LYCOS RETRIEVER 
Carpal Tunnel Syndrome: Median Nerve
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The standard confirmatory test for Carpal Tunnel Syndrome is an electric diagnostic study or (EMG). It is a measure of the electrical activity of the median nerve and the muscles enervated by median nerve. Routine x-rays are not much help. MRI may suggest median nerve compression if the contour of the median nerve is altered which is seen on the MRI.
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Carpal tunnel syndrome (CTS) is a compression neuropathy (disease of the nervous system) caused by an increase in pressure on the median nerve. The carpal tunnel is a space in the wrist bound on three sides by bone and covered with a ligament through which nine tendons and one nerve (the median nerve) travel to the fingers. This nerve supplies sensation to the thumb, index, middle, and half of the ring finger (excluding the pinky), while providing innervation of muscles that control thumb motion.
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Carpal tunnel syndrome occurs when a nerve is pinched in the wrist. This nerve, called the median nerve, is the connection from the brain and spinal cord, down to the finger tips. In patients with carpal tunnel syndrome, the median nerve is pinched as it passes through the wrist. Because of the compression, the nerve does not function properly.
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Drugs - In special circumstances, various drugs can ease the pain and swelling associated with carpal tunnel syndrome. Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and other nonprescription pain relievers, may ease symptoms that have been present for a short time or have been caused by strenuous activity. Orally administered diuretics ("water pills") can decrease swelling. Corticosteroids such as prednisone or lidocaine, injected directly into the wrist or taken by mouth, can relieve pressure on the median nerve and provide immediate, temporary relief to persons with mild or intermittent symptoms. (Caution: persons with diabetes and those who may be predisposed to diabetes should note that prolonged use of corticosteroids can make it difficult to regulate insulin levels. Corticosterioids should not be taken without a doctor's prescription.) Additionally, some studies show that vitamin B6 (pyridoxine) supplements may ease the symptoms of carpal tunnel syndrome.
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Carpal tunnel syndrome (CTS) is caused by the compression of the median nerve, which runs through a small channel in the wrist on the palm side. Under normal circumstances, there is very little pressure on the median nerve because the carpal tunnel is inflexible. It is surrounded by bone on three sides and tough ligament on the fourth side.
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Whether carpal tunnel syndrome is a clinical or electrophysiologic diagnosis remains somewhat controversial. In one study of 2,466 persons in a general population,2 354 (14.4 percent) reported pain, numbness, or tingling in the distribution of the median nerve. Nerve conduction studies confirmed the presence of median nerve neuropathy in approximately 45 percent of these symptomatic patients. Interestingly, nerve conduction studies were negative in almost one third of "clinically certain" patients but positive in nearly one third of "clinically uncertain" patients. Of the 125 asymptomatic patients who were examined (control group), 23 (18.4 percent) were found to have median nerve neuropathy on nerve conduction testing.
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Median Nerve