How carpal tunnel syndrome
This article will give you the latest information on
HOW CARPAL TUNNEL SYNDROME IS DIAGNOSED.
You will learn what examinations should be done and what tests should be ordered and why. I will show you the many different carpal tunnel examinations that doctors and other healthcare providers (HCP's) perform when diagnosing carpal tunnel syndrome (CTS).
You will become an informed and educated patient! after reading the
HOW CARPAL TUNNEL SYNDROME IS DIAGNOSED (PART 1)
Carpal tunnel syndrome is often referred to as a
"CLINICAL DIAGNOSIS"...meaning that the diagnosis comes from the clinical setting (i.e. the patient's history, physical exam, past medical history etc..)
As we talked about in the
EXPLANATION OF CTS
ANATOMY OF THE CARPAL TUNNEL
MY patients typically present with numbness and tingling or a "FALLING ASLEEP" feeling in their hands. They usually notice symptoms more at night (or when trying to sleep).
It generally effects the thumb and first finger or two but can sometimes feel like the whole hand is numb but upon close examination, it should not involve the little finger. BUT watch out for
CONDITIONS THAT MIMIC CTS!
Carpal tunnel syndrome affects more women than men at least 2 to 1 and it seems to occur mostly in ages 45 to 55 for both men and women.
See more helpful information on the
LATEST DIAGNOSTIC CRITERIA FOR CARPAL TUNNEL
HOW CARPAL TUNNEL SYNDROME IS DIAGNOSED (PART 2)
A complete physical exam (i.e. heart, lung, rectal exam etc..) is often NOT DONE at least initially, when someone presents with just carpal tunnel symptoms, UNLESS other
OR RISK FACTORS are suspected or present such as diabetes, hypothyroidism, obesity etc...
You should, however, undergo a thorough exam of your upper extremities including your neck and shoulders.
A lot of my patients ask...why can't I just get X-rays or lab tests to see if I have carpal tunnel syndrome or not?
[See LAB TESTS and XRAYS for CARPAL TUNNEL SYNDROME]
I will break the carpal tunnel physical exam down into 2 PARTS:
Forearm, wrist and hand exam
Keep in mind that some doctors may do some or all of these exams, depending on their experience and skill level...and frankly time. Also it depends on the facts of your individual case and how you present (i.e. what kind of symptoms you are having).
None of these exams or tests are 100 % accurate in diagnosing CTS (rarely anything in medicine is-that's why it's called the art of practicing medicine!). Some of these exams and tests are better than others and some are done just for "completeness" sake.
If you or your doctor or HCP suspects any of the
Carpal tunnel syndrome causes
we have discussed on this website, these should be worked-up or evaluated as well.
HOW CARPAL TUNNEL SYNDROME IS DIAGNOSED (PART 3)
NOW, if all the steps and information from above have been obtained one can typically make the diagnosis of carpal tunnel syndrome based on your CLINICAL PRESENTATION. However, if something doesn't seem quite clear to your provider or doesn't quite fit into place, or if it's a workers comp. case or if you have some of the RISK FACTORS for CTS then your doctor or HCP will probably order at least a
NERVE CONDUCTION TEST/STUDY (NCS)
MORE THAN LIKELEY, they will refer you out to a NEUROLOGIST OR PHYSIATRIST; these are specialists who perform these tests on a regular basis. These tests or studies are considered the gold standard for diagnosing carpal tunnel syndrome-Although these too are NOT 100 % ACCURATE
[ See ABNORMAL NERVE CONDUCTION TEST-NCS ]
they are about 90-95 % accurate in most patients and are generally very helpful. As a note I would never recommend carpal tunnel surgery without having at least ONE EMG/NCS TEST.
ORTHOPEDIC HAND SURGEONS do not do these tests themselves but the results help determine your diagnosis. The results may also help your surgeon decide if you actually need
CARPAL TUNNEL RELEASE
Conservative Carpal Tunnel Syndrome Treatment Plan
The tests also can usually determine how severe of a case of CTS you may have (i.e. mild, moderate or severe).
HOW CARPAL TUNNEL SYNDROME IS DIAGNOSED (PART 4)
A variety of factors including heredity, the
size of your carpal tunnel,
associated conditions/diseases (of the wrist or your body as a whole) and habits (i.e. hobbies and or job)....ALL these things may contribute to the cause of carpal tunnel syndrome. Therefore, the correct diagnosis of your symptoms should not be rushed. You may have two different diagnoses going on at the same time! (i.e. diabetes and CTS or arthritis of the neck pinching a nerve and CTS at the wrist)
As you click through this website you will find a wealth of information on how carpal tunnel syndrome is diagnosed. Hopefully it will help you and your doctor obtain the correct diagnosis and the latest and best treatment options,
so you can get better and move on with your life!
Carpal tunnel syndrome causes
CTS causes and controversy
EMG test for carpal tunnel syndrome
Lab tests and Xrays for CTS
Nerve Conduction test for CTS
Abnormal Nerve Conduction Test for CTS
Latest diagnostic criteria for CTS
Non-surgical treatments for CTS
CTS wrist braces
Carpal tunnel splints