Carpal Tunnel Syndrome Tests: A Comprehensive Guide

What is carpal tunnel syndrome?

Carpal tunnel syndrome (CTS) is a common health condition that causes symptoms like wrist pain and weakness in your hands and wrists. The carpal tunnel is a space in your wrist bones, similar to a passageway that allows tendons, ligaments, and nerves to pass through it and reach your hand.

What causes carpal tunnel syndrome?

Carpal tunnel syndrome happens when something irritates or puts extra pressure on the median nerve that runs through your carpal tunnel. The median nerve helps you move your forearm and gives feeling to most of your fingers and hands. If it's damaged or pressed against the walls of your carpal tunnel, it can send extra or incorrect sensations to your hand and wrists.

What are the symptoms of carpal tunnel syndrome?

Carpal tunnel syndrome symptoms include:

• Tingling, numbness, or a “pins and needles” sensation in the thumb, index, middle, and ring fingers (especially your fingertips).

• Pain in the hand, wrist, or forearm, which may radiate up the arm.

• Weakness or clumsiness in the hand, making it difficult to grip objects or perform fine movements (For example like holding your phone, gripping the steering wheel, holding a pen or typing on a keyboard).

• A swollen feeling or burning in the fingers, especially at night or when using your hand for tasks mentioned previously, like holding a steering wheel or phone.

Please consult a specialist about the current symptoms you are experiencing and if you suspect you may have carpal tunnel syndrome. Request an appointment with Thomson Medical today.

How do you test for carpal tunnel?

The clinical exam for carpal tunnel syndrome should begin with inspection of the hands to assess for osteoarthritis, symmetry, and muscle atrophy. During the later stages of carpal tunnel syndrome, there can be significant muscle wasting in the thumb area because the median nerve controls the muscles that help move the thumb.  Hence, the diagnosis of carpal tunnel syndrome typically starts with a physical examination and a review of symptoms.

Motor exam

The motor exam checks the strength and function of certain muscles in your hand, especially those controlled by the median nerve, which passes through the carpal tunnel. During this exam, your doctor might:

• Ask you to move your thumb away from your palm (abduction) or touch your thumb to your little finger (opposition).

• Test how strong these movements are by having you push against their hand or a small device.

• Look for any muscle weakness or shrinking (especially at the base of your thumb, called the thenar eminence).

Weakness in these thumb movements or visible muscle loss can suggest that the median nerve is being affected by carpal tunnel syndrome.

Sensory exam

The sensory exam checks how well you can feel touch in different parts of your hand. Your doctor will:

• Lightly touch areas of your hand, especially the thumb, index, middle, and part of the ring finger – the areas usually affected by carpal tunnel syndrome.

• Ask you to close your eyes and rate how well you feel the touch compared to a normal area, like your forearm.

• Compare feeling in areas controlled by the median nerve (affected in carpal tunnel) to those controlled by other nerves

If you have numbness, tingling, or reduced feeling in these areas, it can be a sign of carpal tunnel syndrome.

Symptom triggering tests

Doctors will use several simple hand and wrist movements to try to bring out the tingling, numbness, or pain you might feel with carpal tunnel syndrome. These tests help them see if your symptoms can be triggered during the exam, which makes it easier to tell if you have carpal tunnel syndrome. Such tests include:

• Phalen's test:

  • Place the backs of your hands together in front of you, bending your wrists down as far as possible, similar to forming an upside-down "praying hands" position.

  • Hold this position for about 30–60 seconds.

  • If you start to feel tingling, numbness, or pain in your thumb, index, middle, or part of your ring finger (the areas affected by carpal tunnel), the test is considered positive

• Reverse Phalen’s test (Wormser’s test):

  • Put your palms together in a “prayer” position, with your fingers pointing up and your wrists bent back (extended).

  • Hold this for up to 2 minutes.

  • If this position causes tingling, numbness, or pain in the same fingers, the test is positive.

• Tinel’s test:

  • This test is also commonly known as “Tinel’s sign”. Your doctor gently taps over the inside of your wrist, right where the median nerve passes through the carpal tunnel.

  • If you feel a tingling, "pins and needles", or an electric shock in your thumb, index finger, middle finger, or part of your ring finger, this is a positive sign.

• Carpal compression test (Durkan’s test):

  • Your doctor presses down firmly with their thumbs on the inside of your wrist, right over the carpal tunnel, for about 30 seconds.

  • If this causes numbness, tingling, or pain in the same fingers, the test is positive.

Other available diagnostic tests

Some other tests to diagnose carpal tunnel syndrome include:

• Nerve conduction studies:

  • These measure the speed and function of the median nerve.

  • A small electrode is placed on the skin near the elbow to send a small electrical current down the median nerve.

  • As healthy nerves transmit electrical signals quickly, the amount of time taken for the current to travel to your fingers can indicate the extent of nerve damage you are experiencing.

• Electromyogram:

  • A small needle is inserted into the muscles in your hand.

  • It will send electrical impulses that measure the muscle function around the median nerve while you squeeze and relax your hands several times.

• Imaging tests:

  • Imaging tests, such as ultrasounds, X-rays, or magnetic resonance imaging (MRI), may be performed to rule out any other possible causes of wrist pain, such as arthritis.

How do I prepare for the test?

Most physical tests do not require any special preparation. Remember to wear comfortable clothing and avoid applying lotions or creams to your hands and wrists before your appointment. If your healthcare provider plans to conduct nerve studies, they will provide you with the specific instructions required to prepare. If you have any questions or concerns about how to prepare, it is best to consult your healthcare provider directly.

What are some treatments for carpal tunnel syndrome?

Treatment for carpal tunnel syndrome usually depends on the severity of its symptoms, ranging from lifestyle changes and medication to surgery or a combination of these.

