Nerve Conduction Studies: A Diagnostic Tool for Carpal Tunnel Syndrome

Abstract

Objectives: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, yet the role of nerve conduction studies (NCS) in its diagnosis remains debated. This study aimed to evaluate the diagnostic yield of NCS and its correlation with clinical features in patients with suspected CTS.

Materials & Methods: A retrospective cross-sectional study was conducted on 201 patients referred for NCS with symptoms suggestive of CTS. Demographic characteristics, symptom profiles, physical examination findings (Tinel’s sign, Phalen’s maneuver), and NCS results were reviewed. Diagnostic accuracy measures were calculated, and associations between clinical features and NCS-confirmed CTS were assessed using chi-square tests.
Results: NCS confirmed CTS in 65.2% (n=131) of patients. Bilateral symptoms p=0.007), nocturnal exacerbation ( p<0.001), and a positive Phalen’s maneuver (100 vs. 28; p<0.001) were significantly associated with NCS-confirmed CTS. Severe numbness (p<0.001) and pain (p<0.001) also correlated with positive findings, whereas comorbidities showed no significant association (p=0.396).
Conclusions: NCS demonstrates higher diagnostic value in patients presenting with bilateral symptoms, nocturnal pain, and positive provocative tests, supporting a selective rather than routine approach to its use. However, its limited sensitivity in early-stage disease underscores the importance of combining clinical and electrophysiological assessments. Future longitudinal studies are warranted to determine the predictive role of NCS in treatment outcomes.