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Arthritis Q&A by Dr. Shiel

I have been to many specialists regarding what I believe to be carpal tunnel syndrome. I have had a closed fracture on my wrist and forearm at different times in the past. I do repetitive work with lifting light weight with thumb and forefinger daily. During flare-ups, I can't even hold a cup of coffee or brush my teeth. When visiting doctors, they all have me do standard push, pull, and pressure test against there hands. Also, one poked me with a pin and asked if it hurt. My wrist burns and I have pain and numbness in the whole hand, not just the thumb and 2.5 fingers normally associated with CTS. They all have told me its osteoarthritis with only hands-on evaluation. I have not been to an orthopedic surgeon yet. Is there a certain test I can take to rule out carpal tunnel syndrome?

Medical Author: William C. Shiel Jr., MD, FACP, FACR

Answer:

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Carpal tunnel syndrome is commonly diagnosed based on the history and physical examination. For more information, see the Carpal Tunnel Syndrome article of MedicineNet.com.

Confirming the presence of carpal tunnel syndrome requires testing to detect impaired transmission of electrical impulses through the median nerve across the wrist. This test is called a nerve conduction test or NCV.

During a NCV, the examiner stimulates one end of the nerve while a receiver at the other end receives the impulses. The speed at which the impulse is transmitted down the nerve has a normal rate. Carpal tunnel syndrome is confirmed when the speed of transmission of the impulse slows as it crosses the wrist (carpus in Latin).

Thank you for your question.

Last Editorial Review: 12/20/2006

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Arthritis Q&A by Dr. Shiel

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