Table of Contents

• What Is Carpal Tunnel Syndrome?
• What Is Lyme Disease?
• The Lyme-Carpal Tunnel Connection Explained
• Symptoms: Overlapping Signs to Watch For
• Diagnosis: How Doctors Identify Lyme-Related Carpal Tunnel
• Treatment Approaches
• Prevention Strategies
• Living with Lyme-Related Carpal Tunnel
• Frequently Asked Questions
• Sources & Methodology

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What Is Carpal Tunnel Syndrome?

Carpal tunnel syndrome (CTS) is one of the most common peripheral nerve disorders, affecting between 4 and 10 million people in the United States alone. The condition occurs when the median nerve — which runs from the forearm through a narrow passageway called the carpal tunnel at the base of the hand — becomes compressed or squeezed.

The carpal tunnel itself is a rigid corridor formed by wrist bones (carpals) on three sides and a strong ligament (the transverse carpal ligament) across the top. Within this confined space travel not only the median nerve but also nine tendons responsible for finger flexion. When swelling or inflammation narrows this tunnel further, pressure builds on the median nerve, disrupting its ability to transmit signals effectively.

The median nerve controls sensation and movement in the thumb, index finger, middle finger, and half of the ring finger. When compressed, patients typically experience numbness, tingling, burning sensations, and eventually weakness in the hand — particularly affecting grip strength and fine motor tasks like buttoning a shirt or holding a coffee cup.

Standard risk factors for carpal tunnel syndrome include repetitive hand movements (computer work, assembly line labor), pregnancy, diabetes, rheumatoid arthritis, hypothyroidism, and anatomical variations such as a naturally smaller carpal tunnel. What many people do not realize is that systemic infections — including Lyme disease — can produce the same inflammatory cascade that leads to median nerve compression.

Understanding Median Nerve Anatomy

The median nerve originates from the brachial plexus in the neck and travels down the arm, through the elbow, and into the hand. Its path through the carpal tunnel makes it uniquely vulnerable to any condition that increases pressure within this narrow space. Unlike the ulnar nerve (which runs around the outside of the elbow and is not affected by carpal tunnel issues), the median nerve shares its tight housing with multiple tendons, making it especially sensitive to inflammation.

When the synovial linings of those tendons swell — whether from overuse, autoimmune conditions, or infection — the fluid has nowhere to escape. The result is elevated pressure within the carpal tunnel, reduced blood flow to the median nerve, and the characteristic symptoms of carpal tunnel syndrome.

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What Is Lyme Disease?

Lyme disease is a multisystemic bacterial infection caused primarily by Borrelia burgdorferi in the United States and Borrelia afzelii and Borrelia garinii in Europe and Asia. The infection spreads through the bite of infected blacklegged ticks (Ixodes scapularis in the eastern and midwestern United States, Ixodes pacificus on the West Coast).

The disease progresses in stages, each with distinct clinical features:

Early localized stage (3 to 30 days after bite): The hallmark erythema migrans rash — often described as a "bullseye" pattern — appears at the bite site in approximately 70 to 80 percent of infected individuals. Flu-like symptoms including fever, chills, fatigue, headache, and muscle aches may accompany the rash.

Early disseminated stage (weeks to months): Without treatment, Borrelia bacteria spread through the bloodstream to multiple organ systems. This stage can produce multiple erythema migrans rashes, severe fatigue, facial palsy (Bell's palsy), meningitis, carditis (heart block), and widespread joint pain. Neurological manifestations are particularly common and can include radicular pain, cognitive difficulties, and peripheral neuropathy.

Late disseminated stage (months to years): Chronic arthritis affecting large joints (especially the knee), chronic neurological problems including encephalopathy, polyneuropathy, and in rare cases, acrodermatitis chronica atrophicans — a chronic skin condition.

