Diagnosing Carpal Tunnel Syndrome
Diagnosing carpal tunnel syndrome early is important to avoid permanent damage of the median nerve or the spreading of pain to the elbow and shoulder.
Your doctor can determine if you have carpal tunnel syndrome and rule out pain due to another underlying condition (i.e. diabetes, arthritis or fracture) with a physical examination and basic laboratory tests. The doctor will perform several exams that will test the range of motion, strength and painful areas of your wrists and hands.
The examination usually begins with checking the fingers, hands, wrists, arms, shoulders and neck for range of motion, tenderness, swelling, warmth and discoloration. The fingers are tested for sensation and the doctor may ask you to bend your wrists down to check the muscles at the base of the hand for atrophy and strength. The median nerve does not connect to the little finger. Therefore, if you have feeling in that finger but the rest of your hand feels numb and painful it may be a sign of carpal tunnel syndrome.
Diagnostic Tests for Carpal Tunnel Syndrome
Home Tests
Tinel's Sign - Tinel's test is performed by tapping the median nerve along its course in the wrist. A positive test is found when tapping the nerve causes tingling in the fingers
Phalen's Sign - Phalen's test is done by pushing the back of your hands together for one minute. This compresses the carpal tunnel and is also positive when it causes the same symptoms you have been experiencing with your carpal tunnel syndrome.
Electrodiagnostic Test
The nerve conduction test can be used to confirm a diagnosis of carpal tunnel syndrome. Small electric shocks are applied and the speed of nerve impulse transmissions is measured.
With electromyography, a needle is inserted into a muscle and the electrical activity is viewed on a screen. This activity is used to determine the amount of damage the median nerve has suffered.
Ultrasound Imaging
An ultrasonic image can be used to show the extent of impaired movement on the median nerve.
