impaired. This loss of muscle tone is expressed through weakness of the thumb, frequent dropping of objects and eventual inability to make a fist. With additional nerve damage, the muscle begins to atrophy. In advanced CTS, this atrophy of the thenar muscles can be used for easy visual diagnosis, as the bulge that these muscles usually produce on the palm is greatly reduced.
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