Clinical Characteristics of Concomitant Versus Isolated Carpal and Cubital Tunnel Syndromes: A Prospective Cohort Study

Background: Carpal tunnel syndrome (CTS) and cubital tunnel syndrome (CuTS) are the most common upper extremity compressive neuropathies. Although often considered isolated conditions, they may occur concomitantly, and the clinical significance of dual compression remains poorly defined. This study evaluated whether concomitant CTS/CuTS represents a distinct clinical subgroup characterized by greater objective motor impairment compared with isolated entrapment syndromes. Methods: Eighty-six adults evaluated between 2021 and 2025 were prospectively enrolled, including isolated CTS (n = 32), isolated CuTS (n = 26), and concomitant CTS/CuTS (n = 28). Standardized examinations assessed sensory findings and intrinsic motor strength using Medical Research Council grading. Multivariable logistic and ordinal regression analyses identified predictors of decreased intrinsic muscle strength. Results: Patients with isolated CTS were older than those with isolated CuTS or concomitant disease ( P = .0012). Cervical spine disease was more prevalent in concomitant CTS/CuTS ( P = .0187). Sensory complaints and provocative test findings were similar across groups. However, patients with concomitant CTS/CuTS demonstrated significantly reduced intrinsic motor strength, with lower abductor pollicis brevis strength compared with isolated CTS ( P = .0308) and lower abductor digiti minimi strength compared with isolated CuTS ( P = .0319). Concomitant disease independently predicted decreased abductor pollicis brevis strength (adjusted odds ratio = 3.55, P = .0471). Conclusions: Concomitant CTS/CuTS is associated with greater baseline intrinsic motor impairment despite similar sensory findings, suggesting that dual-site compression reflects greater motor involvement rather than the incidental coexistence of 2 isolated entrapment syndromes.