![]() It is also unclear whether the severity and character of symptoms are related to the structural and physiological condition of the median nerve. It is unclear from the literature whether the duration of symptoms correlates with the amount of nerve injury or can be predictive of treatment outcomes. Therefore, the Work Group employed expert opinion in creating recommendation 1 to guide physicians in the appropriate questions that should be asked during patient encounters to improve diagnosis. A high level of evidence is not available in the literature to assess the diagnostic utility of history data and the predictive value of the data in evaluating severity of disease and outcomes of treatment. Obtaining a history relating to carpal tunnel syndrome (CTS) serves to diagnose the disease and to plan appropriate treatment options. Lifestyle and activities: What hand activities are common for the patient (e.g., hobbies, occupation, etc.)? Are there functional limitations due to these symptoms?.Previous treatment: What has been done and what makes it better (e.g., splint, injections, therapy, activity modification, medications, etc.)?.Pace of illness: Is the problem getting better, worse, or staying the same? If it is changing, what has been the rate of change?.Location/Radiation: What is the location of the pain and/or numbness? Are the symptoms in the median nerve distribution of the hand(s)? If the symptom is not focal, does it radiate to a specific area of the body? Are there any other associated symptoms (numbness in the feet symptoms in the neck, shoulder, and more proximal in the arm weakness, clumsiness, dropping things, etc.)?. ![]() Is the numbness/tingling intermittent or persistent? What improves (e.g., shaking hand, holding hand down, warm water) or exacerbates symptoms (e.g., driving, holding a telephone, using vibratory tools, etc.)?
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