Facts on The Carpal Tunnel Compression Test

The carpal tunnel compression test (also known as Durkan's test) is a test with a 90% sensitivity and specificity, which mainly means that it is a highly reliable test for carpal tunnel syndrome. The test is done by merely compressing the carpal tunnel for 30 seconds by the thumbs. When the test produces the same symptoms as those of carpal tunnel syndrome, it is a huge indicator for irritation and damage of the median nerve.

Carpal Tunnel Syndrome is a medical condition known as the damage and irritation of the median nerve or median neuropathy. The median neuropathy is often caused by various conditions that may lead to a carpal tunnel that is altered in position or swollen. If you don't know what a carpal tunnel is by the way, it is the tight space located between the band of fibrous tissue enclosing the wrist and the joint bone. The carpal tunnel is where the median nerve runs through. Hence, if the carpal tunnel is inflamed, it will most definitely lead to a compressed or pinched median nerve.

The symptoms of carpal tunnel syndrome usually include a tingling and numbing sensation on the hands and fingers. It may also be accompanied with pain shooting from the hands towards the upper arms, shoulders and neck. Muscle weakness and atrophied muscles can also be associated with carpal tunnel syndrome although these symptoms are typically those with more serious cases. There are numerous causes that have been known to predispose and exacerbate carpal tunnel syndrome. Contrary to most people's beliefs, CTS isn't acquired just by repetitive movements of the hands and wrists such as typing. Several medical conditions including obesity, pregnancy, rheumatoid arthritis, diabetes mellitus, hypothyroidism, leukemia, multiple myeloma, acromegaly, tumors, lipoma and trauma to the wrist area. There are other rare medical conditions that can also cause carpal tunnel syndrome including the double crush syndrome, the parvovirus b19, gene mutations in SH3TC2 and Colles' fracture. Nevertheless, carpal tunnel syndrome is still described as an idiopathic condition as of the present.

The carpal tunnel compression test comes in during the diagnosis phase. Usually, patients come in complaining of the sensation and pain they feel along their hands, wrist, arms, shoulders and neck. The physician may be suspecting CTS but will still need to perform various examinations to confirm that. Primarily, the physician will conduct a physical exam of the hands, wrists, arms, shoulders and neck to look for other conditions that may have triggered the symptoms. The physician will also perform other tests including the Phalen's maneuver, the Tinel's sign, Durkan test and carpal tunnel compression test. The Phalen's maneuver is done by flexing the wrist in a 90 degrees position as farthest as it could go. The result indicates a positive test when the maneuver invokes the same symptoms as those of the carpal tunnel syndrome. This has a test sensitivity and specificity of 80%. On the other hand, the Tinel's sign is done by tapping the median nerve at the carpal tunnel in the wrist and the volar carpal ligament. The Tinel's sign has a test sensitivity of 70% and a test specificity of 90%. The last and definitely the most reliable test for carpal tunnel syndrome, is the electromyelogram (EMG). This test is utilized to measure the rate of speed of the impulses sent from the brain towards the muscles of the extremities and back.

People with carpal tunnel syndrome have slower electrical impulses compared to those without the medical condition. Armed with the test results and the patient's initial complaint, the doctor will usually diagnose CTS.

The treatment for carpal tunnel syndrome is usually started with rest, immobilization and application of cold compresses. The cold compress reduces the swelling while immobilizing the affected area will help avoid further damage of the median nerve. Most of the time, the physician will prescribe painkillers to get rid of the pain and discomfort commonly associated with carpal tunnel syndrome. There are analgesics, non-steroidal anti-inflammatory drugs (NSAIDs) and narcotics that can help ease the pain. For more permanent solutions, a surgery called carpal release surgery can also be recommended. This surgical method is done by widening the carpal tunnel through incision, allowing the median nerve to be free from compression. This surgery has been proven effective and there have been little complaints of recurrence amongst patients who have undergone the said procedure.

It's not easy thinking about whether you might have carpal tunnel syndrome or not. The carpal tunnel compression test is a test you can do on your own and can help you determine whether you may need to visit a doctor or if it's merely stress talking.