Wondering what that piercing pain, tingling in your fingers, numbness and weakness is? It's most likely caused by carpal tunnel syndrome, a condition that occurs when the median nerve in your forearm gets squeezed or compressed at the wrist. Tests can rule out other conditions.
The median nerve is responsible for sensation to the thumb and fingers on the palm side and also to smaller muscles in the hand that allow movement in your fingers and thumb. In some cases, thickened, irritated tendons narrow the carpal tunnel and compress and injure the nerve.
Carpal tunnel syndrome can make every day activities such as buttoning your clothes or typing very difficult. If caught early, it is very treatable and prevents permanent damage to the median nerve.
Tests to Diagnose Carpal Tunnel Syndrome
Physical Tests
Your doctor will physically examine your neck, hands, shoulders and arms to figure out if daily activities trigger the pain, or if another condition similar to carpal tunnel syndrome is the culprit. Your wrist, base muscle of the hands, and fingers will also be examined for various indicators.
X-rays
These tests produce images of the wrist bones, which indicate if there are abnormalities that may be causing carpal tunnel syndrome, or if you have another condition or disorder.
The Tinel Test
During this test for carpal tunnel syndrome, your doctor presses or taps on the median nerve in your wrist. If it triggers tingling in your fingers or a sensation of shock, you have the condition.
The Phalen Test
Also called the wrist-flexion test, it requires you to hold your forearms in an upright position by pointing downwards with your fingers while keeping the backs of your hands together. Carpal tunnel syndrome is indicated if you experience symptoms such as numbness or tingling in your fingers within 60 seconds. You may also need to perform other movements that are likely to set off your symptoms.
Electrodiagnostic Tests
You'll need to undergo these tests for carpal tunnel syndrome to confirm the diagnosis. They test nerve conduction. A technician places electrodes on your wrist and hand that send small electric shocks through them, and the speed of the impulses transmitted by the nerves are measured.
Electromyography Test
This test indicates how your muscles and nerve are working together. A technician inserts a fine needle into your muscle and views electrical activity on a screen that indicate the amount of damage to your median nerve.
Ultrasound Imaging
During an ultrasound test high-frequency sound waves produce pictures of the median nerve and can indicate if movement is impaired.
Causes of Carpal Tunnel Syndrome
Heredity and repetitive actions, such as typing or painting, are major contributing factors in this condition. They cause the tendons in the carpal tunnel to swell, thicken and become irritated. Other likely causes of carpal tunnel syndrome include a broken or dislocated bone in the wrist, arthritis, diabetes, menopause, pregnancy, and obesity. Sometimes the cause is unknown.
Treatment for Carpal Tunnel Syndrome
RICE - rest, ice, compression, and elevation - is a go-to treatment for carpal tunnel syndrome. Your doctor will likely recommend that you take a nonsteroidal anti-inflammatory drug such as ibuprofen or some other pain reliever. You may also have to wear a wrist brace to immobilize the troubled wrist. If a condition such as diabetes is to blame, you need to treat it as well.
A physical therapist can teach you exercises to strengthen and stretch your wrist. Yoga and chiropractic treatment also show promise for coping with the condition. If you have symptoms for six months or more you may need surgery, which usually involves cutting the tissues or the carpal ligament in the wrist to relieve pressure on the median nerve.
