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Carpal Tunnel Syndrome: Diagnosis and Treatment

Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju
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Sandeep Dhanyamraju MD
Medically reviewed by Sandeep Dhanyamraju

Carpal tunnel syndrome is a neurological disease affecting the wrist zone. The carpal tunnel’s median nerve accounts for normal hand movements. Its nature is fully connected with extrinsic factors such as trauma, monotonous work, tumors, and endocrine profile for females. The listed triggers heavily influence the nerve system functionality. In particular, the vulnerable nerves are located in narrow areas like wrists. In this case, the carpal tunnel shares the pressure impulses and provokes some unpleasant, painful reactions.

The symptoms detect the two conditions that are often misdiagnosed as carpal tunnel syndrome. Hence, the inexperienced neurologists and lack of clinic picture tests could implicate this ailment with wrist tendonitis or arthritis-like syndromes closely resembling carpal tunnel disturbance. 

Anyway, the severe stages of this disorder could have dangerous consequences in the form of surgical interventions. At the same time, minor cases quickly get along with therapy recommendations and medicine prescriptions. 

However, the fundamental point in the treatment strategy of the carpal tunnel disorder is to lead a healthy lifestyle, make temporary relaxing breaks, and follow a vitamin-rich diet. Hence, a special daily ration should include veggies and fruit containing vitamins B, magnesium, selenium, calcium, and a range of helpful minerals.


Carpal Tunnel Syndrome Physical Examination

Early diagnosis is essential to avoid permanent damage to the nerve fibers. A physical examination of the hands, shoulders, and neck can help determine whether the perceived symptoms are related to daily activity or illness and rule out other painful conditions that may mimic carpal tunnel syndrome. Diagnosis is simple and reliable if nocturnal numbness, numbness of the first three fingers of the hand is reported, and a difference in the pad’s sensitivity of the 4th finger. Another decisive sign, if the motor part is involved, is muscle atrophy of the outer part of the thenar eminence, together with muscle weakness in the grip of the 1-2nd finger.


There are also outpatient median nerve problems that your doctor can perform to mimic the symptoms of carpal tunnel syndrome.

  • Tinel’s sign. Pain can be induced or reproduced in the median nerve distribution by wrist percussion to confirm the diagnosis of carpal tunnel syndrome. A reflex hammer is commonly used, and an electric shock is triggered at the entrance to the wrist canal.
  • Phalen’s sign. The appearance of paresthesia in the fingers due to the maximum flexion of the wrist and keeping it in this position for at least one minute. This is done when the patient is asked to keep the palms unfolded for 30 seconds, keeping the elbows flexed and the forearms horizontal. This puts pressure on the median nerve of the carpal tunnel. The test is considered positive if paresthesias are radiating at the level of the first three fingers of the hand.
  • Phalen’s reverse sign. It is performed when the patient is asked to hold the back of the hand with the face for 30 seconds, keeping the elbows flexed and the forearms horizontal. This puts pressure on the median nerve of the carpal tunnel. The test is considered positive if paresthesias are radiating at the level of the first three fingers of the hand.

The range of sensitivity of Tinel’s trait is from 25 to 60%; the specificity is from 67 to 87%. The Phalen test has a sensitivity and specificity range of 40 to 80%. 


Medical Tests and Diagnostical Procedures of Median Nerve Compression

However, two non-invasive and painless tests are performed to confirm the diagnosis and establish the severity of the disease:

  • Electroneurography. That is, the study of the response of the median nerve to electrical stimuli, confirms the diagnosis. 
  • Electromyography. That is, the study of the activity of the muscles innervated by the median nerve, establishes the severity of the disease and makes it possible for the differential diagnosis between various neuropathies. In the first case, electrodes are placed on the arm and wrist, and the nerve response, such as speed, latency, and amplitude, is measured with small electric shocks. In the second, a needle is inserted into the muscles to study their activity, making it possible to establish the severity of the syndrome and exclude other pathologies.

Ultrasound and MRI can show the anatomy of the wrist, but these data are insufficient to diagnose carpal tunnel syndrome.


How to Treat Carpal Tunnel 

All about carpal tunnel treatment

The national clinical investigations consider carpal tunnel-related syndrome to be a nerve pressure ailment or a tunnel neuropathy. This damage of peripheral nerves is provoked by pressure-stimulated or traumatic injuries in the anatomical narrowing. A primary factor for tunnel neuropathy is the narrow pathway through which nerves undergo. In such a way, the unique anatomical structure of wrists and their flexible movements make them vulnerable to cold and tension impacts.

The pain feelings have an extended, explicit, and unbearable nature and could not be eliminated without any actions or agents. If you neglect the wrist abnormalities or think the pain will disappear quickly, you are grossly mistaken.

This insidious disease provokes plenty of accessory neurological disorders. The treatment process of the carpal-tunnel disturbance depends on the severity of the disease and can last for an extended period.

