The evaluation of carpal tunnel syndrome begins with a medical history and physical examination.
Physical findings in someone with carpal tunnel syndrome may include:
- Numbness in the thumb, index, and middle fingers
- Weakness in the thumb
- Muscle wasting in the thumb
Additional findings that suggest carpal tunnel syndrome include:
- Phalen's test:
- Findings on physical examination often include a positive Phalen's test. During this test, the patient holds their wrist in full, unforced, palmar flexion. The development of any sensory disturbance such as numbness, tingling, or burning pain within 60 seconds is diagnostic for carpal tunnel syndrome.
- Tinel's sign:
- Tapping lightly on the underside of the wrist (just proximal to the wrist joint), over the median nerves may cause shooting (electric shock) pains.
- Tourniquet test:
- The tourniquet test may also be performed in patients with suspected carpal tunnel syndrome. The development of numbness and tingling in the fingers after an inflated blood pressure cuff is placed on the upper arm suggests carpal tunnel syndrome.
Testing is necessary to confirm the diagnosis of carpal tunnel syndrome.
Tests that may be used to evaluate carpal tunnel syndrome include:
