Patient Self Diagnose Carpal Tunnel Syndrome - Everything You Need To Know - Dr. Nabil Ebraheim
ฝัง
- เผยแพร่เมื่อ 11 ม.ค. 2018
- Dr. Ebraheim’s educational animated video describes the condition of carpal tunnel syndrome - can the patient self-diagnose this condition?
Carpal tunnel syndrome is the most common type of nerve compression. It may affect from 1-10% of the population in some studies. Repetitive motion, vibrations, certain athletic activities and certain conditions can predispose to carpal tunnel syndrome.
Most common associated conditions of carpal tunnel syndrome:
•Diabetes
•Rheumatoid arthritis
•Pregnancy
•Hypothyroidism
•Advanced age
Carpal tunnel syndrome is a clinical diagnosis. In patients who have a clinical diagnosis of carpal tunnel syndrome based on the history and the physical exam, the electrodiagnostic tests did not change the probability of diagnosing this condition.
So the question is….. can you self-diagnose carpal tunnel syndrome?
These are the most common clinical presentations for carpal tunnel syndrome
Symptoms in median nerve distribution
•Nocturnal numbness
•Thenar atrophy or weakness
•Positive Phalen test
•Positive Tinel sign
•Carpal compression test
Symptoms in the distribution of the median nerve
•Pain and burning sensation
•Numbness and tingling in the thumb, index and middle finger. The small finger should not be affected (patient should not have any symptoms in the small finger). Any symptoms in the small finger are not associated with carpal tunnel syndrome. The little finger sensation is part of the ulnar nerve distribution. Ulnar nerve involvement is not a part of carpal tunnel syndrome.
•Self-administered hand diagram is extremely helpful (most specific test for carpal tunnel syndrome). The patient should highlight the areas where they are experiencing the symptoms.
Night symptoms
•Night symptoms is considered to be a good prognosis for the effectiveness of treatment.
•The patient will experience numbness, pain and paresthesia that is more prominent when the patient is asleep.
•This will wake the patient from sleep and the patient shakes the hand to try and relieve the symptoms.
Thenar atrophy
•The patient may experience weakness, clumsiness or thenar atrophy.
•Thenar atrophy means that there is a long-standing problem.
•Try to compare the affected hand to the other unaffected hand or even a friend’s hand or the hand of a relative.
Positive Phalen test
•Phalen’s maneuver is performed by flexing the wrist for 60 seconds.
•This will increase the carpal tunnel pressure temporarily and produce the symptoms.
•If the test is positive, the patient will have numbness and tingling in the hand and the wrist.
Positive Tinel sign
•This is a common provocative test for median nerve entrapment (indicates irritation of the nerve).
•Light tapping over the nerve at the carpal tunnel causing radiating paresthesia distally into the median nerve innervated digits is positive of carpal tunnel syndrome.
Positive compression test (Durkan’s test).
•The examiner places even pressure with two thumbs directly over the patients median nerve in the carpal tunnel for about 30 seconds.
•Reproduction of the symptoms such as pain, paresthesia an numbness in the distribution of the median nerve distal to the carpal tunnel means that the test is positive for carpal tunnel syndrome.
If the patient has at least three of these six clinical findings, then the probability of carpal tunnel syndrome is high.
Although the patient can probably self-diagnose carpal tunnel syndrome, it is critical for the patient to see their doctor to get a formal accurate diagnosis and to begin treatment. You also see a doctor because other conditions may mimic carpal tunnel syndrome.
The patient may have double crush syndrome. A patient with carpal tunnel syndrome may also have a second problem elsewhere in the course of the median nerve.
Symptoms of cervical disc herniation can also mimic carpal tunnel syndrome. C5-C6 is the most common level that is affected in the neck. The affected area in sensation is almost the same like carpal tunnel syndrome, however, the clinical examination by the doctor will show a herniated disc rather than carpal tunnel syndrome.
Proximal median nerve entrapment such as pronator teres syndrome can mimic carpal tunnel syndrome. In case of pronator teres syndrome, the palmar cutaneous branch of the median nerve is also involved. This nerve supplies sensation to the thenar eminence. In carpal tunnel syndrome, the patient does not lose the sensation on the radial aspect of the palm, however, in pronator teres syndrome, the patient will lose sensation on the radial aspect of the palm.
Martin-Gruber anastomosis is median to ulnar nerve communication in the proximal forearm. With Martin-Gruber anastomosis, the patient may present with atypical (not usual) examination findings.
In my opinion, self-diagnosing carpal tunnel syndrome is possible, but not advisable.
Follow me on twitter:
#!/DrEbraheim_UTMC
I wish I could find a doctor like you. My entire cervical vertebras are all herniated. For over 6 years now, both hands are numb, but the left hand's fingers that just don't work at all are the middle, ring and little finger. It feels like a tight rubber band is around them. Doing simple tasks are now impossible. Sometimes on both hands, the entire hand is numb. Went to a hand surgeon who took an x-ray and said nothing about surgery. All my digits are NOT ALIGNED. Thank you for all your work. It is very helpful.
Very helpful and clear. Thanks!
