Carpal tunnel syndrome (CTS) is diagnosed through a combination of physical examination and sometimes nerve conduction studies. Several tests can help determine if you have CTS.
Physical Examination Tests
Several simple tests can help diagnose carpal tunnel syndrome:
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Carpal Compression Test (Durkan's Test): This involves applying pressure with your thumbs over the median nerve in the carpal tunnel (just below the wrist crease). A positive result is numbness or tingling within 30 seconds. [Source: UAMS Department of Family Medicine, Stanford Medicine]
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Tinel's Sign: Your doctor lightly taps over the median nerve. Tingling or numbness is a positive sign. [Source: UAMS Department of Family Medicine, NIH]
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Phalen's Test: You're asked to hold your wrists in a flexed position (pressing the backs of your hands together) for 60 seconds. Numbness or tingling indicates a positive test. [Source: Cleveland Clinic, UAMS Department of Family Medicine, NIH]
These three tests are quick and easy to perform during a physical exam.
Nerve Conduction Studies (NCS) and Electromyography (EMG)
If physical examination results are inconclusive or strongly suggest CTS, your doctor may order more advanced tests:
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Nerve Conduction Studies (NCS): A small electrical shock is passed through the median nerve to measure the speed of nerve impulses. Slowed impulses suggest CTS. [Source: Mayo Clinic]
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Electromyography (EMG): This test measures the electrical activity of the muscles in your hand. It helps determine the extent of nerve damage. [Source: Johns Hopkins Medicine]
These tests provide more objective measurements of nerve function than physical examination tests alone.
Other Diagnostic Considerations
- Patient History: Your doctor will consider your symptoms, their duration, and any factors that might contribute to CTS. [Source: Mayo Clinic, UpToDate]
- Physical Exam of the Hand: The doctor will evaluate for muscle weakness and atrophy in addition to the sensory tests. [Source: UpToDate]
- Questionnaires: Specific questionnaires, like the CTS-6, can help assess symptom severity. [Source: PubMed]
It's important to remember that a diagnosis of carpal tunnel syndrome often involves a combination of these tests and a thorough evaluation by a healthcare professional.
