In most cases the diagnosis can be made based on symptoms, medical history, and physical exam in the clinic. A corticosteroid injection into the carpal tunnel (cortisone shot) can be used for treatment and diagnosis. An electrodiagnostic study (nerve conduction study) can be ordered to confirm the diagnosis in some cases, but is not always required. Hand surgeons are experts in making the diagnosis of carpal tunnel syndrome and ruling out other causes of symptoms.
Many patients with CTS improve with use of a wrist brace at night or a cortisone injection. Surgery is recommended in cases of severe carpal tunnel syndrome (signs of nerve damage) or if conservative treatment is not successful.
Patients with carpal tunnel syndrome (CTS) feel “numbness” or “tingling” in the fingers. Some patients feel that the hands are “asleep” and have poor circulation from time to time. Symptoms are often worse at night and wake patients up from sleep. Patients tend to shake out their hands for relief. Dropping objects, clumsiness with the hands, or a weak grip are also possible complaints. Some patients also report burning, electric or pins and needles type pain in the wrist or fingers. In severe CTS, the hand is constantly numb in the thumb, index and middle fingers, and there is atrophy in the thumb muscles.