Which symptoms aid in the diagnosis of carpal tunnel syndrome

Which symptoms aid in the diagnosis of carpal tunnel syndrome?

  • Pain, paresthesias, or numbness worse at night or during activities that maintain wrist extension or flexion (e.g., driving) or require repetitive wrist motion
  • Shaking, wringing, or flicking motions of the hands to relieve symptoms
  • Numbness often involving only partial median nerve innervation (e.g., thumb and index finger) rather than entire first three and one-half digits. Pain but not numbness may occur above the wrist.
  • Symptoms of intermittent hand weakness before overt weakness of thenar muscles and lateral lumbricals
  • Provocative tests such as Tinel’s sign, Phalen’s sign, and reverse Phalen’s sign lack sufficient sensitivity and specificity to be reliable in the clinical setting. The gold standard remains electrodiagnostic confirmation.
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