Quick Carpal Tunnel Test - Nerve Conduction
HTML-код
- Опубликовано: 12 фев 2017
- The commonest reason to have #Nerve #Conduction Studies is to evaluate #Carpal #Tunnel #Syndrome. There is a frequent misconception that these are painful and take forever to do. In the hands of an expert these should be quick and fairly painless.
In this video I demonstrate my own practice which is in line with the BSCN Standards and Guidelines as well as those of the AANEM (F-waves are an extra check that I like to do, and apologies for the typo on the 2nd ADM F-wave).
The study was performed at a leisurely pace in less than 2 minutes. My colleague, Paolo, was clearly not harmed, rendered in pain, nor needed to have his hair combed down afterwards!
This type of test would be typical for mild through to severe carpal tunnel. At both extremes of severity i.e. very mild CTS and extremely-severe CTS some extra tests would often be necessary and so would likely increase the overall time taken. Patients should also be aware that to help the process they need to arrive with loose clothing (for fast access), not have creams or oils applied to their skin (these act as electrical insulators) and make sure that they are dressed warmly in the winter (otherwise we need to spend extra time warming the limbs in water baths). Please help us with these - to help you!
I haven't shown the traces (studies were performed on a Dantec Keypoint G3) because that's not what this video is about, but they were all of superb quality.
I should say that some patients are very sensitive to the electrical stimulation, even at very small currents. This should always be the exception rather than the rule. Studies in these circumstances should be very focused and be guided by patient tolerance. 
Наука
Thanks for making this! I have just been booked in for one and had no idea what it entailed. Now I know just what to expect!
My Don has his at 11.15 today in The Walton Centre in Liverpool. We also like many here had no idea what it would entail.
This has been so helpful.
Thanks you.
Getting this done this week and I was nervous not knowing exactly how it would go down, this was super helpful tysm:)
My husband had this done recently and he was telling me about it. I'm fascinated by how the human body works and reacts to certain stimulation, so I had wished I could have seen the test being done. Thank you for sharing this, because my curiosity has been satiated and I've learned something new! 😊
I have the condition. The test for it in 1994 was an inspection of my back. The injury is in my wrist. Because of the vague information I was being given at the medical centre anf the problems it was causeing when trying to explain to the labourers that work in DWP offices, I went to see a specialist in 1999. I had the diagnosis in 1987, but no prognosis. The specialist told me the condition is when the tendon and sleeve become separated and the intense stabbing pain is the nerve, and that every time that happens, the nerve is being damaged. The eventual consequence is nerve death. The realisation at that time was, I had a completely uselless GP. I have only ever had one proper examination by a physician for it. That was at a DWP medical assessment in 1994. He examined the muscles in my back for the diagnosis. Possibly to see if there was any compensationary change in them, since I became injured in 1987. The compensation and muscle change tries to put a twist in the spine. That also becomes very painful. I found out on my own, how to deal with that. I made up an excercise for it.
Great Dr. Simon.
Thank you very much.
Greetings from Germany
thank god i got to see this first i was a bit nervous but not at all now
thank you
Thank you. My tests are in two days.
I had mine 2 months ago and it wasn't the worst pain ever but it was pretty intense at times.
It don’t hurt I just had it done 😂
@@datwanlivingston8545 depends on how bad it is ig
I had this done today and I almost told them to keep that job! It hurt like hell shocked me 26 times in each hand! My muscles definitely work!!!
Getting this done in August. Reading online horror stories gets me anxious but seeing this is very helpful. Seems manageable.
Indeed, don't believe everything you see on Google! Good luck with it, bw Simon
Does an e m g/nerve conduction study test for ulnar nerve entrapment
Hi what is the purpose of this and what does help fix in the hand and arm
This was helpful and interesting!
I have a feeling either you guys are nice, or my doctors were terrible. I had a lot less communication and when I got to the needle part,which he didn't do here, it has horrible
I just got this done a while ago
For some reason I was holding in my laughter, I actually loved that pain 😂
And it was also funny how my fingers moved each time he shocked me
Sadist.
@@escfxp You mean Masochist. She liked receiving pain, not inflicting it.
😂😂 same
On a scale of 1 to 10 how was the pain ?
I had a nerve test done and it hurt. The shocks were painful and there were also some kind of needle pokes involved that also hurt. This guy probably doesn't have the condition. I had the surgery done last week, 3 weeks after the test.