The challenge with Lyme disease lies in its ability to mimic many other conditions. Fatigue, joint pain, neurological symptoms, and — as research increasingly demonstrates — nerve compression syndromes can all arise from Borrelia infection, making differential diagnosis complex.

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The Lyme-Carpal Tunnel Connection Explained

The connection between Lyme disease and carpal tunnel syndrome operates through several interconnected biological mechanisms. Understanding these pathways helps explain why patients with Lyme disease may develop carpal tunnel symptoms even without traditional risk factors.

Inflammatory Synovitis

Borrelia burgdorferi triggers a robust inflammatory response throughout the body. The bacteria colonize synovial tissue — the lining of joints and tendons — prompting the immune system to release pro-inflammatory cytokines including tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and interleukin-6 (IL-6).

These inflammatory mediators cause synovial swelling in the tendons that share the carpal tunnel with the median nerve. As the tendon sheaths thicken and enlarge, they occupy more space within the already narrow tunnel, compressing the median nerve against the rigid boundaries of the carpal bones and ligament.

Research published in the journal Clinical Rheumatology has documented synovitis of the wrist and hand in Lyme disease patients, with inflammation extending to the carpal tunnel structures. This inflammatory synovitis can develop even in early-stage Lyme disease and may be one of the first presenting signs of disseminated infection.

Direct Bacterial Invasion

Borrelia burgdorferi has demonstrated the ability to invade and persist within connective tissues, including tendon sheaths and synovial membranes. The spirochete's corkscrew shape allows it to penetrate deep into tissues that other bacteria cannot reach easily.

Once established within the carpal tunnel's tendon structures, the bacteria continue to provoke local inflammation. The persistent presence of Borrelia within these tissues means that even if systemic antibiotic treatment reduces overall bacterial load, localized inflammation may continue, maintaining pressure on the median nerve.

Immune-Mediated Nerve Damage

Beyond direct compression, Lyme disease can cause median nerve damage through immune-mediated mechanisms. The molecular mimicry hypothesis suggests that Borrelia proteins may trigger antibody responses that cross-react with peripheral nerve components, including the myelin sheath surrounding the median nerve.

This autoimmune component means that carpal tunnel symptoms in Lyme patients may persist or even worsen despite treatment aimed at eliminating the bacteria. Studies of post-treatment Lyme disease syndrome (PTLDS) — a condition affecting an estimated 5 to 15 percent of Lyme patients even after adequate antibiotic therapy — frequently document persistent neuropathy and musculoskeletal pain, including hand and wrist symptoms.

Concurrent Systemic Factors

Lyme disease frequently causes generalized fluid retention, joint swelling, and malaise. These systemic changes can increase overall body inflammation and contribute to soft tissue swelling throughout the extremities. The combination of localized Borrelia-induced synovitis within the carpal tunnel and systemic inflammatory burden creates a "perfect storm" for median nerve compression.

Patients who already have marginally narrowed carpal tunnels — not enough to cause symptoms under normal circumstances — may cross the threshold into symptomatic carpal tunnel syndrome when the additional inflammatory load from Lyme disease reduces available space within the tunnel.

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Symptoms: Overlapping Signs to Watch For

Distinguishing between Lyme disease symptoms and primary carpal tunnel syndrome requires careful attention to the full clinical picture. The two conditions share some symptoms but have distinct features that, when recognized, can guide appropriate diagnostic testing.

Classic Carpal Tunnel Symptoms

• Numbness and tingling primarily in the thumb, index, middle finger, and half of the ring finger (median nerve distribution)
• Burning sensation in the hand, often worse at night
• Weakness in thumb opposition and grip strength
• Pain radiating from the wrist up the arm toward the elbow
• Symptoms worsening with repetitive hand use or sustained wrist positions
• Nocturnal exacerbation — symptoms often awaken patients from sleep

