 Patients with symptomatic, idiopathic CTS as affirmed by clinical examination and NCS presenting to clinic Aged between 18 and 80 years In contrast to other studies the investigators would include patients with; Previous upper limb injuries Previous upper limb surgery or CTS intervention e.g. steroid injections Diabetes mellitus Any other upper limb nerve neuropathies or upper limb neurology Upper limb musculoskeletal degenerative disease osteoarthritis Thyroid disease, Zhang et al. 2011. This will create a pragmatic study design, generalisable to a wider population in clinical practice. 