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Nerve Conduction Test For Carpal Tunnel

by Lyndon Langley
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Nerve Conduction Test For Carpal Tunnel

Nerve Conduction Test For Carpal Tunnel

Tests for carpal tunnel syndrome can seem intimidating when you’re reading about them on medical websites or looking at the long list of symptoms that go along with it. But they don’t have to be scary; they just need to be explained clearly so that you understand their purpose. And once you know what those tests are designed to do, you’ll feel more comfortable having them done.
Electrodiagnostic testing (electromyography) usually consists of three parts — sensory examination, motor evaluation, and nerve conduction studies. The first part is called an electro-myogram (EMG), which measures muscle activity. The second part is an electroneurograph (ENG), which records from the nerves. Nerves carry messages between different areas of the body and help control muscles. The third part is a neurograph, which uses electricity to measure how quickly signals travel within the nervous system.
The EMG portion of this process checks the function of both arms and legs. It’s important because one side could be affected without you realizing that there is even a problem. If both sides look normal, however, then the results of the test will show no abnormalities. Afterward, you’ll get instructions for how to perform the ENG portion of the exam. During this part, you lie down comfortably while hooked up to several wires. You’ll also be asked not to move as much as possible.
During the actual procedure, you won’t notice any discomfort. Two electrodes are placed on your skin where the median nerve runs under your wrist. These are connected by wires to another set of electrodes attached to your torso. An electric current is sent through these wires and travels down the length of the nerve until it reaches the hand. Once the current hits the nerve, it causes it to fire off an impulse. This creates a tiny voltage difference across the area of the nerve being tested. When the current leaves the area, it creates a minute change in potential. This change is measured using sensitive equipment. The faster the signal moves, the smaller the change becomes. In order for the current to hit the right spot, the delay has to be less than 1 millisecond. Anything over 2 milliseconds means that the probe isn’t touching enough tissue to pick up the correct information.
By measuring the amount of time it takes for the current to pass through the nerve, doctors can determine whether or not carpal tunnel syndrome exists. There are actually multiple ways that a doctor can use this data. One method involves comparing the results of the test before surgery to the ones after the surgery. Another way is to compare the results of someone who doesn’t have carpal tunnel syndrome to those who do. Doctors can also use postoperative data to find out if the surgery was effective.
So exactly why does this test help us figure out if we have carpal tunnel? Find out on the next page.
A nerve conduction study is similar to an EMG, but instead of checking your entire body, it only checks the median nerve running underneath your wrist. The nerve controls many of our movements, including breathing, speaking and moving our hands. Because of this, it’s very important that the nerve works properly. So if you’ve had a hard fall or been diagnosed with diabetes, this test may reveal problems with the nerve.
Testing Your Wrist
To conduct a carpal tunnel nerve conduction test, you must make sure that your wrist is clean, dry and free of dirt and cuts. All jewelry should be removed, except for a watch or bandage. Next, the examiner will place gel pads directly beneath each arm pit to keep you from sweating. They apply a drop of numbing medicine onto the pad before doing this, though.
Once everything is ready, he or she will explain what is going to happen. Then, he or she will ask you to raise your left elbow above your head while keeping your forearm straight. He or she will then wrap tape around the underside of your wrist just below the thumb. The tape will hold the electrode firmly in position. Now, he or she will attach the leads to the machine via wires. As soon as these connections are made, the machine will send a quick jolt of electricity into the median nerve.
You shouldn’t feel anything during this part. However, you might hear a slight clicking sound coming from the machine. The noise occurs whenever the current is passing through the joint connecting your wrist to your fingers. That clicking tells the technician that all is well. After a few seconds, the machine will stop sending shocks and remove the leads from your skin. It will take about 30 minutes for the test to be completed.
Now that you know what carpal tunnel is, what types of treatments exist and how the test helps detect carpal tunnel, read on to discover how the treatment itself typically goes.
Carpal tunnel treatment options include rest, splinting, steroid injections and surgical decompression. Surgical decompression is generally reserved for patients who fail conservative therapy. Decompressing the tunnel itself relieves pressure on the median nerve, allowing it to recover much quicker. Surgery may require general anesthesia and hospitalization. Recovery times vary depending on the type of surgery performed.
Procedure Overview
There are four main steps involved in treating carpal tunnel:
1. Exam – The physician performs a thorough physical examination to check for signs and symptoms of carpal tunnel. He or she also examines both forearms to make sure that nothing else appears abnormal.
2. Tests – Electrodiagnostic tests are performed to determine if carpal tunnel is present.
3. Diagnosis – Based on the results of the tests, the physician determines the presence of carpal tunnel.
4. Treatment – Depending on the severity of the disease, there are various treatment options available.
When receiving care for carpal tunnel, it’s best to choose a specialist. Many physicians have varying training backgrounds and techniques. Only a trained health professional should administer injections or prescribe medications. Ask your pharmacist, nurse practitioner or family physician any questions you may have regarding your specific situation.
Next, we’ll discuss some common misconceptions about carpal tunnel.
If you think that carpal tunnel syndrome is caused by poor hygiene, you’d probably be surprised to learn that there are people who suffer from this problem yet never develop symptoms. One theory suggests that bacteria build up in the joints causing the fluid buildup needed for inflammation. Other researchers believe that excess moisture may cause the formation of fungus, leading to infection. Whatever the case, good hygiene definitely reduces the chances of developing carpal tunnel.
Finger squeezing exercises and repetitive motions like typing may aggravate carpal tunnel symptoms. Avoid activities such as playing piano, tennis, golf, bowling, gardening and working with your hands. Try wearing gloves when performing any repetitive tasks. Also, avoid driving too often. Driving puts extra stress on your wrists, especially if you drive fast or frequently.
Some people confuse carpal tunnel with cervical radiculopathy. Both involve compression of the carpal tunnel, but only carpal tunnel is associated with pain. Cervical radiculopathies occur in the neck and upper back regions. Symptoms include tingling, numbness, burning sensations or weakness in the limbs.
Carpal Tunnel Syndrome Myths
Myth #1: Carpal Tunnel Is Caused By Poor Hygiene
Fact: Carpal tunnel syndrome is not contagious. Most cases of carpal tunnel are due to tight muscles surrounding the wrist as well as pressure from swollen tissues.
Myth #2: Carpal Tunnel Can Be Treated With Rest
Fact: Although rest may relieve symptoms temporarily, it can lead to further injury. Swelling increases when blood vessels dilate, making the tendons and ligaments looser. Without movement, this weakens the supporting structures of the hand.
Myth #3: Steroid Injections Relieve Pain From Carpal Tunnel
Fact: Steroid injections provide relief for short periods of time, but they rarely solve the problem completely. They also have the potential to irritate surrounding tissues.
Myth #4: I’m Immune To Carpal Tunnel Syndrome
Fact: Carpal tunnel affects everyone differently. Some people experience severe symptoms, others barely notice symptoms at all.
Carpal Tunnel FAQs
Q: What happens during a carpal tunnel nerve conduction test?
A: First, the patient lies flat on his or her stomach. Two metal plates are taped to either side of the waist, just below the rib cage. Leads are taped to the chest, and leads are taped to the wrist. Current flows through the wrist to the hand.
Q: What does the “click” mean?
A: Clicking sounds are created whenever the needle punctures the bone. It’s a sign that the test is successful.
Q: How long does the test last?
A: The whole test lasts about 30 minutes.
Q: Will I faint during the test?
A: No. Anesthesia is administered beforehand to ensure that you remain calm throughout the test.
Q: Does it hurt?
A: Not unless you pull against the needle. Otherwise, it feels like it would if you were getting a tattoo.

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