How To Test For Carpal Tunnel
The carpal tunnel consists of four bones – scaphoid (at the bottom), lunate (in the middle) and 2 pieces of cartilage called tendons which pass through a narrow channel in the palm side of the hand.
In this article we’re going to talk about how to test for carpal tunnel syndrome, what causes it and how to treat it.
Carpal tunnel syndrome has become common among people who work on their computers all day long. It’s estimated that up to 10 percent of computer users are affected by it. It usually begins between the ages of 30 and 40, but can develop at any age. Women seem more susceptible than men.
Symptoms include pain or burning sensation along the thumb side of the median nerve under the skin where the muscles meet the bone. This may be followed by weakness of grip strength, loss of fine motor skills and eventually muscle wasting around the thumb area. Pain often spreads from the thumb into other parts of the arm. Some patients experience severe pain in both arms.
There are three types of tests used to diagnose carpal tunnel syndrome. One is the Phalen’s sign test, another is the Tinel’s test and the third is the Lasegue’s test. These are described below.
Phalen’s Sign Test
Dr. Morton Phalen was an orthopedic surgeon who first identified carpal tunnel syndrome back in 1887. He noticed that some of his patients had symptoms such as weakness, numbness and tingling in the thumbs when they held the palms up against each other. When he did this himself, he felt no discomfort. So Dr. Phalen concluded that these patients must have carpal tunnel syndrome. His method was later modified by Robert S. Teale, M.D., whose name became associated with the test.
Here’s how the Phalen’s sign test works: First, ask the patient to place his/her hands behind his or her ears and then spread them out so that the fingertips point toward the ceiling. Next, move one hand forward until its fingertips touch the other hand. While keeping the hands close together, rotate both the right and left forearms outward 90 degrees. Then slowly straighten the bent elbows while still holding the hands close together. If the patient feels numbness or pain, carpal tunnel syndrome could be present. After repeating this procedure with the opposite hand, the doctor should compare the results.
Robert S. Teale, M.D., developed the Tinel’s test after noticing that there were cases of carpal tunnel syndrome among athletes who played football.
To perform the Tinel’s test, you need to find the carpal tunnel deep within the forearm just above the elbow. Place your index finger about 1 inch behind the elbow joint and feel if there’s a small click. If there is, the result indicates carpal tunnel syndrome. Now hold your pinky finger over the carpal tunnel opening and apply firm pressure. Feel if there’s a dull ache over the carpal tunnel. If there is, carpal tunnel syndrome is definitely present. Repeat this procedure several times to make sure you’ve found the exact spot where the median nerve is located.
Jean Francois Maurice Jean Pierre Lasegue, M.D., published his findings in “Die Handchirurgie” in 1903. The Lasegue’s test is performed only on the dominant hand.
After washing your hands thoroughly, hold your fingers wide apart and look at the second knuckle. With your eyes closed, turn your head slightly to the right. If you see a white flash in your eye, you probably have carpal tunnel syndrome. The problem occurs because turning your head causes your gaze to shift across the visual field to the same side, thus temporarily blocking vision. Try again using different directions of gaze.
Now place your fingertips on top of your closed eyelids and keep them there. Your eyes should remain open. Make sure your head remains stationary. Slowly lower your chin until your forehead touches your chest. Hold this position for about 5 seconds. Then raise your head gently without moving your body. You should notice that your face turns pale and that your eyelids flutter. This means that you have blocked the carotid artery, possibly causing a stroke. In most cases, however, this happens only during the actual test and not afterward.
If you think you might have carpal tunnel syndrome, consult your physician immediately. There are many treatment options available today including surgery, splints, braces and medications. Most doctors recommend physical therapy before resorting to invasive procedures such as those mentioned above. Physical therapy aims to improve the function of the nerves, muscles and joints involved.
You can help prevent carpal tunnel syndrome by taking breaks every 20 minutes or so to stretch your hands and wrists. Also, use a good ergonomic keyboard, mouse and chair. Wrist supports made of foam or rubber can also provide relief. Use gloves whenever possible. Finally, wear comfortable shoes with low heels.
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