Carpal tunnel syndrome occurs when the median nerve located between the palm of the hand and the forearm is compressed. The pressure causes inflammation, pain, numbness, tingling and tightness in the fingers, wrist, and arm. The causes can be various - for example, systemic diseases, excessive use of the wrist, a localized injury or the anatomy of the wrist itself. By diagnosing and treating this disorder, symptoms can be reduced.
Steps
Method 1 of 2: Diagnosing Carpal Tunnel Syndrome at Home
Step 1. Assess your risk factors
In this way, you can better understand the symptoms, recognize the disease and treat it better. Determine if you have one or more of the following risk factors:
- Gender and age: women tend to suffer more from this pathology than men and the syndrome is generally diagnosed in patients between the ages of 30 and 60.
- Work: Jobs that require intense use of the hands, such as those of factory workers or people on the assembly line, place workers at greater risk of developing carpal tunnel syndrome.
- Systemic diseases: patients with metabolic disorders, rheumatoid arthritis, women in menopause, obese subjects, with thyroid problems, renal insufficiency or diabetes are particularly susceptible.
- Lifestyle: smoking, excessive consumption of salt, a sedentary lifestyle can increase the risk of suffering from it.
Step 2. Recognize the symptoms
If you notice any of the following five symptoms in your wrist, arm, or hand, you may be suffering from the syndrome:
- Tingling in the hand, fingers, or wrist
- Numbness in the hand, fingers, or wrist
- Swelling of the wrist
- Pain in the hand, fingers, or wrist
- Weakness of the hand.
Step 3. Monitor your symptoms
This way, you can better diagnose and treat the condition in case you suffer from it. The doctor can come to conclusions more quickly if he has a detailed medical history.
- Symptoms generally develop gradually.
- Usually, they initially occur during the night; as the syndrome worsens, they also manifest themselves during the day.
- The situation does not improve over time (as it does with a temporary injury) and tends to get worse.
Step 4. Run the Phalen test
This is a very simple test that is used to diagnose carpal tunnel syndrome. There are several ways to perform the test, for example:
- Sit down and rest your elbows on the table;
- Let the wrists fall back in order to achieve maximum flexion and put as much pressure as possible on the carpal tunnel;
- Hold the position for at least a minute.
- Another technique consists in placing the backs of the hands together, bringing them in front of the chest; the fingers must be pointing downwards (the position is exactly opposite to that of "prayer");
- If you experience any pain and tingling in your hands, fingers and / or wrists or feel numbness in your fingers (particularly in the thumb, index, and partially middle finger), the test is positive.
Step 5. Run other diagnostic tests for carpal tunnel syndrome
Several tests have been described to diagnose this disorder, but their specificity is still a matter of debate. However, you can give it a try:
- The Tinel maneuver is performed by tapping the thumb and carpal tunnel with the fingers or a tendon hammer. If it causes tingling in the fingers, the test is considered positive.
- A tourniquet exam (not to be confused with the Rumpel-Leede test) is based on the temporary increase in pressure on the carpal tunnel thanks to the sphygmomanometer sleeve that is applied to the arm. Inflate the cuff to between systolic and diastolic pressure to block venous return in the arm and increase the volume of blood in the hand. If this procedure triggers the symptoms of carpal tunnel syndrome, the outcome is positive. However, do not proceed with this test if you are unable to use the blood pressure monitor correctly.
- The hand lift test is performed by placing the hands above the head for two minutes. If symptoms occur, the test is positive.
- Durkan's test relies on direct pressure on the carpal tunnel to augment the existing one. Press your wrist with your thumb or ask a friend to do it for you. If this causes the typical symptoms, then you suffer from the syndrome.
Step 6. Determine if you need to see a doctor
If the ailment gets worse or doesn't go away, if the pain is unbearable or interferes with work, you need to call your doctor. He will diagnose and treat symptoms appropriately, being able to rule out other serious systemic diseases.
Method 2 of 2: Diagnosing Carpal Tunnel Syndrome in the Doctor's Office
Step 1. Describe your symptoms to the doctor
By discussing the problem with your doctor, you allow him to better understand the symptoms you are showing and also the evolution of the pathology.
- Remember that the doctor can come to better conclusions if you are detailed in the descriptions and do not leave out any symptoms.
- If necessary, the family doctor may refer you to a specialist, such as a neurologist, surgeon, orthopedist, or rheumatologist, to diagnose and find treatment.
Step 2. Undergo a visit
The doctor will want to examine the wrist and hand. It will press specific points to find the painful and numb areas. It will also check for swelling, weakness and the level of tactile sensitivity. If the pain is severe, you will probably need to get tested to rule out other diseases.
- A first visual evaluation is necessary to understand how to proceed with subsequent analyzes.
- Your doctor might perform Phalen's test or other diagnostic maneuvers.
Step 3. Get a blood test
It is essential to take a blood sample to rule out conditions such as rheumatoid arthritis, thyroid changes or other diseases. In this way, the doctor can narrow down the range of possible problems and come to conclusions.
When blood tests rule out other pathologies, imaging tests should be done
Step 4. Ask your doctor for imaging tests
Your doctor can order x-rays, an ultrasound, or you can request them yourself. Thanks to these tests, you can better understand the problem and treat the symptoms.
- X-rays are typically done only as a supportive test or to rule out other causes of pain (such as a fracture or arthritis).
- Through the ultrasound, the doctor can visualize the internal structures and the median nerve in the hand.
Step 5. Perform an electromyography
During the exam, several fine needles are inserted into the muscles to measure electrical signals; in this way, one can understand if there is muscle damage and rule out other diseases.
You will be given a mild pain reliever before the exam to keep the discomfort under control
Step 6. Ask for more details about the nerve conduction study
This test is done to establish nervous system activity and determine whether or not the patient has carpal tunnel syndrome.
- Two electrodes are placed on the hand, on the wrist and a light electrical signal is sent through the median nerve, to understand if this slows down in the carpal tunnel area.
- The result also defines nerve damage in quantitative terms.