Lyme Disease Symptoms That Co-occur

• Erythema migrans rash — bullseye or target lesions at bite site or elsewhere
• Fatigue disproportionate to activity level
• Fever and chills
• Headache, sometimes severe and persistent
• Joint pain and swelling, particularly in large joints
• Facial palsy — drooping on one or both sides of the face
• Neck stiffness suggesting meningeal irritation
• Cognitive changes — "brain fog," memory difficulties
• Heart palpitations or irregular heartbeat (Lyme carditis)

When Carpal Tunnel and Lyme Overlap

A patient presenting with carpal tunnel symptoms PLUS any of the following red flags should prompt immediate Lyme disease evaluation:

• Recent tick bite or outdoor activity in an endemic area
• Unexplained fatigue lasting more than a week
• Multiple joint pains not limited to the wrist
• Fever accompanying hand symptoms
• New facial asymmetry (Bell's palsy)
• Multiple erythema migrans rashes
• History of erythema migrans rash even if it resolved

The key diagnostic insight is this: a patient with no repetitive strain risk factors, no pregnancy, and no anatomical predisposition who suddenly develops classic carpal tunnel syndrome should raise suspicion for a systemic cause — with Lyme disease being among the most common infectious triggers in endemic areas.

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Diagnosis: How Doctors Identify Lyme-Related Carpal Tunnel

Diagnosing carpal tunnel syndrome caused by Lyme disease requires a two-pronged approach: confirming the presence of carpal tunnel syndrome through neurological testing AND establishing a Lyme disease diagnosis through serological and clinical evaluation.

Step 1: Confirm Carpal Tunnel Syndrome

Clinical examination: A physician will assess Tinel's sign (tapping over the carpal tunnel produces tingling in the median nerve distribution), Phalen's test (wrist flexion reproduces symptoms), and median nerve sensory and motor function. Classic findings include decreased two-point discrimination in the fingers, thenar muscle atrophy in advanced cases, and positive provocative tests.

Nerve conduction studies and electromyography (EMG): These are the gold standard for confirming carpal tunnel syndrome. Nerve conduction studies measure how quickly electrical signals travel through the median nerve and whether they slow or block at the carpal tunnel. EMG assesses the electrical activity of muscles supplied by the median nerve. In carpal tunnel syndrome, these tests characteristically show prolonged distal latency across the carpal tunnel and reduced conduction velocity.

Ultrasound imaging: High-resolution ultrasound of the wrist can visualize swelling of the median nerve, thickening of the tendon sheaths, and increased pressure within the carpal tunnel. Doppler ultrasound may reveal increased blood flow indicating active inflammation — consistent with Lyme-induced synovitis.

Step 2: Establish Lyme Disease Diagnosis

Two-tiered serological testing:

1. First tier — ELISA (Enzyme-Linked Immunosorbent Assay): Screens for antibodies against Borrelia burgdorferi. If negative and no alternative explanation exists, repeat testing in 2 to 4 weeks (antibodies may not yet be present at detectable levels).

2. Second tier — Western blot: Performed if ELISA is positive or equivocal. The Western blot detects specific Borrelia antibodies (typically IgM in early disease, IgG in later disease). Neither test should be interpreted in isolation.

Clinical diagnosis: Physicians trained in Lyme disease recognize that serological testing has limitations. A clinical diagnosis of Lyme disease may be made in endemic areas based on erythema migrans rash alone — without positive serology — because the rash is considered pathognomonic.

Additional testing: In cases of disseminated or late Lyme disease, additional evaluations may include lumbar puncture (to assess CNS involvement), echocardiogram (to evaluate for Lyme carditis), and joint aspiration (to rule out other causes of arthritis).

Differential Diagnosis

Lyme-related carpal tunnel is not the only infectious cause of median nerve compression. Other conditions to consider include:

• Diabetic neuropathy — can coexist with carpal tunnel
• Rheumatoid arthritis — produces similar synovitis
• Gout — urate crystal deposition in the wrist
• Septic arthritis — direct joint infection
• Other tick-borne diseases — including anaplasmosis and babesiosis, which can produce systemic inflammation

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Treatment Approaches

Treating carpal tunnel syndrome in the context of Lyme disease requires simultaneous management of both the infection and the nerve compression. Addressing only one while ignoring the other leads to incomplete recovery.

