In order to diagnose carpal tunnel syndrome, your healthcare professional will ask you a series of questions about your symptoms. In addition, you may need one or more tests to determine if you have carpal tunnel syndrome.

The pattern of your symptoms is important in making a diagnosis of carpal tunnel syndrome. Most people have symptoms fall into one or more of these patterns:

• Symptoms usually occur while holding a newspaper, a phone, or gripping a steering wheel.
• Symptoms also occur while sleeping.
• Symptoms might even wake you from sound sleep with a feeling of having to shake out your hand.
• Some people notice that numbness or pain is worse when they wake up in the morning.

Symptoms of carpal tunnel syndrome are most pronounced in the palm of the hand and the fingers. But the little finger is never involved. The most common initial carpal tunnel symptoms include:

• Numbness
• Burning
• Pain
• Tingling
• Itching
• Soreness

Eventually, shooting electric shocks, hand weakness, and hand clumsiness may appear. These are considered more advanced symptoms of carpal tunnel syndrome.

A proper evaluation by your healthcare professional can rule out disorders which cause similar symptoms. The most common disorders which can "mimic" carpal tunnel symptoms are:

• Thoracic Outlet Syndrome
  
• Tendonitis
• Rheumatoid Arthritis
• Radiculopathy
• Fibromyalgia
• Hypothyroidism
• Lupus
  

Your healthcare professional tests the feeling in your fingers, as well as the strength of the muscles in your hand. Three "provocative tests" (Durkan test, Phalen test, and Tinel test) are often used, which require pushing, tapping, and bending your wrist. In doing so, you can provoke carpal tunnel symptoms to temporarily appear or worsen.

You may need an X-ray of your wrist to exclude other causes of wrist pain. These are usually due to arthritis or a fracture. Thus, X-rays are used to rule out other conditions. They are not helpful in making a diagnosis of carpal tunnel syndrome.

An ultrasound of the wrist provides a picture of the nerves and tendons deep inside. This can help show whether the median nerve is being confined (or entrapped) and compressed.

Electromyography measures the small electrical discharges produced in your muscles. During this test, a thin-needle electrode is inserted into specific muscles of your hand to evaluate the electrical activity when a muscle contracts and rests. This test can identify damage to the muscles controlled by the median nerve. It can also rule out other conditions.

This is a variation of electromyography. It requires two electrodes taped to your skin. A small shock is passed through the median nerve to see if electrical impulses are slowed down in the wrist's carpal tunnel space. Slowing is a sign of nerve damage. This test can be used to diagnose carpal tunnel syndrome and rule out other conditions.

There are known risk factors for getting carpal tunnel syndrome. They can increase the probability of seeing symptoms many-fold. The major risk factors include:

• Having a family member with the disorder
• Being pregnant
• Being female
• Having diabetes, rheumatoid arthritis or lupus
• Obesity
• Smoking
• Working in hand-stressing jobs
• Having emotional stress
• Poor sitting posture

A number of disorders share similar symptoms with carpal tunnel syndrome. Therefore, in order to properly treat carpal tunnel, an accurate diagnosis is important. The diagnosis begins with your healthcare professional asking specific questions during a physical exam. Then you may require more specific tests including X-rays, ultrasound, electromyography, and a nerve conduction study.