Despite being the most common entrapment neuropathy (pinched nerve) in the extremities, a gold-standard test for diagnosing carpal tunnel syndrome (CTS) has yet to be established. In part, this is due to how the symptoms develop from patient to patient, as well as the presence of other conditions that can result in a similar collection of symptoms. So when a patient presents with suspected CTS, how does their doctor of chiropractic determine if it’s CTS or something else?
The most useful starting point is a review of the patient’s history, which can reveal factors that point to the possibility of carpal tunnel syndrome, such as a job that requires forceful gripping of heavy tools. On the other hand, if a patient has a history of neck pain or whiplash, then it would make sense to evaluate the neck as a possible source of median nerve entrapment or the history may point to potential contributing factors, such as hormonal issues, that may require co-management with another healthcare professional.
Patients may also complete a CTS-specific questionnaire to collect data on the symptoms they’re experiencing, the location of the symptoms, and the intensity of the symptoms (typically on a 0-10 scale where 0=no pain and 10=excruciating pain).
The subsequent examination will follow the course of the median nerve to determine if there is pressure on multiple sites. At this point, a doctor of chiropractic may have a fairly strong suspicion on what is causing the patient’s symptoms, and he or she can formulate a treatment recommendation.
However, if the case is complicated, the patient may be referred for more advanced testing—like electrodiagnostic testing—to confirm the diagnosis. Because these tests can be unpleasant and painful to the patient and there is up to a 34% possibility for a false positive, it may sometimes be more useful to inform a diagnosis rather than as the initial means to make a diagnosis. This was confirmed by a 2018 study that concluded that electrodiagnostic testing is not a reliable screening method for determining the severity of CTS.
During the course of care, patients may also be asked to complete short assessments, such as the Boston CTS Questionnaire (BCTSQ) that includes eleven questions (scored 1-5 for “normal” to “very severe”) for symptoms and eight questions for function (scored 1-5 for “no difficulty” to “cannot perform the activity at all due to hand and wrist symptoms”). Not only does this information help track a patient’s progress to determine if the treatment plan needs modification but it can be used to prove “medical necessity” to the patient’s insurance company.
So, if you are experiencing wrist pain, numbness, hand weakness, and carpal tunnel symptoms and you type in pain management near me, you may find Coast Chiropractic Centers with Dr. Timothy Harcourt, me, comes up.
You may wonder, “Do I need an MRI scan of my neck or wrist.”?
What is carpal tunnel syndrome?
You may have a “funny feeling like a numbness frequently called paresthesia. Even a handshake may be painful or weak. Some people have prescribed chemicals that may temporarily reduce the numbness but not fixing the problem. The numbing in the fingers can be annoying and even debilitating.
Also, if you feel arm pain it may indicate things are getting worse and may indicate a bulge on the disc or worse yet a herniated disc in your neck. Persistent or worsening pain intensity and/or frequency necessitates a visit to see a professional.
Call me, Dr. Tim Harcourt, at (239) 278-3344 and mention this article for an awesome discounted first visit to include history, exam, and adjustment or Class IV high-intensity laser treatment
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