The modern medical treating methods should include the patient’s overall health history and refer to the somewhat effective ways to achieve the positive deliverables. In this case, the patient is advised to apply various non-surgery methods and tools. However, patients with arthritis and diabetes need the particular treatment for the carpal-tunnel-related symptoms, which are removed by surgical intervention. 

To make clear the differences between two common treatment strategies of the various states of carpal tunnel syndrome, you may investigate the table below.


Non-Surgery Methods Surgery Methods
  • Topical treatment. It includes splinting bandages, the use of compresses, and the introduction of drugs into the carpal pathway. These procedures can quickly relieve painful manifestations and reduce local inflammation effects.
  • Drug therapy. Drug therapy is based on the medical case particularities and the treatment final goal depending on the underlying or concomitant disease. At the same time, B vitamins, non-steroidal anti-inflammatory drugs, vasodilators, diuretics, anticonvulsants, muscle relaxants, glucocorticosteroids, antidepressants, etc., are often prescribed.
  • Physiotherapy. This method is valid for both drug therapy and the postoperative period during the patient’s rehabilitation.
  • Open access surgery with topical anesthesia: the carpal ligament is dissected through an incision with 5 mm in length in the carpal-tunnel area.
  • Endoscopic surgery. There are two types of similar intervention – dual incisions and single incisions. In the first case, an endoscope is inserted into one incision, and an instrument for dissecting the ligament into the second. In the other case, both tools are inserted alternately into a single hole.


Anyway, everyone should realize that they could face carpal tunnel syndrome at any moment. So, the preventive measures would be helpful to minimize the risk of this syndrome occurring.

  • Massage. Simple massaging actions could reduce the pressure prescriptions and resume the normal functional abilities of the hand elements. Moreover, the massage has heating effects on the hands and stimulates the work of median nerve ties.
  • Yoga. This is a complex mix of well-grouped exercises which help to enhance the health and the integral functions of all organs, tissues, and nerve ties.
  • Relaxation breaks and warm natural clothing stuff. The ingenious is always simple. Let your hands have minor periodical breaks and use the gloves for the hard, monotonous tasks and keep them from cold weather effects, and you crucially decrease the risks of carpal-tunnel-related syndrome.


Alternative Treatment for Carpal Tunnel Syndrome 

You can relieve the symptoms of tunnel syndrome without medication and surgery. This requires:

  1. Reduce the stress on the hands and wrists, exclude activities that worsen the condition.
  2. Fix the arm with a splint, orthosis, or an elastic bandage to restrict movement.
  3. Remove swelling with ice, limit fluid and salt intake.
  4. Perform arm gymnastics aimed at stretching the joints. We recommend exercising under the supervision of a physiotherapist.

If there is no improvement, then you should not delay seeking medical attention.

Carpal tunnel syndrome is not life-threatening; it is a slowly ongoing pathological process. The disease has a favorable prognosis for recovery, but some people are in no hurry to visit a doctor due to the neglect of their health. Over time, this leads to decreased motor activity, muscle strength, and fine motor impairment. If left untreated, irreversible processes will begin, the median nerve will atrophy. This will lead to the loss of the functionality of the brush, which will no longer be possible to return.



  • Who suffers from carpal tunnel syndrome?

The dangerous and severe disease affects females primarily. Women are more vulnerable to such neurological disorders because they frequently have work that involves monotonous tasks and suffers from hormonal imbalances due to pregnancy or menopause changes. In these cases, each woman who feels the painful perceptions in the wrists should immediately apply to the neurologist’s consultation to prevent the severe ailments which require the surgeon’s interventions.

  • What is carpal tunnel syndrome caused by?

This syndrome is caused by various internal and external factors varying from hormonal imbalances to accidental traumas. So, nobody could be assured to avoid such syndrome; however, everyone should know the step-by-step actions about how to treat carpal tunnel.

  • Who is most likely to get carpal tunnel syndrome?

Women have a higher probability of gaining this syndrome than men. In this case, an annual medical examination should occur with a neurologist consultation about any pain in the wrist area.

  • Which muscles are affected by carpal tunnel syndrome?

Muscles are less vulnerable in the case of carpal tunnel syndrome symptoms. The essential object of the painful effects is a median nerve located in the carpal tunnel. So, the adverse reactions in your wrists should give you a clue to apply for the proper neurological aid.

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Edward Medina
Edward Medina
15:34 30 Jun 22
Just such an amazing staff that makes you feel like part of their family. I’ve been going there for over 5 years now... and each visit I get the very best care and treatments that I have ever received in the 20+ years that I’ve been dealing with severe debilitating migraines. Since i started seeing them the number of my migraines has dropped from 15-20 a month to 2-3 every 3 month. I highly recommend them …they will change your life!read more
Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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