A) Home Page Hand Symptoms Severity Checkup 2024 

  • Hand Symptoms Severity Checkup

    Note: your evaluation is included in your CarpalRx Bundle purchase

  • Welcome!

     The purpose of this evaluation is for Dr. Z to determine:

            >What problem you're having with your hand

    >How severe it is

    >How to treat it

     It'll take about 5 minutes to complete. (However, you're welcome to tell us as much about your condition as you wish at the end.) 

    All information is strictly confidential.

    And remember, we're happy to help as long as you need us.

    It's what we do!

    Thank you.

     The CarpalRx Team

  • Sex*
  • Which best describes your "build"?*
  • Do you (or did you) use your hand(s) extensively as part of your occupation or hobby?*
  • Check EACH of the following that applies to you (if known), no matter the severity or date of occurrence:*

  • >>Describe other metabolic disorder(s):

  • Check EACH of the following that best describes the most stressful use of your hand(s) at work & play:*
  • Women only:

  • About Your Hands

  • Which hand is dominant?*
  • Which limb is affected; Left or Right? If the answer is BOTH, please complete a separate Questionnaire for each hand:*
  • Where are your symptoms are PRIMARILY located:*
  • How much do your hand symptoms interfere with your normal daily activities?*
  • Overall, which is (are) your MOST distressing hand or finger symptom(s)? Check all that apply.*
  • Is your thumb worse than your other fingers?*
  • Is your little (pinky) finger affected?*
  • Do you have VISIBLE swelling in your fingers, finger joints, palm, or wrist?*
  • In general, when are your symptoms worse?*
  • In general, which describes your WORST symptom(s):*
  • Did you have carpal tunnel surgery on the hand you're describing?*
  • Date of Surgery
     - -

  • About Your Pain (if any)

  • Throbbing*
  • Dull*
  • Sharp*
  • Aching*
  • How long have you had pain?*
  • When is your pain worse?*

  • About Your Numbness (if any)

  • Describe your numbness*
  • How long have you had numbness?*
  • When is your numbness worse?*

  • About Your Tingling (if any)

  • Describe your tingling*
  • How long have you had tingling?*
  • When is your tingling worse?*

  • Final Questions

  • Describe any loss of hot or cold temperature in any fingers:*
  • Do you have weakness (loss of grip strength) in your hand or fingers?**
  • Do you have difficulty gripping or picking up small objects, like keys or buttoning a shirt?*
  • Very Important -- Please look carefully at your palm. Observe the muscle between your wrist and the base of your thumb. Does that muscle appear flat and wrinkled like in the picture below?*
  • Image field 95
  • Today's Date*
     - -

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  • Great! We're all done. We'll email you soon with your results. Thank you so much!

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