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Study finds reliability problems with nerve test for carpal tunnel syndrome

ANN ARBOR, Mich. - A nerve test widely used to diagnose carpal tunnel syndrome should not be relied upon to give a "yes-no" answer to the question of whether a person has the painful hand condition, a new University of Michigan study says.

In fact, the results show, people without any typical carpal tunnel syndrome symptoms can register abnormal results on nerve conduction tests depending on how the test is performed - and not all of those who complain of symptoms like wrist pain and tingling fingers will show nerve damage during the test. What's more, the test can produce very different results depending on who performs it.

For the estimated 850,000 Americans who visit their doctors each year complaining of carpal tunnel-like symptoms, and the 260,000 who have corrective wrist surgery annually, the study shows the importance of being examined by an experienced doctor using a range of tests.

Published in a recent issue of the journal Muscle and Nerve, the U-M study is the first of its size and kind. It was performed by a team of experts from several areas of the university, who conclude that doctors should use a continuous scale to evaluate test results, rather than the current practice of choosing a cutoff point to distinguish between normal and abnormal results.

"When job placement or surgery hangs in the balance, the reliability of a test like this becomes even more important," says co-author and U-M health scientist Deborah Salerno, Ph.D. "The results of our study were mixed, and, at times, the difference in reliability was striking. For reliable results, you want to have an experienced examiner do the test, and use appropriate criteria to see if the results are normal."

The study looked at 158 workers, mostly women, whose work includes a large amount of time spent at a computer keyboard. Not all the subjects complained of symptoms typical of carpal tunnel syndrome. Each underwent two rounds of nerve conduction tests, spaced three weeks
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
8-Nov-1999


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