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Carpal Tunnel Diagnosis

MEDICAL ENCYCLOPEDIA 
Carpal Tunnel Diagnosis
What is carpal tunnel?
Causes and Risk Factors
Symptoms
Diagnosis
Treatment

Do you think you are experiencing carpal tunnel syndrome?  If so, carpal tunnel isn't likely to go away on its own. Even if you stop doing any activity with your hands and arms and rest and take time off, when you start up again, it's likely that the pain will return too.  But do you know what to expect when you go see your doctor?  And which specialist you should see?

In order to start to diagnose carpal tunnel, you may choose to see a family doctor, an internist , or an occupational medicine specialist.  You may later be referred to an orthopedic surgeon (orthopedist), a neurologist, a hand surgeon, a plastic surgeon, a rheumatologist, a physical therapist or a psychiatrist for further testing, if required.

Medical exams
When you see your doctor, s/he will review your medical history and ask questions about symptoms: how you hurt, where you hurt, and how long you've been hurting.  Prepare a list of questions for your appointment.  You might want to ask things like: What is going on in my hand and wrist that is giving me these symptoms of pain and numbness?  Are you sure that it is a problem with my Carpal Tunnel? Where else could the pain be coming from?

Specific tests
Diagnosis of carpal tunnel syndrome is based on the history of symptoms, presence of risk factors, physical and neurological examination, and diagnostic tests. To help with getting a proper diagnosis, you may be asked to participate in a couple easy, non-invasive tests of your range of motion.  Or a nerve conduction test might also be required by the doctor to 'confirm' the diagnosis.  Differential diagnosis includes inflammation (radiculopathy) of nerve roots C6 and C7 in the cervical spine and compression of the median nerve outside the carpal tunnel.  

Some other tests doctors can use to try to produce or evaluate the symptoms of carpal tunnel syndrome include:

Electromyogram (EMG) - This test can verify if any muscles of the hand or wrist has lost part of its nerve supply. This test can be performed during the first visit, eliminating the need for another appointment.

The Tinel test - During the Tinel test, the doctor taps on or presses on the median nerve. The test is positive when tingling in the fingers or a resultant shock-like sensation occurs.

The Phalen test - The Phalen, or wrist-flexion, test involves having the patient hold his or her forearms upright by pointing the fingers down and pressing the backs of the hands together.

Nerve conduction study - Nerve conduction study tests can to indicate whether the electrical impulses traveling along the median nerve are slowed in the carpal tunnel.  This tests is useful to checking for other conditions that might mimic carpal tunnel syndrome, such as a pinched nerve in the neck.

Once you've established a diagnosis, it's time to learn more about how doctors treat CTS.  Carpal tunnel syndrome can be treated at home through non-surgical treatment, or is treated by surgery.  Learn more about carpal tunnel surgery in our Treating Carpal Tunnel section that follows.

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Tags: surgical treatment, ask questions, diagnosis, treatment, tingling, symptoms, numbness, muscles, surgery, wrist, neck, cervical, carpal tunnel syndrome treatment, carpal tunnel treatment, ask the doctor, tingling sensation, orthopedic surgery, surgery questions, medical treatment, plastic surgery
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