Tests and Diagnosis of Carpel-Tunnel-Syndrome

Carpal tunnel syndrome (CTS) is a condition arising from the compression of the median nerve innervating your fingers and lying along with tendons within the carpal tunnel. This tunnel is about the size of your thumb. When this tunnel narrows due to certain factors such as injury or swelling of the tendons this can apply pressure to the median nerve causing symptoms characteristic of carpal tunnel syndrome.

Symptoms associated with this condition usually have a gradual onset. These can include frequent burning, tingling, or itching sensation and numbness in the palm, fingers and wrist of the affected hand. Occurring usually in one or both hands during the night, you may wake up with a sudden urge to ’shake out’ your hand or wrist. And as the condition progresses, you may experience symptoms during the day as well. Chronic and/or untreated cases may be characterized by weakness and wasting of the muscles at the base of the thumb.

If you feel any of the symptoms above you should consult your doctor right away to determine whether or not you are suffering from carpal tunnel syndrome so that early and appropriate medical intervention will be given.

Diagnosing carpal tunnel syndrome

To prevent permanent damage to your median nerve, you need to undergo immediate diagnosis and treatment. Your doctor may do the following to establish a diagnosis of CTS:

* Physical examination

Your doctor will physically examine your hands, arms, shoulders, and neck to help him determine if your symptoms are related to your daily routine or to an underlying medical problem, so he can rule out other conditions with similar symptoms. Your wrist will be assessed to see if it is tender, swollen, warm, and discolored. The sensation in each of your fingers will also be evaluated, and the muscles at the base of your hand will be examined to assess their strength and to look for signs of wasting (atrophy).

* Routine laboratory tests and x-rays

These routine tests will show any underlying medical problems that may be causing your symptoms such as diabetes, arthritis, thyroid disorders, and fractures.

* Tine1 test

In this test, the doctor will tap or apply a little pressure on the median nerve in your wrist. When you experience tingling in your fingers or a shock-like sensation, the test result is positive.

* Phalen test

Also called the wrist-flexion, this test requires you to hold your forearm upright by pointing your fingers down and pressing together the back of your hands. If you feel any or all of the symptoms such as tingling, worsening numbness in your fingers within one minute, you are most likely suffering from carpal tunnel syndrome.

* Electrodiagnostic tests

Often times a more definitive diagnostic test is needed. Hence you may be recommended to undergo electrodiagnostic tests. Electromyography involves insertion of a fine needle into a muscle to measure its electrical activity as viewed on a screen to determine the degree of damage to the median nerve. A nerve conduction study involves placement of electrodes on your hand and wrist. Then minute electric shockwaves are introduced to measure the velocity of impulse transmission carried out by the nerves.

* Ultrasonography

Through ultrasound imaging, the impaired movement of the median nerve can be observed to establish a carpal tunnel diagnosis.

* Magnetic resonance imaging (MRI)

Although MRI can reveal the anatomy of your wrist, it has not been particularly useful in establishing a diagnosis of carpal tunnel syndrome.

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