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Simple Tests for Carpal Tunnel Syndrome

Medical costs continue to rise at a rapid rate. Cases of carpal tunnel syndrome (CTS) aren't helping matters. Researchers are looking for ways to diagnose problems like CTS using clinical tests instead of expensive medical studies. This is called a clinical prediction rule (CPR).

One way to do this is to compare the results of clinical tests with medical studies and see if the outcomes are the same. In this study patients with CTS were given nerve and muscle tests (nerve conduction velocity and electromyography).

After a brief rest, the patients were tested by two different physical therapists (PTs). The PTs gave standard CTS tests used to test for nerve compression. A total of 21-items were tested. Four tests combined with the patient's age (over 45 years) were found to be predictive of CTS.

The most helpful sign was the flick sign. The patient shakes his or her hand and the symptoms go away. The simple question, "Do you have trouble with fumbling or dropping objects from your affected hand?" was also predictive of CTS. The two most commonly used tests (Phalen's test and the Tinel sign) were not diagnostic of CTS.

This study was the first step in finding a CPR for the diagnosis of CTS. More study is needed to verify the findings of this study before it can be used on a regular basis.

References: LtCol Robert S. Wainner, PT, PhD, et al. Development of a Clinical Prediction Rule for the Diagnosis of Carpal Tunnel Syndrome. In Archives of Physical Medicine and Rehabilitation. April 2005. Vol. 86. No. 4. Pp. 609-618.

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