Is diagnosis of Carpal Tunnel Syndrome easy?
When the patient complains of tingling (paresthesias) and/or pain, often radiating to the forearm, mainly at night or early in the morning, the condition is most probably due to CTS. However, it is necessary to carry out an objective neurological test and EMG/ENG (electromyography/electroneurography) tests. The objective neurological test examines the strength, the osteotendonitic reflexes, and sensitivity, and can involve clinical tests. The most common tests are the Tinel and Phalen tests. In the first case, the carpal tunnel is tapped with a reflex hammer and the patient must feel a shock in the median nerve distribution area; the second test consists in bending or stretching the hand over the forearm for one minute; the patient must feel a tingling sensation or the tingling sensation must worsen. However the tests can often give negative false or positive false results; it is therefore not advisable to rely too much on the results obtained. Therefore an EMG/ENG test is recommended.