I was going to comment the same thing, the amount of shock I got was very elevated and painful, the doctor did it several times, also the needle poking was painful and wierd. He wasn't even kind of at least anticipated me to the pokes, he said I definetly need the surgery on both hands.
Hello Cindy, i too had the intense test done , and it was painful needless to say i have very bad carpal tunnel syndrome and also need surgery, how was it for you and is there any down time ? Thanks
Same here! That was traumatic as hell! The shock was brutal on me then the doc comes in and starts jabbing me with a needle! 😫
After my back surgery they would poke my legs and toes with a safety pin. Frankly it was a relief to be able to feel pain after a few weeks of just watching them jab me with no feedback.
When having this test done . Is it best to do so when it is having a flare up or at its worst ? Or does this make no diffrence ?
Hi, a common question and it makes no difference, bw Simon
I didnt even need this test to be diagnosed with severe carpal tunnel syndrome. I've got surgery in 2 months for my right hand.
hi dr., is this test [nct] is a confirmatory test for CTS? does it shows if the problem is in cervical region?
Hi, the tests we perform have two parts. In this video I’m just demonstrating the Nerve Conduction aspect which is more focused towards the peripheral nerves, but there's also an EMG part (other videos) which adds further information that can help address cervical nerve root damage. Bw Simon
Hello can you tell me if the person having this test did have carpal tunnel syndrome would the shocks cause them pain is that what the test is looking for . I think I may have cubuler as my pain is in little and ring finger
Mr man 1977, These tests are not about causing pain, rather, measuring the conductive properties of the nerves. Most people have some level of transient discomfort but nothing major. There are some who find it difficult but usually as a result of anxiety, so the less one thinks about it, the better. Some people can even fall asleep!
I had a NCS and was diagnosed with CTS. Wondering if the ulner nerves are also included in the study. I don't think my ulner nerve was tested. My test was very fast. How can I tell by the results what was tested. I don't recall shocks around the ulner nerve about my elbow where I was having stabbing pain.
Same and my whole arm goes to sleep every night and burns.
Well i thought the video was quite helpful and made me less nervous about how it was going to be but now reading the comments about how painful it is I'm seriously not looking forward to having it done now 😢
Most people are absolutely fine with them, but you're only ever going to hear from a vocal minority. Bw Simon
Believe me it hurt like hell
If it hurts does that mean there is nerve damage or in fact capal tunnel? I have this tomorrow 😮
Some doctors tell that it carpal tunnel sydrome might be related to the neck problem
May I ask doc if do you need to put it on the neck part what I'm seeing in the video.
Or when it is putted on hand, it can also detect the neck part?
I hope you'll notice.
Thank you doc.
Hi, there is no direct connection. However, around 5% of those with CTS experience discomfort in their neck for a number of reasons. Either as a 'misinterpretation' of signal by the brain, or concomitant arthritis, or that busy people are busy with many joints and overuse occurs across the whole limb. But fundamentally, CTS is a wrist problem and neck problems are neck problems. Bw Simon
I've had pins and needles for over two years now been told it's most probably carpal tunnel syndrome as my spine scan was fine, is it time to get surgery?
Depends how bad it is, as there is a range of options available. So first get it assessed and then get it sorted. Bw Simon
Gotta question, is there something I can take that will help my nerves react better? I feel pretty healthy 28 years old , about a month ago I had a nerve test at a job I was applying I aced every other test but I feel like the nerve test I did ok in, I got like a 3. Something close to a 4 (idk what that was for) I’m trying to shoot for like a 2, I do work out I drink caffeine daily before I workout(pre workout) , I sometimes also take a pump with L Arginine will this help if I take before the test as it slows more blood flow through my arms? They want me to retest but at a medical center now for the nerve test
What did you have the test done? What were the issues you were having prior
How did it turn out? Hope you are well
@@user-wb2yv7ll9d I ended up retesting at the time they stuck needles to see the nerves with a sonogram which looked and felt weird to see the nerves I barely passed got the job but then I joined a new job 2 years later lol
I've been managing my carpal tunnel syndrome for around two years now and my Physio has suggested I consider surgery since it's starting to get worse. Will I have this test if being treated through the NHS?
