How Do You Know if it's Carpal Tunnel?

How do you know if that burning, tingling, pain or numbness in your hands is carpal tunnel syndrome or not? Your doctor can put them to the test. Here are six tests to diagnose Carpal Tunnel Syndrome.

What is Carpal Tunnel Syndrome?

Your carpal tunnel is the bone and ligament passageway at the base of your hand that's home for your median nerve and tendons. The median nerve runs from your forearm to your hand and controls sensation and movement to the palm side of your thumb and fingers, but not your pinky. Carpal Tunnel Syndrome occurs when swelling or irritation narrows the carpal tunnel, which causes pressure on the median nerve. Symptoms include itching, burning, tingling, pain and/or numbness in the thumb and fingers. Women get Carpal Tunnel syndrome more often than men.

The National Institute of Neurologic Disorders and Stroke (NINDS) says carpal tunnel syndrome is usually caused by a congenital predisposition in which the tunnel is simply smaller in some people. Other contributing factors include trauma or injury to the wrist, over active pituitary gland, hypothyroidism, rheumatoid arthritis, fluid retention, cysts or tumors in the wrist and repeated use of vibrating hand tools. NINDS is not convinced that repetitive tasks like computer work, factory work or sports cause carpal tunnel syndrome. 

How do doctors diagnose Carpal Tunnel Syndrome?

In addition to performing a thorough exam of the head, neck, shoulders, arms and hands, NINDS says there are a number of tests doctors can perform to diagnose or rule it out. Your doctor might start by simply asking you to move your hands or arms in a way that usually causes symptoms. He might also perform:

1. The Tinel Test requires that the doctor taps or presses on the median nerve in the wrist. If tingling or a shock-like sensation occurs in the fingers, the test is positive and indicates possible Carpal Tunnel Syndrome. 

2. The Phalen Test requires that the patient hold her forearms upright by pointing the fingers down and pressing the backs of her hands together. If tingling or increasing is felt in the fingers within 1 minute that indicates Carpal Tunnel Syndrome.

Electrodiagnostic Tests

1. Nerve conduction studies place electrodes on the hand and wrist.  Small electric shocks are applied and the speed at which the nerves transit impulses is measured.

2. Electromyography tests involve inserting a needle into a muscle.  Electrical activity is viewed on a screen to determine how severely the median nerve is damaged.

3. Ultrasound tests can show impaired movement of the median nerve

4. MRI can show the anatomy of the wrist but isn't not considered useful in diagnosing carpal tunnel syndrome.

Once your doctor has diagnosed Carpal Tunnel Syndrome, treatment might include physical therapy, exercise, medications and sometimes surgery. It might also include lifestyle and health changes to prevent carpal tunnel syndrome from recurring. Acupuncture and chiropractic care have benefitted some patients and yoga has proven to reduce pain and improve grip strength in some carpal tunnel syndrome patients. 


National Institutes of Health

National Institute of Neurological Disorders and Stroke

Carpal Tunnel Syndrome Fact Sheet