Carpal tunnel syndrome is diagnosed from the pattern of symptoms and confirmed by nerve conduction studies with electromyography. The typical story is numbness and tingling in the thumb, index and middle fingers that wakes you at night and is relieved by shaking the hand.
Carpal tunnel syndrome is diagnosed from the pattern of symptoms and confirmed by nerve conduction studies with electromyography. The typical story is numbness and tingling in the thumb, index and middle fingers that wakes you at night and is relieved by shaking the hand.
Symptoms follow the median nerve distribution: the thumb, index and middle fingers and half the ring finger, sparing the little finger. Night-time waking is characteristic, as is relief from shaking or hanging the hand. Symptoms often appear when gripping a steering wheel or holding a phone. As it progresses, people notice dropping things or difficulty with buttons and keys, and eventually thinning of the muscle at the base of the thumb.
Examination checks sensation in the median distribution, strength of the thumb muscles, and looks for wasting. Provocative tests such as tapping over the wrist or holding the wrist flexed are commonly performed, but they are neither sensitive nor specific enough to settle the question. A negative bedside test does not exclude the diagnosis and a positive one does not confirm it, which is precisely why electrodiagnostic testing exists.
Nerve conduction studies measure whether the median nerve is slowed across the wrist and by how much, which grades severity and guides treatment. Electromyography checks for muscle involvement. Crucially, the study also distinguishes carpal tunnel syndrome from a cervical nerve root problem or a more generalised neuropathy, which produce similar complaints and respond to entirely different treatment. Both CNS offices perform and interpret this on site.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.