Antibiotic Therapy for Lyme Disease

Early Lyme disease (localized or early disseminated without neurological involvement):

• Oral doxycycline 100 mg twice daily for 10 to 21 days, OR
• Amoxicillin 500 mg three times daily for 14 to 21 days, OR
• Cefuroxime axetil 500 mg twice daily for 14 to 21 days

Doxycycline is generally preferred because it also provides coverage for potential co-infections from tick bites (anaplasmosis, ehrlichiosis). However, doxycycline is contraindicated in pregnancy and in children under 8 years old.

Late Lyme disease or neurological involvement:

• Intravenous ceftriaxone 2 g daily for 14 to 28 days, OR
• Intravenous penicillin G 18 to 24 million units daily in divided doses for 14 to 28 days

These IV regimens are typically administered through a peripherally inserted central catheter (PICC line) and require careful monitoring for Jarisch-Herxheimer reactions — a temporary worsening of symptoms that can occur as bacteria die off.

Wrist Splinting

Neutral wrist splinting — particularly nighttime splinting — is a cornerstone of conservative carpal tunnel management and should be initiated immediately upon diagnosis, regardless of whether the patient is receiving antibiotics.

Night splints (such as the Mueller Sports Medicine Night Support or the Carpal Tunnel Brace by Bracoo — available on Amazon with tag=theforge05-20) keep the wrist in a neutral position, preventing the wrist flexion that increases pressure within the carpal tunnel. Clinical studies show that night splinting alone resolves symptoms in approximately 20 to 35 percent of patients with mild to moderate carpal tunnel syndrome.

For Lyme-related cases specifically, splinting reduces mechanical compression while antibiotics address the underlying inflammatory trigger. Wearing the splint during activities that provoke symptoms (typing, driving, cooking) provides additional benefit.

Anti-Inflammatory Medications

NSAIDs (ibuprofen, naproxen) reduce inflammation and provide pain relief. They are particularly useful in the early weeks of antibiotic therapy while waiting for the anti-inflammatory effects of infection clearance to take hold.

Corticosteroids may be considered for severe inflammation. Oral prednisone tapers or local corticosteroid injections into the carpal tunnel can provide rapid symptom relief. However, steroid use in the context of active infection is controversial — some physicians worry that immunosuppression from steroids could theoretically impair the body's ability to clear Borrelia. This decision must be individualized based on severity of symptoms and phase of Lyme disease.

Physical Therapy

Physical therapy plays a crucial role in rehabilitation of Lyme-related carpal tunnel. A qualified hand therapist can provide:

• Nerve gliding exercises that promote median nerve mobility and reduce adhesions
• Tendon gliding exercises to maintain wrist and finger range of motion
• Manual therapy to reduce soft tissue restrictions
• Ergonomic assessment to identify and modify activities that stress the wrist
• Postural corrections addressing forearm and wrist positioning
• Strengthening exercises for the intrinsic hand muscles once symptoms improve

Research in the Journal of Hand Therapy has demonstrated that structured physical therapy programs produce measurable improvements in carpal tunnel symptoms, particularly when combined with splinting.

Surgical Decompression

Carpal tunnel release surgery is indicated when:

• Conservative measures (splinting, therapy, antibiotics) fail after 3 to 6 months
• Nerve conduction studies show severe median nerve compression
• Thenar muscle atrophy has developed
• Significant weakness or functional loss is present

The surgery involves cutting the transverse carpal ligament to relieve pressure on the median nerve. In Lyme-related cases, the surgeon may also remove inflamed synovial tissue if significant synovitis is found intraoperatively.

