Carpal tunnel syndrome is defined by numbness and tingling in the median nerve distribution, nocturnal exacerbation of symptoms, and positive provocative testing (eg, Phalen test, Tinel’s sign, compression test). For most patients, the presence of the classic signs and symptoms should be adequate for the diagnosis. However, many physicians order confirmatory testing and some insurance companies require the confirmatory testing prior to approving surgical treatment. The most commonly ordered test is a combination of nerve conduction studies and electromyography. As pressure increases on physicians to control health care–associated costs and implement evidence-based medicine into clinical practice, we must critically analyze the data regarding nerve conduction studies. Should they be considered the “gold standard” for the diagnosis of carpal tunnel syndrome, or are they unnecessary studies that increase costs and delay treatment?
Source: Healio Orthopedics
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