What Doctor does to Check Carpal Tunnel Syndrome

Proper diagnosis of carpal tunnel syndrome is done by the doctors to avoid misdiagnosis. If you are wondering about what the doctor does to check CTS, here is a clear explanation.

History taking and physical examination through clinical assessment can support a CTS diagnosis. In history taking several questions will be asked by the doctor. After these questions, physical examination will be performed to support the history taking. Below are the common questions asked by the examining physician:

• What is your job? (photography, computer jobs, and playing golf are some of the activities that may cause CTS)

• The number of hours of work (The longer time the wrist is flexed, the greater is the risk for having carpal tunnel syndrome).

• Have you ever experienced wrist pains or numbness? If yes, how frequent? (Recurrent loss of sensation in the hand may indicate a different condition that points to neuromuscular alteration and not CTS. In such case, you will have to undergo other diagnostic tests)

One of the physical examination is the Phalen’s maneuver. This procedure is done by flexing the wrist gently as far as possible then holding this position and waiting for symptoms to occur. If there is numbness while holding the wrist in acute flexion position within 60 seconds, the doctor will consider you positive for carpal tunnel syndrome. Phalen’s sign is defined as pain in the median-innervated fingers within 60 seconds of wrist flexion.

Another thing that the doctor does to check Carpal Tunnel Syndrome is the Tinel’s sign. This is a less specific test among all the physical examination of CTS. This is the way to detect irritated nerves. It is performed through light percussion on the skin over the area near the wrist to elicit a sensation in the nerve distribution. Positive Tinel’s sign is implied when there is pain upon percussion.

The last physical assessment is the Durkan Test. This is also known as carpal compression test done by or applying pressure over the palm nerve for 30 seconds to evaluate the symptoms of carpal tunnel syndrome – pain and numbness.

In order for the doctor to come up in the diagnosis of CTS, the doctor will also need to check the nerve conduction through electrodiagnostic study. In electrodiagnostic study the speed conduction of nerve to the median will be compared in other nerves supplying the hand. To those people who have carpal tunnel syndrome, speed conduction is slower than the other nerves of the body. There are still many types of electrodiagnostic tests a doctor does to check carpal tunnel syndrome, but the most specific and the most reliable test is the Combined Sensory Index or also known as Robinson Index. Physicians rarely use MRI and CT scans as a diagnostic test for CTS.

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