July 17, 2018

Three Tests for Carpal Tunnel Syndrome

John Bracey, M.D., hand surgeon with the UAMS Department of Orthopaedic Surgery, said that carpal tunnel syndrome affects 2.7 percent of the population and nets 500,000 surgeries a year in the United States, estimated to be a $2 billion annual impact.

Bracey spoke to family medicine providers at the 40th Annual Family Medicine Intensive Review Course last May, covering how providers can test for carpal tunnel and how to manage it.

A few tests he recommended were:

Tinel’s sign (lightly tapping over the nerve to see if it generates a tingling sensation)

Phalen’s test (pushing the dorsal surface of hands together and holding 30 – 60 seconds)

Carpal Compression Test (Apply pressure with thumbs over the median nerve within the carpal tunnel, located just distal to the wrist crease. The test is positive if the patient responds with numbness and tingling within 30 seconds.)

If the patient shows signs of carpal tunnel syndrome, the provider can conservatively manage with a neutral wrist brace (helpful during sleep), stretching and exercises, ergonomic interventions or steroid injection.