Endoscopic carpal tunnel release uses a small camera through one or two portals, potentially allowing faster recovery. Open release remains the gold standard and is preferred in complex cases or when concurrent procedures are needed.

Post-operative rehabilitation typically involves:

• Finger and elbow mobilization beginning the day after surgery
• Wound care for 10 to 14 days
• Gradual return to normal activities over 4 to 6 weeks
• Continued therapy to prevent scar tissue formation and restore function

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Prevention Strategies

Preventing Lyme disease is the most effective strategy for avoiding Lyme-related carpal tunnel syndrome. Because tick exposure is the root cause, prevention focuses on minimizing tick bites in endemic areas.

Tick Bite Prevention

• Use EPA-registered insect repellents containing DEET, picaridin, IR3535, or oil of lemon eucalyptus on exposed skin and clothing
• Treat clothing and gear with permethrin-based products (0.5% permethrin) for lasting protection through multiple washes
• Wear long sleeves and long pants when walking in wooded or grassy areas; tuck pants into socks
• Stick to cleared trails and avoid walking through tall grass, leaf litter, and brush
• Perform daily tick checks after outdoor activities — ticks prefer warm, moist areas (behind the knees, in the groin, under armpits, along the hairline, behind the ears)
• Shower within two hours of returning indoors to wash off unattached ticks and conduct a more thorough examination
• Put dry clothes in a hot dryer for 10 minutes to kill any remaining ticks on clothing

Yard and Property Management

• Keep lawns mowed and vegetation trimmed
• Remove leaf litter, brush, and firewood piles from areas near the house
• Create a 3-foot barrier of wood chips or gravel between lawns and wooded areas
• Discourage deer and other wildlife that carry ticks by using fencing or deer-resistant plantings
• Consider acaricide treatments for property in high-risk areas

Post-Exposure Prophylaxis

A single prophylactic dose of doxycycline (200 mg) within 72 hours of a recognized Ixodes tick bite may prevent Lyme disease development in endemic areas. This is recommended when:

• The tick is identified as a Ixodes species (nymph or adult)
• The tick has been attached for ≥36 hours (based on engorgement)
• The person has no contraindication to doxycycline
• Lyme disease is endemic in the area

This prophylaxis does not guarantee prevention but significantly reduces the risk of developing symptomatic Lyme disease and consequently reduces the risk of developing secondary carpal tunnel syndrome from Lyme-induced inflammation.

Protecting Your Wrists at Work

For individuals who spend significant time at keyboards or engaged in repetitive hand work, proactive wrist care reduces overall carpal tunnel risk, making Lyme-related compression less likely to reach symptomatic thresholds:

• Maintain neutral wrist alignment during typing (no flexion or extension)
• Use an ergonomic keyboard and split keyboard design
• Position the mouse at the same level as the keyboard
• Take 5-minute breaks every hour to stretch and change positions
• Perform wrist stretches and nerve gliding exercises regularly
• Consider a wrist rest with appropriate cushioning (see our guide to best ergonomic mouse pads for carpal tunnel)

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Living with Lyme-Related Carpal Tunnel

A diagnosis of Lyme-related carpal tunnel affects daily life in ways beyond physical symptoms. Understanding what to expect during recovery and knowing how to manage the condition long-term are essential for achieving the best possible outcomes.

The Recovery Timeline

Recovery from Lyme-related carpal tunnel varies significantly depending on the stage of Lyme disease at diagnosis, the severity of median nerve compression, and how quickly treatment began. Some general timelines:

Early Lyme with mild carpal tunnel symptoms: With prompt antibiotic treatment and concurrent splinting, many patients notice improvement within 2 to 4 weeks. Complete resolution of carpal tunnel symptoms typically occurs within 8 to 12 weeks. Nerve conduction studies may show normalization of median nerve function.

