Carpal Tunnel Syndrome

Diagnosis

Your doctor will look for decreased feeling in your fingers and for muscle weakness in your hand. Your doctor will check your thumb muscles for signs of wasting and your wrists for signs of arthritis. Your doctor may check whether fluid is accumulating in several different parts of your body, including your hands, feet and legs, since extra fluid can add pressure in the carpal tunnel.

The examination will probably include tests to check whether the nerves in your wrist are working well. The Tinel's test is done by tapping over the median nerve at the wrist. In Phalen's maneuver, the wrist is flexed for 30 to 60 seconds. If you develop pain, numbness or tingling during these tests, the median nerve in the carpal tunnel may be compressed.

Doctors usually diagnose carpal tunnel syndrome based on your history of hand symptoms and the physical examination. X-rays and other imaging tests rarely help. Your doctor can confirm the diagnosis of carpal tunnel syndrome by ordering nerve tests (called nerve-conduction studies) of the median nerve in your affected hand. These tests are not perfect, however. In some people, symptoms or an examination suggest carpal tunnel syndrome, but the nerve tests are normal. Your doctor may order blood tests to look for evidence of diabetes or thyroid disease since these are common triggers of carpal tunnel syndrome.

Expected Duration

How long carpal tunnel syndrome lasts depends on the cause. Sometimes the syndrome comes and goes and does not need to be treated. A person who has carpal tunnel syndrome caused by overuse during sports may recover quickly with treatment, rest and modified activity. In someone whose carpal tunnel syndrome is caused by arthritis, symptoms may be more stubborn and require longer therapy.