Diagnosis
Even during pregnancy, the diagnosis of carpal tunnel syndrome is divided into several steps. During the doctor-patient consultation (anamnesis), the description of the perceived symptoms can provide an initial indication of the presence of carpal tunnel syndrome. Subsequently, this suspected diagnosis can be substantiated by further measures.
During an orienting physical examination, both hands must be examined in comparison. In this step, the physician pays particular attention to visible abnormalities such as redness, swelling, bruising and/or injuries. Subsequently, the mobility of the hand and fingers as well as their sensitivity can be checked using various test procedures.
In addition, various provocation tests are part of the standard diagnosis of carpal tunnel syndrome, even during pregnancy. In these tests, the doctor tries to provoke the pain typical for the presence of carpal tunnel syndrome. For example, he taps the carpal tunnel to check whether there is irritation of the median nerve.
In addition, prolonged strong flexion of the wrist can lead to the pain typical of carpal syndrome. An electrophysiological examination can also be performed during pregnancy without hesitation. This method can help to confirm the diagnosis “carpal tunnel syndrome” and estimate the extent of the disease.
During this examination, the nerve conduction velocity, i.e. the time required by the median nerve to transmit a defined stimulus, is measured. A reduction in the nerve conduction velocity is typical for the presence of a pronounced carpal tunnel syndrome. In some cases, further imaging procedures may also be necessary.
During pregnancy, the preparation of radiographic, computer resonance imaging and magnetic resonance imaging should be avoided if possible. For this reason, the performance of an ultrasound examination during pregnancy can help to confirm the diagnosis “carpal tunnel syndrome”. In addition, the so-called “electromyography” (short: EMG), as the measurement of the electrical activity in the muscles supplied by the nerve in the area of the ball of the thumb, represents an important method in the diagnosis of carpal tunnel syndrome. This examination method can also be performed during pregnancy, if necessary.