Pain-Free Living

Carpal Tunnel Syndrome Diagnosis

By Julia Aparicio

Early diagnosis is imperative for carpal tunnel syndrome, a nerve disorder that occurs when the median nerve that runs through the carpal tunnel becomes compressed. Left untreated, the condition can lead to permanent damage of the median nerve and muscle deterioration. Conducting a simple physical examination of the hands, arms and shoulders can help determine whether the patient is experiencing carpal tunnel or a different ailment with the same symptoms. During a thorough exam, the wrist is examined for tenderness and swelling, while each finger is tested to see how it experiences sensation. The muscles at the base of the hand also are inspected for signs of weakness.

Tests also can be used to generate the symptoms of carpal tunnel, such as hand movements that can cause symptoms. In the Tinel test, for example, a physician applies pressure to the median nerve on the wrist. If the patient has carpal tunnel syndrome, the test will result in a tingling or jolting sensation in the fingers. Another possible examination is the Phalen test, known as the wrist-flexion test. This test consists of a simple maneuver by the patient, in which he or she holds the forearm upright while pointing the fingers down and pressing the backs of the hands together. If the patient begins to feel tingling or numbness in the fingers, that is an indication carpal tunnel syndrome is present.

In many cases, electrodiagnostic tests also are required to confirm a diagnosis. According to the National Institute of Neurological Disorder and Stroke, in a nerve conduction study, electrodes are placed on the hand and wrist, and small electric shocks are applied. The test measures the speed with which nerves transmit impulses. In electromyography, a fine needle is inserted into a muscle, and electrical activity viewed on a screen shows the severity of damage to the median nerve.

An ultrasound also can show if the median nerve is an irregular size.

Last Reviewed November 15, 2015

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