It depends what you mean by 'everything points to CTS'. If your score on the website questionnaire is very high (>70%) but nerve conduction studies are normal, which is quite a rare event, then we also look for evidence of CTS using high resolution ultrasound imaging. If that is normal too then we would normally suggest a trial of splinting for 2-3 months followed by testing again to see if an abnormality is developing. If everything is still normal at that point and no other explanation for the symptoms has emerged then one might consider a trial of local steroid injection but I'm not sure that we have actually had a case like that yet. Your score was 46% which is quite well below that 70% threshold so your symptom pattern is perhaps best described as equivocal for CTS - it's a possible diagnosis certainly but if it is the right one it is too mild to detect with nerve conduction studies as yet. I see you have not tried a night splint so that would be the obvious next thing to experiment with as that is a safe intervention which may either throw a bit more light on the diagnosis or may solve the problem itself.
I'll move this to the Canterbury patients forum in a day or two. JB
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It depends what you mean by 'everything points to CTS'. If your score on the website questionnaire is very high (>70%) but nerve conduction studies are normal, which is quite a rare event, then we also look for evidence of CTS using high resolution ultrasound imaging. If that is normal too then we would normally suggest a trial of splinting for 2-3 months followed by testing again to see if an abnormality is developing. If everything is still normal at that point and no other explanation for the symptoms has emerged then one might consider a trial of local steroid injection but I'm not sure that we have actually had a case like that yet. Your score was 46% which is quite well below that 70% threshold so your symptom pattern is perhaps best described as equivocal for CTS - it's a possible diagnosis certainly but if it is the right one it is too mild to detect with nerve conduction studies as yet. I see you have not tried a night splint so that would be the obvious next thing to experiment with as that is a safe intervention which may either throw a bit more light on the diagnosis or may solve the problem itself.
I'll move this to the Canterbury patients forum in a day or two. JB