The CTS-SS is the 11-item validated sub-scale of the Boston Carpal Tunnel Questionnaire (BCTQ), focused exclusively on subjective discomfort.
Symptom Sentinel Probe
Answer the 11-question inventory to establish the mean symptom severity score (1.0 to 5.0) and establish clinical impairment baseline.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Rapid bedside assessment of carpal tunnel syndrome severity.
Correlating clinical severity with electrodiagnostic findings (NCS/EMG).
Documenting baseline severity before and after carpal tunnel release.
Identifying candidates for urgent surgical intervention.
Patient Population
Applicable to patients with confirmed or suspected CTS. Often used alongside electrodiagnostic testing to stratify severity.
Section 2
Formula & Logic
Severity Grading
Mild
Intermittent symptoms, paresthesias only at night or with activity, no muscle atrophy
Moderate
Frequent symptoms, daytime paresthesias, mild weakness or atrophy
Severe
Constant symptoms, significant weakness, definite thenar atrophy, profound sensory loss
Clinical Correlation
01
Assess for thenar eminence atrophy (Abductor Pollicis Brevis weakness).
02
Test two-point discrimination in thumb/index finger (normal ≤ 6mm).
03
Document Tinel and Phalen test results.
04
Compare to electrodiagnostic findings (conduction velocity, latency).
Section 3
Pearls/Pitfalls
Atrophy as Red Flag
The presence of thenar atrophy indicates chronic, severe compression with axonal loss. This mandates urgent surgical referral regardless of symptom duration, as prolonged denervation may result in permanent motor deficits.
Section 4
Literature
Clinical Neurosurgery
The CTS-6 is a pragmatic clinical grading system used by hand surgeons and neurosurgeons to quickly stratify disease severity and guide treatment urgency.
Section 5
Evidence Appraisal
Clinical Standard
The CTS-6: a simple questionnaire to grade the severity and functional impact of carpal tunnel syndrome
