The carpal canal syndrome is caused by the compression of the median nerve on the voluntary side of the hand joint. Median nerve (n. medianus)skates distally to the hand when person extend fingers, and proximally to the upper arm when person bend fingers. A force that can lead to hyperplasia and fibrosis of tendons and median nerve inside the carpal tunnel can occur in repetition of these two movements. This syndrome is most commonly idiopathic etiology. Because of posttraumatic conditions in that part or anatomical anomalies it leads to mechanical pressure on the nerve. Increased intradermal pressure (ITT) is the major cause of compression of the median nerve. Symptoms of carpal canal syndrome usually begin gradually. Symptoms of carpal canal syndrome are often caused by activities that include flexion and extension of the wrist or lifting of hands (eg. holding the phone, driving, reading, typing). Physiotherapeutic assessment is a physiotherapeutic examination consisting of an objective and subjective part, specific physiotherapeutic measurements and tests, and therapy plan. Before the physiotherapeutic examination, it is necessary to take an anamnesis. Provocative tests for the carpal canal syndrome include the Phalene test, the Tinel test, the manual carpal copression, and the arm elevation test. This can be useful when it is interpreted in a proper clinical context. Although, the sensitivity and specificity of these provocative tests is at best moderate. Physiotherapeutic treatment is indicated in the following cases: no muscular weakness or atrophy is present, the symptoms are present for less than a year, and EMG has not been found denervation and the measurement of nerve conduction shows only mild abnormalities.