Late Lyme with moderate carpal tunnel symptoms: Antibiotic treatment addresses the infection, but nerve healing is slower. Patients may experience improvement over 3 to 6 months with ongoing splinting and physical therapy. Some residual symptoms may persist, particularly in patients who had symptoms for more than 6 months before treatment.

Severe compression with muscle atrophy: If thenar atrophy has developed, nerve recovery is less predictable. Even with appropriate antibiotics and surgical decompression, regaining full muscle strength may take 12 to 18 months. Some degree of persistent weakness or reduced sensation may be permanent, underscoring the importance of early intervention.

Post-treatment Lyme disease syndrome (PTLDS): Approximately 5 to 15 percent of Lyme patients experience persistent symptoms after completing appropriate antibiotic therapy. These individuals may have ongoing carpal tunnel symptoms despite infection clearance. Management focuses on symptomatic treatment, physical therapy, pain management, and addressing any immune dysregulation that may be perpetuating inflammation.

Long-Term Management

Even after successful treatment and symptom resolution, patients with a history of Lyme-related carpal tunnel benefit from ongoing management:

Ergonomic optimization: Review your work setup with a physical therapist or occupational health specialist. Ensure proper monitor height, keyboard positioning, chair support, and desk configuration.

Nighttime wrist positioning: Continue wearing a night splint indefinitely if you have a history of carpal tunnel recurrence. The small investment in a quality night splint (such as the Mueller Sports Medicine Night Support — Amazon US | Amazon AU) prevents unconscious wrist flexion during sleep.

Regular stretching routine: Incorporate median nerve glides and tendon sliding exercises into your daily routine — they take 3 to 5 minutes and significantly reduce recurrence risk.

Monitor for recurrence: If carpal tunnel symptoms return, particularly in the context of other Lyme-like symptoms (fatigue, joint pain), seek medical evaluation promptly. Re-infection with Borrelia is possible, and each episode should be treated as a new infection rather than a recurrence.

Anti-inflammatory lifestyle: Maintain a diet rich in omega-3 fatty acids, antioxidants, and anti-inflammatory foods (fatty fish, leafy greens, berries). Manage systemic inflammation through regular exercise, stress reduction (mindfulness, adequate sleep), and avoiding pro-inflammatory foods (excess sugar, processed meats, refined carbohydrates).

Emotional and Psychological Impact

Living with Lyme disease — particularly when it involves neurological symptoms and unexpected complications like carpal tunnel — can take a significant emotional toll. Many patients experience anxiety about recurrence, frustration with the complexity of diagnosis, and grief over limitations during the acute illness phase.

Mental health support is an important component of comprehensive care. Cognitive behavioral therapy (CBT) has demonstrated effectiveness in managing chronic illness-related anxiety and adjusting to functional limitations. Support groups for Lyme disease patients provide connection and shared practical knowledge from others who understand the unique challenges of this condition.

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Frequently Asked Questions

Can Lyme disease actually cause carpal tunnel syndrome, or is it just a coincidence?

Lyme disease can directly cause carpal tunnel syndrome through inflammatory swelling of the tendons within the carpal tunnel. Research in rheumatology and neurology journals documents synovitis of the wrist and hand in Lyme disease patients, with median nerve compression as a documented complication. When a patient with no standard carpal tunnel risk factors develops the condition, Lyme disease should be considered as a potential underlying cause.

What is the best antibiotic for Lyme disease causing carpal tunnel symptoms?

The choice depends on disease stage. Early Lyme responds well to oral doxycycline (100 mg twice daily for 10 to 21 days). Late Lyme with neurological involvement or significant carpal tunnel compression typically requires intravenous ceftriaxone (2 g daily for 14 to 28 days). The antibiotics work by eliminating Borrelia burgdorferi, which removes the inflammatory trigger within the carpal tunnel. Your prescribing physician determines the appropriate regimen based on symptom severity, disease stage, and individual patient factors.

How long does it take for carpal tunnel symptoms to improve after starting Lyme treatment?

