Boston Carpal Tunnel Syndrome Questionnaire

Boston Carpal Tunnel Syndrome Questionnaire gives a measure of the severity of the tingling and numbness in your hand.


Do you want to know how serious your carpal tunnel syndrome is? Take this little test, and take it with you to your chiropractor. Also note which is your dominant hand, and whether you have symptoms in one or both hands.

You must give ONE answer only, and if you have CTS in both hands, then fill in the questionnaire for each hand.

The following questions refer to your symptoms for a typical twenty four hour period during the past two weeks; circle one answer.

The test comes in two parts:

  • Symptom severity
  • Functional disability


Here is the list of eleven question to test the severity of your symptoms. Pain is very subjective. The Boston carpal tunnel syndrome questionnaire gives you a more objective sense of the pain and disability you are having.

Are you being a baby and the symptoms are really minor? Compared with the risks of surgery, should you be putting up with your pain.

Or, are these symptoms really severe and you are putting up with pain and disability and sleep nights when a course of treatment from your chiropractor really is indicated. It doesn't happen often, but neglected a pinched median nerve really can cause permanent weakness and numbness in your hand.


  • How severe is the hand or wrist pain that you have at night?
    1. I do not have hand or wrist pain at night.
    2. Mild pain
    3. Moderate pain
    4. Severe pain
    5. Very severe pain
  • How often did hand or wrist pain wake you up during a typical night in the past two weeks?
    1. Never
    2. Once
    3. Two or three times
    4. Four or five times
    5. More than five times
  • Do you typically have pain in your hand or wrist during the daytime? I never have pain during the day. I have mild pain during the day. I have moderate pain during the day. I have severe pain during the day. I have very severe pain during the day.
  • How often do you have hand or wrist pain during the daytime? Never Once or twice a day Three to five times a day More than five times a day The pain is constant.
  • How long, on average, does an episode of pain last during the daytime? I never get pain during the day. Less than 10 minutes 10 to 60 minutes Greater than 60 minutes The pain is constant throughout the day.
  • Do you have numbness (loss of sensation) in your hand? No 1 have mild numbness. I have moderate numbness. I have severe numbness. I have very severe numbness.
  • Do you have weakness in your hand or wrist? No weakness Mild weakness Moderate weakness Severe weakness Very severe weakness
  • Do you have tingling sensations in your hand? No tingling Mild tingling Moderate tingling Severe tingling Very severe tingling
  • How severe is numbness (loss of sensation) or tingling at night? I have no numbness or tingling at night. Mild Moderate Severe Very severe
  • How often did hand numbness or tingling wake you up during a typical night during the past two weeks? Never Once Two or three times Four or five times More than five times
  • Do you have difficulty with the grasping and use of small objects such as keys or pens? No difficulty Mild difficulty Moderate difficulty Severe difficulty Very severe difficulty

Add up your scores, and divide by 12. A typical group filling in this Boston Carpal Tunnel Syndrome Questionnaire report an average of 3.4.


Boston Carpal Tunnel Syndrome Questionnaire

Boston Carpal Tunnel Syndrome Questionnaire objectively evaluates the pain and disability of the tingling in your arms and hands; now to the second half of this process.


Functional status

Activity No difficulty Mild difficulty Moderate difficulty Severe difficulty Cannot do at all due to Hand or Wrist symptoms
Writing 1 2 3 4 5
Buttoning of clothes 1 2 3 4 5
Holding a book whilst reading 1 2 3 4 5
Gripping a phone 1 2 3 4 5
Opening a jar 1 2 3 4 5
Household chores 1 2 3 4 5
Carrying of grocery bags 1 2 3 4 5
Bathing and dressing 1 2 3 4 5

Once again, add up your scores, and divide by 8. A typical group filling in this Boston Carpal Tunnel Syndrome Questionnaire gave a result of 3.0.

You should then repeat this questionaire (without looking at your first response) three months later. It will give you a reliable result of how effective the chiropractic treatment was.


Useful links



  • Chiropractic Conditions is a central page at Chiropractic Help. It provides you simply and easily with the sorts of conditions that the average chiropractor would be treating.
  • Healthy Living Tips is another vital page at Chiropractic Help. Sparkling good health is not just about having your subluxations adjusted. Our healthy living tips page gives you some insights into different foods you could and perhaps should be eating.

Tingling in arms and hands

The chiropractic management of CTS depends on correctly discovering the oft multiple sites of entrapment. Surgery on the wrist often doesn't help the tingling in arms and hands, or relieves the symptoms only partially if these other areas in the below the elbow, inter scalene triangle and cervical spine aren't  also corrected; one way of measuring this process is the Boston carpal tunnel syndrome questionnaire.

The Upper Limb Tension Test should be used to rule out a frankly pinched nerve in the neck.

Surgery will not help at all if there is also tingling in the pinkie. It's not Carpal Tunnel syndrome. Think rather of the various conditions that can affect and cause a Thoracic Outlet syndrome ...

Right now I'm busy with a lady who had surgery a year ago which did not help at all; not surprisingly as the tingling was also in the pinkie. She has an unusual condition called Tietze's syndrome that sometimes affects the biomechanics of the collar bone and the inter scalene triangle.

All in all, pain and tingling in arms and hands has to be very carefully evaluated to ensure that the treatment addresses the man potential causes of the ache.


There is anecdotal evidence that a length of duck tape applied diagonally across the hand during hard physical work may relieve the symptoms of carpal tunnel syndrome.


Did you find this page useful? Then perhaps forward it to a suffering friend. Better still, Tweet or Face Book it.


Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?


Interesting questions from visitors

CLS writes:

Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.


You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.

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