Carpal tunnel syndrome occurs when there is a pinch or pressure on the median nerve that is located between the palm of the hand and the forearm. This can cause inflammation, pain, numbness, tingling and a feeling of pressure in the fingers, wrist and arm. There are many reasons why someone can develop this syndrome, including underlying health conditions, overuse of the wrist, environmental injuries, or the anatomy of your wrist. Diagnosing and treating the syndrome can help a person reduce symptoms.
Method 1 of 2: Diagnosing Carpal Tunnel Syndrome at Home
Step 1. Assess your risk factors for carpal tunnel syndrome
Assessing your risk factors can put you in a better position to understand the symptoms, recognize the condition, and better treat it. Assess whether you have one or more of the following risk factors:
- Gender and age: Women are more likely to develop carpal tunnel syndrome than men and it is most commonly diagnosed between the ages of 30 and 60.
- Occupation: Having a job that involves a lot of use of your hands, such as factory or assembly line work, puts you at higher risk for the syndrome.
- Underlying conditions: People with metabolic disorders, rheumatoid arthritis, menopause, obesity, thyroid disease, kidney failure, or diabetes are more likely to develop the condition.
- Lifestyle factors: smoking, high salt consumption, sedentary lifestyle can increase your risk of carpal tunnel syndrome.
Step 2. Know the symptoms
If you notice one or more of the following five symptoms in your wrist, hand, or arm, you may be developing or already have carpal tunnel syndrome:
- Tingling of hand, fingers or wrist.
- Numbness of hand, fingers or wrist.
- Swelling of the wrist.
- Pain in hand, fingers or wrist.
- Weakness of the hand.
Step 3. Track your symptoms
Keeping track of your symptoms can put you in a better position to diagnose and treat the condition, if you have it. Your doctor can also better diagnose the condition if he/she has a more detailed history of the condition.
- Symptoms usually become apparent gradually.
- Symptoms often first appear at night. As the condition worsens, you will begin to feel the symptoms during the day as well.
- Symptoms that do not go away over time (as opposed to a temporary injury) and gradually worsen over time.
Step 4. Try Phalen's Trial
This is an easy test that can be used in the diagnosis of carpal tunnel syndrome. There are several ways to test this. Try the following:
- Sit at the table and place your elbows on the table.
- Flex your wrist to the maximum to increase pressure in the carpal tunnel.
- Hold this position for at least a minute.
- Another way to do the experiment is to hold the backs of both hands together in front of you, fingers pointing downwards (as an opposing prayer position).
- Any pain and tingling of the hands, fingers and/or wrist and numbness in the fingers, especially in the thumb, forefinger and part of the middle finger, is a positive result.
Step 5. Try the other tests for carpal tunnel syndrome
There are several tests for diagnosing carpal tunnel syndrome, but the specificity of these tests is debatable. You can try them:
- Tinel's sign is done by tapping the wrist and carpal tunnel with your fingers or a reflex hammer. If it causes tingling in your fingers, that is considered a positive result.
- The Tourniquet test is based on temporarily increasing pressure on the carpal tunnel by placing a blood pressure cuff around the upper arm or forearm. Inflate the cuff between the systolic and diastolic pressures to block venous return from the arm and increase blood volume in the hand. If this causes symptoms, then the test is positive. But do not perform this test unless you are familiar with using a blood pressure cuff correctly.
- In another test, the hands are held above the head for two minutes. If this causes symptoms, then the test is positive.
- The Durkan compression test is based on direct pressure applied across the carpal tunnel to increase the pressure. Press the carpal tunnel with your thumb, or ask a friend to do it. If this causes symptoms, then the test is positive.
Step 6. Ask yourself if you should see a doctor
If symptoms worsen or don't go away, if the pain is unbearable, or if you're having trouble working, talk to your doctor. Your doctor can diagnose and treat the symptoms appropriately and rule out any serious underlying conditions.
Method 2 of 2: Diagnosing carpal tunnel syndrome at the doctor's office
Step 1. Tell your doctor your symptoms
Speaking to your doctor means telling them more about the symptoms you're experiencing and your history of the condition.
- Remember that your doctor can diagnose the condition better if you are detailed and not withholding symptoms.
- Be aware that your doctor can refer you to a specialist in neurology, surgery, orthopedics or rheumatology if needed for diagnosis or treatment.
Step 2. Get a physical examination
Your doctor will want to evaluate your wrist and hand. He will press points to find out if there is pain or numbness in the area. He will also check for swelling, sensations, and weakness. If the pain is intense, additional tests may be needed to rule out other health problems.
- A preliminary survey where he visually examines the area is required to provide indication and direction for follow-up testing.
- Your doctor may also perform Phalen's test or other carpal tunnel tests in the office.
Step 3. Get a blood test
Blood samples may be requested to rule out additional medical conditions, such as rheumatoid arthritis, a thyroid problem, or other underlying medical problems. Ruling out these problems will help your doctor diagnose the problem.
Once blood tests have ruled out other medical problems, additional imaging tests may be necessary
Step 4. Request an image test
Imaging tests, such as an X-ray or ultrasound, may be requested by the doctor, or you can request one yourself. By having these image scans performed, the problem can be better identified and the symptoms can be better treated.
- X-rays are only used to support the diagnosis or to rule out other causes of pain (such as fractures and arthritis).
- Your doctor may use an ultrasound to visualize the structure of the median nerve in your hand.
Step 5. Have an electromyogram performed
An electromyogram is a test in which several fine needles are inserted into the muscles to measure electrical discharge. This test can determine if there is muscle damage and it can rule out other conditions.
A mild pain reliever may be prescribed prior to the test to reduce the pain
Step 6. Request a nerve conduction study
This medical conduction test is used to see how the nervous system is functioning and can determine if you have carpal tunnel syndrome.
- During the test, two electrodes are placed on your hand and wrist and a small shock is sent through the median nerve to determine if electrical impulses are slowed down in the carpal tunnel.
- The result can indicate how much damage has occurred to your nerves.