Carpal tunnel test or exam


A complete carpal tunnel test or exam can be done in about 5-10 minutes. Keep in mind I'm talking about the physical examination part, (I'm not talking about the time it takes to get a medical history etc..., also I'm not talking about getting EMG /NCS studies. (These tests will be done at a later date if needed).

Remember from " THE BEST EXPLANATION and ANATOMY OF THE CARPAL TUNNEL ", that it's pressure on the median nerve at the carpal tunnel junction that gives you carpal tunnel symptoms. The median nerve is a long nerve...it originates from the neck and branches out (and ends) in the fingers!


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Why am I telling you this in an article about carpal tunnel syndrome (CTS) examination?

Because I want you to understand why a test or exam is being done...usually we remember things better if we know why.


When looking at How Carpal tunnel syndrome is Diagnosed, the examination of the ENTIRE UPPER EXTREMITY plays a key role.

We will first look in-depth at the exams that pertain to the forearm, wrist and hand...Then we will go over a "carpal tunnel neck exam."

Carpal tunnel test

The two classic tests or exams that are most widely used for detecting nerve compression at the wrist are called TINEL'S pronounced (Teh-nails) and PHALEN'S (Faye-lens). More precisely called the Phalen's maneuver and the Tinel's sign (or Tinel's test).

Although these two tests are standard for a carpal tunnel exam, they are not that reliable for diagnosing CTS. One study of 100 people Without carpal tunnel syndrome for example, found a positive Tinel's test in 45% of them!...the Phalen's test was a little better, being positive in only 20% of the normal patients (i.e. they really didn't have CTS but these two tests were indicating that they did).

Another study had 44 patients who were actually already diagnosed with CTS by Nerve Conduction Studies (NCS), and the Tinel test was positive in only about 60% of the people and the Phalen's was positive in about 75% of the people. So in other words to be totally accurate they should have both been positive 100% of the time...because these 44 people already were diagnosed with CTS.

Carpal tunnel test

Although not done as frequently as the Tinel's and Phalen's tests, the HAND-SYMPTOM DIAGRAM TEST has proven to be at least as accurate if not more so then the two "classic" tests mentioned earlier.

The Katz hand symptom diagram test is cheap and pain free. Patients can fill out the form while waiting in the lobby. As stated with all these exams and test, they are best when combined all together, because currently there is no one test that is 100% accurate for diagnosing carpal tunnel syndrome.

Carpal tunnel test

Another quick and easy exam to do is what I call the
CARPAL TUNNEL THUMB TESTS. The thumb is obviously very important; it allows us to oppose our other fingers so we can grip things. A branch from the median nerve stimulates the thenar (Thee-nar) or thumb muscle. If those nerve impulses have been blocked or pinched off for some reason, the thumb can become weak or even shrink in size which is called atrophy (At-trophy). These two "thumb tests" are a good screening tool to detect thumb weakness or thenar atrophy.

Carpal tunnel test

LISTED BELOW are some other less well known tests for diagnosing carpal tunnel syndrome. Some of the reasons for doing these tests are that they can be done quickly and they really don't cost anything and are pain free...unlike EMG/NCS studies which can cost about $450-$500, and can be somewhat painful or at least cause discomfort.

These carpal tunnel tests are meant to be used as screening tests to see if you may need further testing to diagnose CTS. Most of these tests generally prove to be accurate only about 50% of the time, with the exception of the SQUARE WRIST SIGN which was correct in 69% of the cases (In one study of 142 hands with CTS).



For More Info on Other Carpal Tunnel Test

FLICK SIGN, CLOSED-FIST SIGN, CARPAL TUNNEL COMPRESSION TEST, TOURNIQUET TEST, 2-POINT DISCRIMINATION TEST, ABNORMAL MONOFILAMENT TESTING



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