Jonnie Callan - GodFist
Hi Jonnie, that sounds like a long time to have unresolved symptoms. Basically, it would depend on which surgeon you see and their clinical assessment of severity. Some surgeon's refer more and some refer less. Some like to have baseline data even when it's diagnostically clear to predict outcome. Some prefer to reserve them for situations of doubt or if multiple problems are present e.g. CTS plus an Ulnar nerve or Neck problem or CTS plus diabetes etc. Good luck and all the best, Simon
Dr Simon Freilich thank you for the response, my symptoms started shortly after my son was born so I couldn't have managed without my hands, I have no muscle wasting, loss of grip strength or anything like That. My symptoms were intermittent until just recently, now that burning sensation is pretty much always there in some form.
I'm a little concerned about any long term limitations I may have after surgery. I like to workout and play video games. is it common to lose any dexterity, ability to bare weight on my palms or substantial grip strength after recovery?
@@jonniecallan86 Hey Jonnie, I hope you got better by now! (since this comment was posted 2 years ago) I'm wondering if you have experienced any form of long term limitations after your surgery? (I'm an artist so I'm quite concerned) Thank you and hope you have a great day/night! :D
@@boomfrozen1160 not at all, infact I've been training harder than I ever have and my grip strength and dexterity is better than it's ever been.
This isn't bad at all. I had both intramuscular and surface tests done. The needle pokes weren't any worse than an injection. The only startling thing was the movements my arm made. Painless...
Lucky you! I had this done and the pain for me was so intense that I was in tears by the time it ended, plus I had several spots of bruising on my arm that took weeks to completely clear. I was not ready for that first jolt when it hit and actually yelled, "Oh, Lord!" 😬😆 I was sweating bullets through the rest of it and maybe my doctor sucked or something because each zap felt like sticking my finger in an electrical socket. I will never have this done again for any reason on Earth...
Please I have been managing my carpal tunnel syndrome for 5 years now and it's getting worst as days go by please who will I contact for treatment am in Nigeria please I need help am in pains
I had this done a few years ago and they made me lay down. I didn't know exactly what they were doing but it took a whole to do. It felt like I was being stuck all over with a very large needle. It hurt like hell and I have a high tolerance level for pain. It was almost unbearable.
good to know. I have test coming up and am nervous they are going to make my hand worse then what it already is.. Because Hey I can't do that stop forcing my hand..means stop, but no
broke wrist 3 months ago and PT and healing time means i can move my hand a bit better - however, i'm concerned about carpal tunnel being triggered by the break. the PT says the pain i'm feeling is just the wrist still swollen. now am getting a sharp pain in my palm ... and i'm sure the dr and pt are getting tired of my asking ... how long does a broken wrist take to heal for an older person? moving the hand up/down and sideways and holding anything or swatting at something without thinking - PAINFUL.
Hi Marny, common situation and quandary! Needs to be discussed with your local team. Wishing you a speedy recovery, bw Simon
Hello..it's a few yrs later..so what were the results of your test. I'm having the same problem after surgery I ruptured a ligament in my wrist. Now I'm having pain and trigger fingers
Hello Doc . I will be having carpal test the next week for my medical exam. How can I tell right now if I can pass the carpal test? By the way I'm 25 years old
Hi James, depends entirely on your symptoms and whether or not they match up with cts. Good luck with it and your eventual diagnosis! Bw Simon
Is it more accurate to have this test in a seated position vs laying down? I had one today and they did mine laying down.
Hi Bill, lying or seated positions are irrelevant to carpal tunnel studies. Usually a question of comfort (patient or physiologist) and / or whatever else is being tested. Bw Simon
@@DrSimonFreilich Thank you!
I had this done yesterday.. that's why I'm here. Dr confirmed straight after the test saying he confirmed I had CT in both hands !! Next step is for them to cut my carpal tunnel or stretch it somehow?
Hey how's your wrist now?
Hey, I’m getting a twitch in both my middle fingers when I click my controller or mouse, literally any mouse I use I get a twitch I’ve had this for a while now. Is this something I should be concerned about?
Do you play Minecraft PvP by any chance?
When I had this done, my hand jumped at every shock & neurologist said nothing, is that normal?
Update?
why dont you move the wires that you place on the fingers onto the 3rd finger, I had this test done myself and he didnt move them to my 3rd finger either!