Excellent video, really helpful. I have obvious tendinopathy, but I wanted to look at this from other angles before seeing my doctor. It could be multiple things. ...The appointments with my GP are short, he can't know everything, and I've been under-treated & misdiagnosed for these reasons in the past. It works out a lot better if I've done my homework.
Very discriptive thanks a lot
This was very helpful. I have watched some of your other videos and you always explain things so clearly.
Thank you.I would like to know is there treatment process for 4th stage Parkinson's disease
Thank you so much. Very informative.
always good ...
So good many thanks
Very helpful. Thank you.
Good, thanks
This is really helpful, I have all the pains when doing the self test and all the side-effects, my consult thinks its my hands but the simple test for carpal tunnel showed up negative. I still decided to go for surgery privately.
What "simple test"are you referring to? EMG?
Thank you so much sir
Wonderful
Thank you doctor. You are much helpful.
Wonderful! very helpful for me! Thank you so much!
Sir i experienced this carpal tunnel syndrome and my palm in thumb finger the muscle not same n my right hand and i have also ganglion cyst in my left hand pls advice what i will do thnk u
You are helpfull
I did the carpal tunnel exercises and wrist stretches and they seem to work. I'm buying the roll on numb product. It's pretty cheap and known to work in 5 minutes.
Hi..can I ask..it isposible for the carpal tunnel to go up to the brain if it is done early..?
What to do
Sir, which doctor whom should we approach for this problem for treatment.Kindly guide.
what if all those test are negative..but im still getting numbness and tingling in thumb ..index and middle finger? what else could be causing it?
thank you.
Thank you so much for the treatment process for the carpel tunnel syndrome. It is very useful for me.
My ring finger is numb only at the INSIDE tip area. Cant see logically if its ulna or median nerve.
Yeah I just hope that surgery doesn’t affect performance I need it for my job can’t afford to have permanent stuff going on as a result including feeling and fumbling around it can be a great hazard if so. I was more curious what this surgery will do especially long term even though I know I’ll end up needing it just for a heads up because idk I’ll have to figure out everything with work then besides recovery that’s fine and one thing but like I said long term.
my pinky and index finger are numb and my fingers are weak, does not sound like CT, anyone know what it might be?
Me too, Goose, me too! Work up this morning with both hands pinkie and 4th finger in cramps & spasm - stayed that way for an hour. Meanwhile my left thumb is numb- what gives? Dehydration, hypocalcium levels, cervical disk impingement or all my doctors favorite lines " Old Age-- You're just wearing out, you and your joints!" Should I March to my orthopaedic surgeon? He had hoped not to see me for a checkup for 6- 8 months at least. It is weird the things that happen, right?
هل من مترجم للعربية (ملخص الفيديو ) ؟
All my for gers go .numb o my right hand .and I drop thing use my eyes to see what I am doing g.and it goes up my arm
MERSI BEAUCOUP DR NABIL
I am not getting any symptoms doing the 3 tests, and the pain doesnt wake me. I do have a pain in the neck too. I do get tingling in the palm and first three fingers but not the ring finger. The pain in the neck coincides with the tingling.
Neck or shoulder issues can/will give you the effects of carpal tunnel.
You were very helpful thank you doctor
What to do I had it for 2 months
See a doctor
I had to for mine unfortunately 😞
When I had this problem, I was in extreme pain during the night and it would wake me up. The operation was done and I was able to go home after a few hours. Very little post operative pain and tried to rest it until the stitches came out.
Like how much time operation take to complete ?
@@anmol098thind I think about an hour
@@karenax254 and how much it cost
@@anmol098thind. I had medical insurance
Thank you doctor
Pain in wrist
consult an Ayuredic doctor
i suffer for 6 months cant sleep well😭😭😭
So, have your symptoms improved? I have just been diagnosed with CTS.
Regular X-rays won't show anything as far as CTS.
Not even an MRI, will Help.
The best Exam that will help is getting an EMG test.
I'm am not a Doctor, nor Am I practicing medicine on Anyone. But, that is what my Orthopedic Dr. is Requesting, an EMG. It's an Electrical Exam of Your "Continuity" of your Nerves in your hand.
They measure the amount of "Electrical Signals going through your medial Nerve.
Depending on The electrical signals passing thru your Carpel Tunnel, will determine the Compression of nerves.
Hope you get a Competent Dr.
@@victorm9283 Good luck with you studies.
❤
With whom to consult for this
Neurologist or orthopaedic
Workers comp in my case was maxed out with ace-puncture, ice/heat treatments, massages and the such before a single shot of cortisone cured me within 24 hours.
How long did the shot last? I just had one a week ago.
@@nyniceguy1318 It has been about 8 years and it never came back - I guess in my case it was a cure.
I cant afford to see my doctor
Meanwhile the government is giving billions and billions of dollars away to foreign countries.
@@willrobinson9575 facts
Brain naughty naughty
I have same problem, but I don't know what he says, any body please translate in Tamil language
Pls send madicne
ق
great info, but next time can you please speak a little faster? almost to slow for me to listen to, ADHD sorry no disrespect to you
You can change the speed setting on youtube. I find it really helpful because everyone speaks at different speeds.