If you are having pain in the wrist, palm, or fingers, you may want to see the doctor to be examined for CTS. A doctor’s exam will include questions about your personal and family medical history and a detailed physical examination of your hands, arms, shoulders, and neck to help determine if your pain is related to daily activities or to an underlying disorder. This can also rule out other conditions that mimic CTS. The doctor will examine each finger for sensation. One way a doctor can rule out CTS is if the symptoms include the pinky finger since the pinky is not serviced by the median nerve. Other routine laboratory tests and X-rays can help uncover other disorders that might cause the same symptoms.

The doctor will test the strength of the affected hand and examine the size of the muscles at the base for signs of atrophy. The doctor may also use specific techniques to try to elicit the symptoms of CTS. The Tinel test involves tapping or pressing on the median nerve in the wrist; if this produces tingling or shock-like pain in the fingers, it indicates you may have CTS. Phalen’s test (or the wrist-flexion test) involves the patient pressing the backs of their hands together with the fingers pointing to the floor and the forearms parallel to the ground; if symptoms such as tingling or numbness occur in the fingers within one minute, CTS is suspected.

Most diagnoses are made utilizing history and physical symptoms.  However, in order to confirm a diagnosis of CTS, the doctor may order one or more diagnostic tests. In a nerve conduction test, electrodes are placed on the hand and wrist. A small electric impulse is applied to the median nerve to see if the impulses are slowed down by passing through the carpal tunnel. In an electromyogram, a fine needle is inserted into a muscle and the electrical activity is recorded to determine the severity of damage to the median nerve. An ultrasound image can show impaired movement of the median nerve if it is pinched in the carpal tunnel.