How Do I Diagnose Carpal Tunnel Syndrome?

Carpal tunnel is diagnosed--fundamentally--by physical examination and "history". A typical subjective history includes numbness and tingling in the thumb, index and long finger that awakens one at night or develops while driving or talking on the phone (or with any activity that involves flexing the wrist). Tapping the wrist may cause a "paresthesia" or electric shock to radiate into the fingers. Nerve conduction studies (EMG's) are often ordered to confirm the diagnosis. These study results are also valuable in assessing the severity of the nerve entrapment (in the case of carpal tunnel it is the median nerve). However, nerve studies may be normal in 10-15% of cases----which is why the history and physical exam are so important.

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