Lets take a look at what clues you can look for before you go to your chiropractor, PT, or medical doctor. I’ll also show the top FIVE signs I look for when diagnosing carpal tunnel syndrome in my office.
What are the Signs or Symptoms of Carpal Tunnel Syndrome?
Examining the signs and symptoms you’re experiencing is the best way to figure out if your have carpal tunnel syndrome. The good news is that the signs and symptoms of carpal tunnel are rather predictable so there’s a lot of things you can look at at home before you go to the doctor. Here’s a brief list of the most common signs and symptoms of carpal tunnel syndrome as well as some factors that make you more likely to have it:
- Paresthesia (tingling or abnormal sensation) in the first 3 1/2 fingers of the palm on the thumb side which especially bothersome at night. This is really the number one symptom you’re going to have and is prevalent in 77% of patients with carpal tunnel syndrome.
- Pain in the palm of your hand, your fingers, your wrist, and sometimes your forearm or elbow.
- Your symptoms are worse with gripping activities like driving, picking up your drink, or holding your phone.
- The affected hand is starting to become weak when you’re performing simple tasks.
- You’re over 45 years of age.
- Shaking your hands out relieves the discomfort briefly.
- You have a history of cardiovascular disease.
- You work at a desk or computer for most of your workday.
Although this list is not exhaustive, it’s a good place to start. If a few of those bullet points apply to you then your discomfort may likely be carpal tunnel syndrome. Remember that this isn’t enough to arrive at the diagnosis, that takes some other tests your chiropractor, PT, or medical doctor can do in their office.
My Top FIVE Signs You May Have Carpal Tunnel Syndrome
Some of the above factors are more indicative of carpal tunnel than others, so let me show you my top five signs you may have carpal tunnel syndrome. Go through this list quickly and watch the video which should be helpful. In order to nail it down, I’ll typically do a number of orthopedic tests if you come to the office, but I initially look for these 5 important factors to narrow down my diagnosis list.
Here are the 5 signs of carpal tunnel syndrome that I use to diagnose this condition in my office:
- You have a positive “Flick Sign.” This means that if you shake your hands vigorously for a few seconds it reproduces or relieves your symptoms.
- You have a wrist thickness to width ratio of greater than 0.67. To figure this out you simply measure your wrist thickness from front to back and width from side to side. Put them in a ratio and use a calculator to divide. The video is helpful in showing you how to do this.
- You’re 45 years of age or older. This one is pretty self-explanatory, but the condition is more common in those in this age range.
- You have decreased sensation on the palmar side of your thumb when compared to your thenar region, the meaty muscular portion of your thumb. You may have symptoms in both areas with CTS but if it’s more decreased in your thumb then this sign is positive.
- You score a 1.9 or higher on the Boston Carpal Tunnel Syndrome Questionnaire. This questionnaire is free, and I’ll post it below. You simply take the mean (average) of the numbers you circle when answering it. Try the Boston Carpal Tunnel Syndrome Questionnaire here.
Check out my video on how to assess for the 5 signs you might have carpal tunnel.
What Else Can Cause Similar Symptoms to Carpal Tunnel Syndrome?
The symptoms of carpal tunnel syndrome are ultimately not super unique and other conditions or injuries can cause similar like complaints. Here is a list of other common conditions, with short descriptions, that can cause similar symptoms.
- Cervical radiculopathy (commonly referred to as a pinched nerve) – This condition develops when there is a problem with the nerve roots of the neck, especially in the C6 and C7 nerve roots. When they’re irritated, typically by a cervical disc or degenerative changes, they can also cause paresthesia in the hand. If you have neck pain or your hand and wrist symptoms are irritated with neck movements, then this is more likely the condition causing your discomfort.
- Brachial plexus injury – The brachial plexus is a bundle of nerves formed by some of your cervical nerve roots. Compression or traction injuries of the brachial plexus can cause symptoms in the arm that feel like they’re related to a nerve. Many times this condition has a neck pain or shoulder pain symptom as well.
- Cervical myelopathy – This condition usually happens when there a disc in your neck, changes in the bone of your vertebrae, or a space occupying lesion affecting your spinal cord. There is unique exam that we can do to rule this condition out as a cause of your symptoms. This is more likely if you’re having carpal tunnel symptoms in both arms and is a more serious condition than any of the others conditions mentioned.
- Median nerve neuropathy – The median nerve is involved in carpal tunnel syndrome, but in this condition it’s getting irritated or compressed in a different spot. This typically happens in the meaty part of your forearm and you’ll notice tightness and pain in the area just below the front of your elbow.
This is where you definitely need to have a healthcare provider step in and determine whether it’s carpal tunnel or not that’s causing your symptoms.
All of these problems that can mimic carpal tunnel involve nerves, so it’s not a good idea to wait and simply hope they’re going to go away. I’ve seen all of these conditions in our chiropractic practice before, and some of them I will treat while others I will refer to a neurologist or orthopedic MD.
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