Carpal Tunnel Syndrome And Tarsal Tunnel Syndrome - Diagnosis

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Describe the exams that led to a diagnosis of carpal tunnel syndrome. Did you think it was something else?

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How is carpal tunnel syndrome diagnosed?

The diagnosis of carpal tunnel syndrome is suspected based on the symptoms and the distribution of the hand numbness. Examination of the neck, shoulder, elbow, pulses, and reflexes can be performed to exclude other conditions that can mimic carpal tunnel syndrome. The wrist can be examined for swelling, warmth, tenderness, deformity, and discoloration. Sometimes tapping the front of the wrist can reproduce tingling of the hand and is referred to as Tinel's sign of carpal tunnel syndrome. Symptoms can also at times be reproduced by the examiner by bending the wrist downward (referred to as Phalen's maneuver).

The diagnosis is strongly suggested when a nerve conduction velocity test is abnormal. This test involves measuring the rate of speed of electrical impulses as they travel down a nerve. In carpal tunnel syndrome, the impulse slows as it crosses through the carpal tunnel. A test of muscles of the extremity, electromyogram (EMG), is sometimes performed with the nerve conduction velocity test to exclude or detect other conditions that might mimic carpal tunnel syndrome.

Blood tests may be performed to identify medical conditions associated with carpal tunnel syndrome. These tests include thyroid hormone levels, complete blood counts, and blood sugar and protein analysis. X-ray tests of the wrist and hand might also be helpful to identify abnormalities of the bones and joints of the wrist.

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Comment from: Tammy, 45-54 Male (Caregiver) Published: December 05

My husband has just returned from a pain specialist. He's had issues with his thoracic spine for some time now and the issues have includes severe knots in his shoulder. Over the past couple of months he's developed severe pain and numbness that starts where the knot is, travels down his arm and into his thumb and two fingers. This specialist is saying he has carpal tunnel syndrome which makes no sense to me because he doesn't do repetitive motions, he does have the symptoms of carpal tunnel including muscle atrophy, burning sensation and severe pain along with numbness tingling, etc. What I don't get is if the pain is starting in his back/shoulder and travelling down, not up then how can this not be related to his original injury in his spine which would be about C7-8 down to T7.

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