testing for carpal tunnel syndrome

Exams and Tests

Several simple carpal tunnel syndrome tests can be performed to evaluate the nerve function of the hand.

  • You should always start with a visual and manual inspection of the hand looking for any obvious abnormalities that may help to explain the problem.
  • Range of motion of the wrist is often evaluated. By placing the palms of the hands together, wrist extension can be evaluated. By placing the backs of the hands together, wrist flexion can be evaluated. People who have had prior wrist injuries or wrist arthritis often have abnormalities in wrist range of motion.
  • The sensation over the hand should be checked, in particular sensation of soft touch, pinprick, or 2-point discrimination, to see if there is any abnormaility in any way.
  • The strength of the hands and fingers should be checked, often using the opposite, or good side, for comparison.
  • Some other tests for carpal tunnel syndrome include:
    • Phalen sign
      • Hold elbows at shoulder level and place backs of hands together with wrists bent at 90 degrees.
      • Hold this position for 60 seconds.
      • This position increases the pressure in the carpal tunnel and on the median nerve.
      • If the test reproduces or worsens symptoms (pain and tingling in hands), it may indicate carpal tunnel syndrome.
    • Tinel sign
      • Hold the wrist and tap on the palm side of the wrist.
      • A positive test produces tingling into the thumb, index, or middle fingers. This is a sign of an irritable nerve where the tapping was done.
      • If this test gives tingling in your thumb, index, or middle fingers, it may indicate carpal tunnel syndrome.
  • Patients can also be sent to a specialist (neurologist, rheumatologist, or orthopedic surgeon) for evaluation of nerve conduction or the presence of possible arthritis leading to carpal tunnel syndrome. Nerve conduction testing measures the speed an electrical impulse travels in the median nerve across the wrist. For people with carpal tunnel syndrome, this impulse will travel more slowly across the wrist than for people who do not have carpal tunnel syndrome. For people who have advanced carpal tunnel syndrome, measurements of electrical activity in the hand muscles may reveal signs of muscle deterioration.

http://www.emedicinehealth.com/carpal_tunnel_syndrome/page5_em.htm

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~ by pcl4 on September 4, 2008.

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