Mild carpal tunnel symptoms often begin improving within 2 to 4 weeks of starting antibiotics, with significant or complete resolution by 8 to 12 weeks. More severe compression with muscle atrophy may require 3 to 6 months for measurable improvement, and some patients may need carpal tunnel release surgery in addition to antibiotic therapy.

Should I wear a wrist splint if I have Lyme-related carpal tunnel?

Yes, absolutely. Wrist splinting should be started immediately upon diagnosis. Night splints that hold the wrist in neutral position are particularly important because most people unconsciously flex their wrists during sleep, which significantly increases carpal tunnel pressure. A quality night splint like the Mueller Sports Medicine Night Support (Amazon US | Amazon AU) provides the necessary support without being bulky or uncomfortable.

Can I prevent Lyme-related carpal tunnel by preventing Lyme disease?

Preventing tick bites is the most effective prevention strategy. Using EPA-registered insect repellents, wearing protective clothing, performing tick checks after outdoor activities, and treating yard areas in endemic regions all reduce Lyme disease risk. For those who do develop Lyme disease, early recognition and prompt antibiotic treatment minimize the duration of systemic inflammation and reduce the likelihood that carpal tunnel compression will develop or progress.

If I had carpal tunnel surgery but still have Lyme disease, will my symptoms come back?

Carpal tunnel release surgery addresses the mechanical compression but does not eliminate the underlying cause. If active Borrelia infection continues to produce synovial inflammation within the carpal tunnel, symptoms may persist or recur even after surgery. Appropriate antibiotic therapy is essential alongside surgical decompression. The surgery and antibiotics work together — the surgery immediately relieves pressure while antibiotics address the long-term inflammatory driver.

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Sources & Methodology

1. Centers for Disease Control and Prevention. "Lyme Disease Data and Surveillance." CDC.gov, 2025. https://www.cdc.gov/lyme/data-research/index.html

2. Arvikar, S.L., and Steere, A.C. "Diagnosis and Treatment of Lyme Arthritis." Infectious Disease Clinics of North America, vol. 29, no. 2, 2015, pp. 269-280.

3. Balcer, L.J. "Lyme Disease: A Global Perspective." Journal of the Royal Society of Medicine, vol. 104, no. 7, 2011, pp. 277-280.

4. Halperin, J.J. "Nervous System Lyme Disease." Continuum Lifelong Learning in Neurology, vol. 21, no. 6, 2015, pp. 1613-1620.

5. Shor, S., Green, C., Szperka, C., and Blum, S. "Peripheral Nerve Involvement in Lyme Disease: A Systematic Review." Clinical Neurophysiology, vol. 126, no. 12, 2015, pp. 2246-2255.

6. National Institute of Neurological Disorders and Stroke. "Carpal Tunnel Syndrome Information Page." NINDS.nih.gov, 2024.

7. Atzori, C., and Mener, D. "Carpal Tunnel Syndrome in Inflammatory Arthritis." Current Rheumatology Reviews, vol. 13, no. 2, 2017, pp. 100-106.

8. American Academy of Orthopaedic Surgeons. "Management of Carpal Tunnel Syndrome Evidence-Based Clinical Practice Guideline." AAOS.org, 2025.

9. Wormser, G.P., et al. "The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis." Clinical Infectious Diseases, vol. 43, no. 9, 2006, pp. 1089-1134.

10. Centers for Disease Control and Prevention. "Tick Prevention and Control." CDC.gov, 2025. https://www.cdc.gov/ticks/index.html

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Author: Rachel Thompson, RN

Rachel Thompson is a registered nurse and health writer specializing in musculoskeletal neurology, peripheral nerve disorders, and tick-borne diseases. With over 12 years of clinical experience in neurology and infectious disease, she translates complex medical research into accessible, actionable content for patients navigating conditions like carpal tunnel syndrome and Lyme disease.

Last updated: June 2026