Houston Methodist. Leading Medicine

Hand FAQ

Question:

I saw a doctor for numbness and tingling in my fingers that I thought might be carpal tunnel syndrome. After that examination I was sent to a physical therapist for more tests. Wouldn't it be easier to just do an MRI or some medical test instead of all the poking and prodding I went through?

Answer:

Some medical conditions aren't easily diagnosed with an X-ray, CT scan, or MRI. Carpal tunnel syndrome (CTS) is one of those problems. Sometimes it's caused by a medical condition such as a tumor, hormone imbalance, liver disease, or diabetes.

Once the doctor has ruled out a medical cause, it's time to look at posture, nerves, or muscles as the possible cause. Again, problems with these variables don't show up on imaging studies. Nerves can be tested using nerve conduction studies. Muscles can be tested with electromyography. Both of these tests can be uncomfortable and expensive.

In general, the rising costs of health care have pushed researchers to find ways to predict who's at risk for CTS. The next step is to reduce the risk by eliminating as many of the risk factors as possible.

A second step involves using a clinical prediction rule (CPR). Researchers help doctors find out which tests used in the clinic are the most reliable and accurate. There may be a CPR for each disease, illness, and condition. There may be one best test or a group of tests that give an accurate prediction.

You may have endured a variety of tests because a clear CPR for CTS isn't available yet. The first study on this topic was reported this year (2005). More studies will be done to verify the results.

LtCol Robert S. Wainner, PT, PhD, et al. Development of a Clinical Prediction Rule for the Diagnosis of Carpal Tunnel Syndrome. In Archives of Physical Medicine and Rehabilitation. April 2005. Vol. 86. No. 4. Pp. 609-618.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
All content provided by eORTHOPOD® is a registered trademark of Medical Multimedia Group, L.L.C.. Content is the sole property of Medical Multimedia Group, LLC and used herein by permission.

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