Good question, the detail is complex but the short answer is that we don't have to test every branch of every nerve. It very much depends on individual symptoms and the findings as we go along. Hence, these are quite bespoke tests. Bw Simon
All my emgs have been extremely painful. A 110 finger in the socket hurt less
💯💯💯💯💯💯💯💯💯💯💯💯
To whom I will contact for my carpal tunnel syndrome Neurologist or orthopedic? It is my starting stage
Great question. If you feel it might be mild through to moderate then a Rheumatologist and they'll give you the best non surgical options, if moderate and onwards then an Orthopaedic (hand) surgeon. They can also help you with non surgical treatments too but can cut out middle people and stages if symptoms are bothersome. I personally don't believe (and I have looked into this) that neurologists have much of a place in cts management beyond making the diagnosis. Physiotherapists and GPs are good at the mild stage. Good luck and best wishes, Simon
@@DrSimonFreilich how does one determine if their pain is mild to moderate VS moderate & onwards? I've been having pain for 1 year now in both of my hands that I suspect is CTS. I'm finally going to the hand orthopaedic next week.
Mine is nExt week friday.
Some doctors tell that pinched nerve on neck can be related or a cause of carpal tunnel syndrome
Is it possible that it came from a pinched nerve on neck or elbow doc?
Thank you so much
I had an MRI on my neck the other day and the Dr also requested this nerve test for me. They have my MRI results but told me they want my nerve test done before they give me the results.
I have tingling and shooting pain from finger tips all the way up to my shoulder and neck.
I also realised I get slurred speech and kept thinking it's a migraine coming but never got the headache... Now worried it's something to do with my neck 😮
How did your go ?
Doc is carpal tunnel syndrome symptoms is painful at rest?
Thank you
Yes, often worse at night or when arms are upraised eg reading or driving
Is hand numbness also a carpal tunnel syndrome?
Thank you
Hi, yes it can be, but one of a number of causes. Around 40% of those with CTS have numbness outside of its classic distribution, with many patients experiencing it diffusely across the hand. Why that occurs is uncertain but as I explain to my patients, brains dont always read the textbooks. Bw Simon
I just had one today and it was very sharp and painful
Same with me! People acting like this is just a little jolt or zap and I'm full on holding my tears in during the procedure and sweating bullets. I actually did cry once the doctor left so I could put my top back on and check out and my mom could tell it was not a good experience for me. I didn't need it because I knew I had carpel tunnel (all the classic symptoms) so it was really just a money grab in my opinion...
Sorry that my english is not good but i have too carpal tunnel syndrome en my doctor say that i should do a injection of cortisone and now it’s one month en it’s working very good without any test i done the injection. They said if i weit than maybe you should do surgery, so i have doen it before the test. I want to just share my experience 🙏🙏
There are different approaches and all are valid. Bw Simon
In doing this how do you know if you have permanent nerve damage?
Depends on how bad they're damaged. Bw Simon
@@DrSimonFreilich just got this done today got them all in my left leg the shocks and needles results say I had nothing wrong with my nerves. I've had injections that didn't help and had a MRI s showing that my lower disc is smudged right up against my nerves and I'm in intense pain still.
I'm having this done tomorrow
@@Weasel0539 good luck!!!
@@Weasel0539 how was it?
Is this method always accurate
Very. Bw Simon
I am 15 and I have carpal tunnel syndrome or 5 years and I might have to have to have surgery but I have to see a neurologist first. How do you know that f it is postive?
Una Mackenzie
Hi Una, it's mainly to do with the speed that the nerve sends a signals and how much signal can pass through the nerve. It's rare for carpal tunnel to happen at such a young age and so it's good that you are seeing a neurologist first to check things out. Good luck and I hope that all goes well. Bw Simon
Go to a physical therapist
So what has joe public learned from this video - you can now have a time counter on your videos, great!
Simon, how is Cubital Tunnel tested. I have this in next few months.
Very similarly to what you have seen here. Bw Simon
@@DrSimonFreilich Thanks Simon. I am just looking at your Ulnar Neuropathy and it's so informative. I am not making my own diagnosis here but you mention C7/C8 in neck as probable cause and I personally feel that as more likely than elbow as I have always had issues there. But I guess the conduction test will tell. I assume they will test it from that point of the body.
I have to get an emg done is this painful
Hi, it varies between people but at the end of the day it is a needle going through the skin so some discomfort is to be expected. Bw Simon
@@DrSimonFreilich a needle with electricity. Can be very painful indeed
I guess this is useful for general public, but not for neurology residents.
That’s a joke, it hurts like the dickens.
FACTS!
Exactly extreme pain in my hand right up to my arms was so glad when the test was over
Some asmr this
Bad video of the test . Too far away making this video. Can’t see anything.