Lifestyle changes

You can reduce your risk for developing this painful condition with some lifestyle adjustments:

• Take short, frequent breaks to stretch and bend your hands and wrists.

• Switch up activities often or use each hand alternately to provide your wrists with some rest. This step is particularly crucial if you're operating vibrating machinery or applying significant force with your hands.

• Avoid using excessive force while writing, typing or gripping.

• Refrain from excessive or extreme bending of your wrists, aiming to maintain a relaxed, neutral position.

• If your work environment exacerbates your symptoms, consider adjusting your workspace or altering the way you perform tasks.

• Position your keyboard at or below elbow level and choose a computer mouse that facilitates comfortable wrist movement.

• Practice good form and posture to avoid straining neck and shoulder muscles, which can compress the nerves in your neck.

• Keep your hands and wrists warm, as hand pain and stiffness are more common in people who work in a cold environment.

Wrist splint or brace

Wearing a wrist brace or splint is a common treatment that helps immobilise your wrist, offering it the necessary rest and support to alleviate symptoms associated with carpal tunnel syndrome. Furthermore, using a brace while you sleep can prevent unintended wrist movements during the night that may worsen your discomfort, ensuring the wrist remains in a stable, neutral position and promoting more restful sleep.

Physiotherapy

Physiotherapy can help you to adjust the way you use your hands and wrists during your daily routine. Therapists may introduce:

• Stretching techniques to relieve tension

• Strengthening exercises for wrist and hand muscles

• Ergonomic advice to improve posture and reduce repetitive strain

Medication

Your healthcare provider might suggest over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) or acetaminophen to reduce inflammation and relieve pain. Don't take these medicines for more than 10 days in a row without talking to your provider. These should be taken sparingly and only under medical supervision

Another type of medication your healthcare provider may prescribe is corticosteroids. Corticosteroids are a prescription anti-inflammatory medication. Your healthcare provider may give you cortisone shots in your affected carpal tunnel.

Carpal tunnel release surgery

If conservative treatments do not work, your doctor may suggest carpal tunnel surgery. However, the procedure is only for severe and persistent symptoms. 

For carpal tunnel release surgery, your surgeon will aim to create more space inside your wrist. They will make an incision (cut) in the ligament that connects your wrist to your palm (your transverse carpal ligament). The procedure reduces tension on your carpal tunnel and gives your tendons and nerves more space.

Carpal tunnel release surgery is usually an outpatient procedure, which means you can go home the same day. Your healthcare provider will advise you what to expect and will give you recovery instructions.

Microsurgical neurolysis

In rare cases where carpal tunnel release surgery fails, your doctor may recommend microsurgical neurolysis. This procedure releases tight scar tissue around the median nerve to relieve pressure. In some cases, soft tissue will then be transferred to the bare median nerve to prevent scarring from happening again, which would cause the symptoms to return.

Always  consult your doctor or a hand surgeon if you have signs and symptoms of carpal tunnel syndrome that interfere with your normal activities and sleep patterns. Early diagnosis and treatment offer the best chances for effective relief and prevent the symptoms from getting worse.

Unsure what treatment suits your individual situation best? Request an appointment with Thomson Medical today to discuss with a specialist what the next best course of action is for you.

How much are carpal tunnel syndrome tests in Singapore?

Carpal tunnel syndrome diagnostic tests in Singapore typically cost around SGD 100 to SGD 500. For a full diagnostic workup—including consultations, physical exams, and nerve conduction studies— costs can range from SGD 500 to SGD 1,500 at private specialist clinics.

If surgery is needed, subsidised day surgeries at public hospitals generally range from SGD 593 to SGD 1,211, while private hospital fees range from SGD 6,878 to SGD 8,278. For just the diagnostic tests (not surgery), expect to pay in the lower end of the SGD 152 to 1,500 range, depending on the clinic and whether advanced nerve studies are required.

Prices for day surgery follow what is reflected on MOH’s website as of May 2025.

What are some tips to prevent carpal tunnel syndrome?

It can be difficult to prevent carpal tunnel syndrome, especially if a health condition or activity you cannot avoid causes it. Protective steps include:

• Taking regular breaks from repetitive tasks

• Using proper technique and maintaining good posture when working with tools or typing on a keyboard.

• Keeping wrists in a neutral position

• Stretching and strengthening hand and wrist muscles

• Maintaining a healthy weight and managing underlying health conditions

FAQ

How can I test myself for carpal tunnel?

You can try the Phalen’s test at home by pressing the backs of your hands together with wrists flexed for 60 seconds. Tingling or numbness in the fingers may indicate CTS, but a proper diagnosis should be made by a healthcare professional.

Can I heal carpal tunnel on my own? 

Mild cases can improve with rest, wrist splints, and lifestyle changes. However, it often does not fully heal on its own if pressure on the median nerve continues. If symptoms persist or worsen, medical treatment is usually needed to prevent long-term nerve damage.

What are five symptoms of carpal tunnel?

What are the signs of nerve damage in your hands?

Signs include persistent numbness, tingling, muscle weakness, loss of coordination, and visible muscle wasting in severe cases.

How do I know if it's carpal tunnel or arthritis?

Carpal tunnel affects the thumb, index, middle, and ring fingers, often causing numbness and tingling, while arthritis typically causes joint pain, stiffness, and swelling, often in the base of the thumb or finger joints.

What is the best exercise for carpal tunnel?

Gentle stretching and nerve-gliding exercises can help. For example, gently extend your fingers and wrist, hold for 15–20 seconds, and repeat several times a day.

When should I be worried about pins and needles in my hands?

You should seek medical attention if the sensation is persistent, getting worse, or accompanied by weakness, poor coordination, or muscle loss, as these could be signs of underlying nerve damage.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.