The carpal tunnel is a narrow, channel made up of ligaments and bones that lies at the base of the hand and encapsulates the median tendons and median nerve, which controls sensation to the palm-side of the thumb and all fingers except for the little one. It also controls impulses to some of the muscles that allow for thumb and finger movement (bending). Carpal tunnel syndrome occurs when the median nerve becomes compressed at the wrist, causing tingling, numbness, and pain in the fingers, hand, and arm. This condition typically begins gradually—with burning, tingling, or itching sensations in the fingers at night—and, if left untreated, can progress into severe pain, loss of sensation (including the ability to differentiate between hot and cold), and decreased grip strength and muscle mass. Most people who suffer from carpal tunnel syndrome have a genetically inherited smaller tunnel. Other conditions that may lead to carpal tunnel syndrome include trauma or injury that causes swelling in the wrist, rheumatoid arthritis, fluid retention during pregnancy, and stress. Women are more likely to develop carpal tunnel syndrome than men—and carpal tunnel syndrome is extremely rare in children. Physical therapy treatment for carpal tunnel syndrome may include stretching and strengthening exercises as well as education about changing wrist positions and maintaining proper posture.