How Is Carpal Tunnel Syndrome Diagnosed?
If you are experiencing ongoing numbness, pain, or tingling in your fingers, hand, and/or wrist, you might have Carpal Tunnel Syndrome. If you found this article, you may wonder whether you should see your doctor or wait to see if your discomfort diminishes. Read on to find out what may be causing your symptoms and if it is time to make an appointment.
Carpal Tunnel Syndrome is a condition that arises when the nerve that runs from the arm to the hand becomes compressed in the wrist. Inflammation in the wrist may constrict the small passageway – known as the carpal tunnel – through which the median nerve passes, causing pain and a lack of sensation in your affected hand.
Carpal Tunnel Syndrome has long been thought to be directly related to repetitive activities. This is true in some cases; other times, it may be caused by genetic factors. Some women tend to have smaller carpal tunnel openings than men, which may help to explain why women are about twice as likely to be diagnosed with Carpal Tunnel Syndrome. Certain health conditions, including diabetes and obesity, may increase the risk of Carpal Tunnel Syndrome. (1)
If you suspect Carpal Tunnel Syndrome, you should see a doctor for a proper diagnosis.
“I would not recommend that people do preliminary tests at home because the tests are nuanced and could lead to the patient incorrectly interpreting the results,” says Timothy Niacaris, MD, Ph.D., a Texas-based orthopedic surgeon specializing in hand, upper extremity, and microvascular surgery. “Primary-care physicians can diagnose and even begin non-surgical treatment.”
Orthopedists and hand surgeons can also diagnose Carpal Tunnel Syndrome. A doctor will ask about your symptoms and your medical history, then examine your hands and wrists. Doctors may ask you to hold your hands and wrists in different positions, or they may use a reflex hammer or other tools to determine the cause of your discomfort. Sometimes, your doctor may order nerve conduction tests (2) to see how quickly an electrical signal travels along the median nerve.
“What tests are used in making the diagnosis differ between surgeons,” Niacaris says. “Electromyogram (EMG) or nerve conduction tests are most useful for gauging the severity of the nerve compression.”
The first course of treatment for Carpal Tunnel Syndrome
If you are diagnosed with Carpal Tunnel Syndrome, your doctor may recommend a first course of treatment such as:
• Wearing a wrist splint (3) at night
• Taking over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) when pain flares
• Taking frequent breaks or avoiding activities that cause hand or wrist pain or numbness
• Applying ice for 10 minutes per hour
• Placing your affected hand and wrist in warm water, (4) then doing stretches to flex and extend the wrist
• Getting a corticosteroid injection to provide temporary relief
When do I know I may be a good candidate for surgery?
If these strategies don’t provide relief or your discomfort increases over time, it may be time to meet with a specialist to discuss surgical options.
“The ideal patient referred to me is one where the primary-care physician has already made the clinical diagnosis, provided the patient with a nighttime splinting program that they have failed, and possibly have also obtained EMG and nerve conduction studies,” Niacaris says.
Dr. Niacaris performs the SmartRelease® Endoscopic Carpal Tunnel Release procedure to relieve long-term discomfort for his patients. During an endoscopic procedure, (5) doctors make tiny incisions and use a camera to guide them through the carpal tunnel. This technique allows you to recover quickly and resume your usual activities sooner. (6)
