Structural bony alterations of the carpal tunnel, such as old fractures or congenital defects. Neuropathic medical conditions such as diabetes, alcoholism, rheumatoid arthritis, and gout. Wrist size and shape. The gold standard in diagnosing CTS is the nerve conduction test. The conduction rate of an electrical impulse is measured between the forearm and the hand.
Nerve damage is indicated if the nerve conduction is slower than normal.
A simpler method is the Phalen's test, in which the wrist is flexed for 60 seconds. If a person has CTS, the increased pressure in the carpal tunnel will cause symptoms of pain and tingling in the affected fingers. Treatment Effective treatment must include identifying and eliminating the conditions that caused the problem, not just treating the symptoms. It is critical that the person with CTS cease to work in positions that irritate the wrist. When conservative treatment is not effective, the person with CTS may require carpal tunnel surgery.