I'm seeing a specialist to find out if I have carpal tunnel syndrome or something else. It's been one test after another and I still don't know what's wrong. Is this typical?

Diagnosing nerve entrapments such as carpal tunnel syndrome can be a challenge. There's really no single test that says, yes you have carpal tunnel syndrome or no you don't. Most physicians, surgeons, and other specialists rely on what you tell them (the medical history) and what they see during the exam.

Sometimes when the results are inconsistent or unclear, the physician will order electrodiagnostic tests. Electrodiagnostic tests include electromyograms(EMGs) and nerve conduction velocity (NCV).

An electromyogram (EMG) measures the electrical activity of muscles at rest and during contraction. Nerve conduction studies measure how well and how fast the nerves can send electrical signals to the muscles. Carpal tunnel syndrome can reduce nerve signals to the muscles resulting in muscle atrophy (wasting) and weakness.

Electrodiagnostic tests are often done to confirm a diagnosis, especially if surgery is a treatment consideration. The physician carefully weighs the pros and cons of each test ordered. Are the results of the test going to confirm or rule out the provisional diagnosis? Will the results of the test change (in any way) the treatment decision(s)?

If the answer to these questions is no, then there may be no need to add inconvenience, delay, discomfort, and cost in making a diagnosis.

Reference: 

Brent Graham, MD. The Value Added by Electrodiagnostic Testing in the Diagnosis of Carpal Tunnel Syndrome. In The Journal of Bone & Joint Surgery. December 2008. Vol. 90A. No. 12. Pp. 2587-2593.

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