Diagnosing Carpal Tunnel Syndrome

carpal tunnel painThe symptoms of carpal tunnel syndrome often appear gradually and can overlap with a number of other medical conditions. Seeing a doctor for a proper diagnosis is an essential step in developing an effective treatment program.

Diagnosing Carpal Tunnel Syndrome

If you are experiencing numbness, tingling, burning in your thumb, index, middle finger and ring finger, or other potential carpal tunnel syndrome symptoms, your doctor will take a full medical history before conducting a physical or neurological exam. Some of the tests that they might perform include:

  • Tinel's test. Your doctor will lightly tap your wrist near the median nerve to see if this creates tingling in your hand.
  • Phalen's test. Your doctor will ask you to bend your affected wrist to see if this causes tingling within 60 seconds.
  • Pressure provocation test. Your doctor will press their thumb on the wrist over the carpal tunnel for 60 seconds to see if this results in numbness or tingling.
  • Two-point discrimination test. With this test, your doctor is attempting to see if you can tell whether points of pressure are two separate entities. This test is performed with a gadget called a 2-point disk-criminator—a small, flat, eight-sided tool with needle-like prongs sticking out from all sides.

If these tests suggest that carpal tunnel syndrome is a possibility, your doctor may ask you to undergo a nerve conduction study. This is the only way to definitively diagnose carpal tunnel syndrome. A nerve conduction study can also determine whether there is a mild, moderate, or severe compromise of the median nerve—which can help you decide which treatment options are most likely to be effective.

Ultrasound is rapidly becoming a very reliable test to measure the size of the median nerve and in some areas is replacing the nerve conduction study as the preferred diagnostic test. 

An ultrasound, X-ray, or MRI isn't normally necessary but may be ordered to rule out other potential causes of your pain. Blood work could also be ordered if your doctor suspects you have a disease such as diabetes that could be causing damage to your nerves.

Evaluating Your Carpal Tunnel Treatment Options

Your treatment options depend on the severity of your carpal tunnel syndrome. Mild cases often respond well to conservative treatments such as braces, nerve gliding exercises, and over-the-counter pain relievers. More severe cases may require injections and ultimately surgery to release the nerve.

Contact Our Baltimore Office Today for Carpal Tunnel Treatment

Ultrasound-guided carpal tunnel release performed with the SX-One MicroKnife uses ultrasound to view critical anatomy in the wrist and hand before creating space to transect the transverse carpal ligament (TCL). The procedure is known for its quick recovery time, with most patients being able to return to work in three to six days. Learn more about how Dr. Eric H. Williams, a nerve expert who specializes in reconstructive surgery and pain relief, can help you quickly and effectively address your carpal tunnel pain by contacting our Towson office.

Eric H. Williams MD
Specializing in reconstructive surgery and pain relief in the Greater Baltimore area.
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