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Step 1
First let's figure out if you have carpal tunnel syndrome. Carpal tunnel syndrome is caused by compression of the median nerve at the wrist. Classic symptoms include numbness and tingling in the thumb and first two fingers, possible weakness of the hand, changing in hand writing and pain (see the picture I included above). There are four common areas that can compress the nerve as it travels from the neck to the fingers. I will describe each below.
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Step 2
Is the wrist the problem area? Extend your wrist as far as it will go and hold that position for 30 seconds. Did you experience an increase in symptoms? Now flex your wrist as far as it will go and hold for 30 seconds. Did you experience an increase in symptoms? Finally, moderately press of the palm side of the wrist right in the middle using your opposite thumb. Did you feel pain, numbness, electrical sensations? Mark your answers on a piece of paper.
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Step 3
Is the problem in your forearm? There is a small muscle located on the inside of your forearm called the pronator teres. The median nerve run underneath this muscle. If the muscle is tight then it can place the nerve under pressure causing swelling. Locate the pronator teres by bending your elbow half way and measuring out 2" down. The pronator teres runs diagonally across the forearm (look up on google if you need more help locating the muscle). Press in with your opposite thumb using moderate pressure. The muscle should not be painful, tight and cause your carpal tunnel symptoms if it is normal. This is a common problem in people that use a hammer or screw driver for a living. Mark down whether this was a positive test on your paper.
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Step 4
Is the problem at your shoulder? Raise your arm above your head for 30-60 seconds. Did this produce the numbness and/or tingling in your hand? If so, then mark this as a positive test.
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Step 5
Is your neck involved? Extend your neck back gently and rotate your head to the side of your carpal tunnel symptoms. Gently apply a mild pressure downward on your head using your opposite hand. If you feel more symptoms into your arm or hand then mark this as a possible test.
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Step 6
The nerve that comes from the neck travels down through the shoulder and forearm then into the wrist. This nerve can be compressed anywhere along its length. If you have multiple areas that are positive then it is likely you are experience issue beyond simple carpal tunnel syndrome. I have often come across patients that have failed to respond to surgery because the nerve was compressed at multiple sites. It is important to educate yourself and ask plenty of questions before undergoing any medical procedure.
