Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Expect your doctor to perform several simple carpal tunnel syndrome tests to evaluate the nerve function of your hand. You can also perform a few of these tests at home.
Your doctor will most likely start with a visual and manual inspection of your hand looking for any obvious abnormalities that may help to explain your problem.
Range of motion of the wrist is often evaluated. By placing the palms of the hands together, wrist extension can be evaluated. By placing the backs of the hands together, wrist flexion can be evaluated. People who have had prior wrist injuries or wrist arthritis often have abnormalities in wrist range of motion.
The sensation over your hand will often then be checked to see if your sensation of soft touch, pinprick, or
two-point discrimination (the ability to feel two points distinctly using a sharp pin on the fingertips) is abnormal in any areas.
The strength in your hands and fingers can be checked, often using your opposite, or good side, for comparison.
Physical tests to evaluate for carpal tunnel syndrome include the following:
Hold your elbows at shoulder level and place the backs of your hands together with your wrists bent at 90 degrees.
Hold this position for 60 seconds.
This position increases the pressure on the median nerve.
If the test reproduces or worsens your symptoms (pain and tingling in your hands), you may have carpal tunnel syndrome.
Have someone hold your wrist as shown in the picture and tap on the palm side of your wrist.
A positive test produces tingling into the thumb, index, or middle fingers. This is a sign of an irritable nerve where the tapping was done.
If this test gives you tingling in your thumb, index, or middle fingers, you may have carpal tunnel syndrome.
You may also be referred to a specialist (neurologist, rheumatologist, or orthopedic surgeon) for evaluation of your nerve conduction or the presence of possible arthritis leading to carpal tunnel syndrome. Nerve conduction testing measures the speed with which an electrical impulse travels in the median nerve across the wrist. For people with carpal tunnel syndrome, this nerve impulse will travel more slowly across the wrist than normal. For people who have advanced carpal tunnel syndrome, measurements of electrical activity in the hand muscles may reveal signs of muscle deterioration.
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