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Tests and diagnosis
By Mayo Clinic staffYour doctor may conduct one or more of the following tests to determine whether you have carpal tunnel syndrome:
- History of symptoms. The pattern of your signs and symptoms may offer clues to their cause. For example, since the median nerve doesn't provide sensation to your little finger, symptoms in that finger may indicate a problem other than carpal tunnel syndrome. Another clue is the timing of the symptoms. Typical times when you might experience symptoms due to carpal tunnel syndrome include while holding a phone or a newspaper, gripping a steering wheel, or waking up during the night.
- Physical exam. Your doctor will want to test the feeling in your fingers and the strength of the muscles in your hand, because these can be affected by carpal tunnel syndrome. Pressure on the median nerve at the wrist, produced by bending the wrist, tapping on the nerve or simply pressing on the nerve, can bring on the symptoms in many people.
- X-ray. Some doctors may recommend an X-ray of the affected wrist to exclude other causes of wrist pain, such as arthritis or a fracture.
- Electromyogram. Electromyography measures the tiny electrical discharges produced in muscles. A thin-needle electrode is inserted into the muscles your doctor wants to study. An instrument records the electrical activity in your muscle at rest and as you contract the muscle. This test can help determine if muscle damage has occurred.
- Nerve conduction study. In a variation of electromyography, two electrodes are taped to your skin. A small shock is passed through the median nerve to see if electrical impulses are slowed in the carpal tunnel.
The electromyogram and nerve conduction study tests are also useful in checking for other conditions that might mimic carpal tunnel syndrome, such as a pinched nerve in your neck.
Your doctor may recommend that you see a rheumatologist, neurologist, hand surgeon or neurosurgeon if your signs or symptoms indicate other medical disorders or a need for specialized treatment.
References
- Carpal tunnel syndrome fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm. Accessed Dec. 20, 2010.
- Carpal tunnel syndrome. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00005. Accessed Dec. 20, 2010.
- Carpal tunnel syndrome. American Society for Surgery of the Hand. http://www.assh.org/Public/HandConditions/Pages/CarpalTunnelSyndrome.aspx. Accessed Dec. 20, 2010.
- Scott KR, et al. Etiology of carpal tunnel syndrome. http://www.uptodate.com/home/index.html. Accessed Dec. 20, 2010.
- Wright PE. Carpal tunnel, ulnar tunnel, and stenosing tenosynovitis. In: Canale ST, et al. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa.: Mosby Elsevier; 2008. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-03329-9..50076-3&isbn=978-0-323-03329-9&type=bookPage§ionEid=4-u1.0-B978-0-323-03329-9..50076-3--cesec9&uniqId=230418749-3. Accessed Dec. 20, 2010.
- Clinical practice guideline on the diagnosis of carpal tunnel syndrome. Rosemont, Ill.: American Academy of Orthopaedic Surgeons. http://www.aaos.org/research/guidelines/CTS_guideline.pdf. Accessed Dec. 21, 2010.
- Clinical practice guideline on the treatment of carpal tunnel syndrome. Rosemont, Ill.: American Academy of Orthopaedic Surgeons. http://www.aaos.org/research/guidelines/CTSTreatmentGuideline.pdf. Accessed Dec. 21, 2010.
- Scott KR, et al. Treatment of carpal tunnel syndrome. http://www.uptodate.com/home/index.html. Accessed Dec. 21, 2010.
- Amadio PC (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 21, 2010.
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