CNS’ AANEM Accredited EDX Lab provides state-of-the art testing to evaluate the peripheral nervous system through needle electromyography (EMG) along with motor and sensory nerve conduction studies, which is valuable for assessing suspected carpal tunnel syndrome.

What is the Carpal Tunnel?
The carpal tunnel is a space located in the wrist area and is subject to compression. The median nerve passes through the carpal tunnel. Repetitive hand and wrist movement is thought to contribute to the compression. 

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome, which can be identified as a specific nerve injury, often starts by tingling and numbness in your fingers or hand. This can be a minor tingling or feel like an electric shock. The sensation may be localized in your hand, or could travel up your arm depending on severity of your condition. Some patients report this tingling or numbness in their hands as constant, while others may only experience it while holding objects. 

A common sign of carpal tunnel syndrome is when symptoms only affect the thumb, index, middle, and sometimes ring fingers, leaving the little finger unaffected.

Aside from tingling and numbness, some patients report hand weakness. This can be found in more advanced cases of carpal tunnel syndrome. This may be reported as difficulty lifting items, dropping items from closed hand, reduced grip strength.  Some cases can include muscle atrophy.

What causes Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome can be caused by pressure or irritation on the median nerve as it runs through the carpal tunnel space from your wrist to your hand. The median nerve is responsible for transmitting nerve signals on the palm side of your hand, and controls your thumb and first three fingers.

While CTS is the result of problems inside the carpal tunnel passage in your wrist, the root causes of damage to this area can vary. Repetitive motions can cause swelling. Wrist fractures or breaks can cause the tunnel to heal abnormally, constricting the space reserved for the median nerve. Rheumatoid arthritis and certain other conditions can also result in inflammation inside the carpal tunnel space creating pressure on the median nerve. Anything that may cause pressure, inflammation, or deformation of your hand might result in a flare up for carpal tunnel syndrome.

How is Carpal Tunnel Syndrome diagnosed?

Electrodiagnostic evaluations have the following components to help diagnose carpal tunnel syndrome: taking a focused neuromuscular history and physical exam; a differential diagnosis based on the history and physical; and testing of the nerves and muscles with EDX studies, such as nerve conduction studies and needle electromyography; then determination of a final diagnosis.

According to ²American Academy of Neuromuscular & Electrodiagnostic Medicine (AANEM):

Many patients are referred with merely symptoms and/or clinical findings and there is an expectation that the EDX physician will be able to arrive at the correct diagnosis only after the completion of the EDX evaluation.

Electrodiagnosis (EDX) is valuable is assessing the function and structural integrity of the peripheral nervous system. An extension of the clinical examination and has the following components, including nerve conduction studies (NCS), electromyography (EMG) and special testing, such as neuromuscular junction, etc.).

EDX testing does not always establish an etiologic diagnosis.

How is Carpal Tunnel Syndrome treated?

Treatment begins by speaking with your healthcare provider about your symptoms and treatment options. Carpal tunnel treatment often starts with nonsurgical treatment options. These may include:

• Over-the-counter pain relief medications
• Physical therapy
• Changes in your routine
• Wrist splints
• Steroid injections

If nonsurgical treatments for carpal tunnel syndrome do not have the desired outcomes, then your healthcare provider may suggest other surgical options.

About CNS

At CNS, our team of Board Certified Neurologists in Las Vegas are experienced in electrodiagnostic medicine (EDX) evaluations. To learn more about what to expect during your EDX Study appointment visit our Electromyography Lab.

References

¹ Dumitru, Daniel and Anthony A. Amato and Machiel J. Zwarts.
Electrodiagnostic Medicine, 2^nd Ed., Hanley and Belfus, 2002
²American Academy of Neuromuscular & Electrodiagnostic Medicine.
The Utility of EMG and NCS in Traumatic Nerve Injury. AANEM slides, 2016.