Skip to content

Patients › General-Health

Nerve Tests and Conduction Studies

What nerve conduction studies and EMG are, why they are done for carpal tunnel and other nerve problems, what to expect, and how accurate they are.

Updated Jul 2026
A nerve conduction study: a probe on the forearm with electrode leads on the hand.
Nerve conduction studies measure how well nerves carry signals, helping diagnose carpal tunnel and other nerve problems. Kieran Hirpara 4.0

What you're feeling

You may notice pain, numbness, or tingling in your hand or arm. These sensations often follow a specific nerve path. For example, carpal tunnel syndrome affects the median nerve. You might feel symptoms in your thumb, index, and middle fingers. Ulnar neuropathy at the elbow can cause tingling in your ring and little fingers. Suprascapular nerve issues may lead to shoulder pain or weakness.

Your symptoms often change with activity. They may flare up after repetitive tasks like typing or lifting. Reaching behind your back to fasten a bra can become difficult. Tucking in a shirt might feel awkward or painful. Nighttime is a common time for symptoms to worsen. You might wake up with a numb hand that you need to shake out. This happens because fluid shifts or nerve compression increases when you lie still.

Some days are better than others. Your surgeon may use nerve tests to check how well your nerves are working. These tests help measure the severity of the problem. They also help predict how well surgery might help you. However, symptoms do not always match test results perfectly. Some people have clear signs of nerve trouble but normal test results. Others have abnormal tests but mild symptoms.

Regardless of test results, you might still benefit from treatment. If your symptoms suggest mild-to-moderate nerve compression, your surgeon may discuss carpal tunnel release. This procedure can relieve pressure on the nerve. Ultrasound can also show if the nerve is intact or damaged. It helps your surgeon see indirect effects of previous issues.

In shoulder cases, nerve health is crucial. Poor nerve function can affect recovery after joint replacement. Your surgeon will carefully check your nerves before and after surgery. This helps protect your long-term function. Even if tests are unclear, your experience matters. If daily tasks are hard, tell your surgeon. They can tailor a plan to help you return to normal life.

What's actually happening

Nerves act like electrical wires that carry signals from your brain to your muscles and skin. When these nerves get squeezed or irritated, the signals slow down or stop. This is what happens in conditions like carpal tunnel syndrome or ulnar neuropathy. The pressure builds up in tight spaces around your wrist or elbow, damaging the nerve’s ability to function properly.

Your surgeon uses nerve tests to measure how well these signals travel. These studies are the best way to see how severe the damage is and to predict how well you might do after surgery. Sometimes, an ultrasound is used instead. This imaging test uses sound waves to look at the nerve’s structure. It can confirm if the nerve is intact and show any swelling or changes caused by the pressure.

There is often a gap between how your symptoms feel and what the tests show. For example, about 73% of people with mild-to-moderate carpal tunnel syndrome have clear signs and symptoms. However, only 51% show clear evidence of nerve damage on tests or ultrasound. This means that even if tests are normal, your symptoms are real. If your signs and symptoms suggest nerve trouble, additional testing helps confirm that surgery will actually help.

In more complex cases, like shoulder issues, nerve health is critical. Tests can predict how well your shoulder function will recover after joint replacement. They help your surgeon protect the nerves during the operation. Even if tests are not perfectly clear, your surgeon may still offer surgery for mild-to-moderate nerve compression if it fits your clinical picture. The goal is to relieve the pressure so your nerves can heal and send signals clearly again.

What to expect

Your surgeon may recommend nerve tests to check how well your nerves are working. These studies help measure the severity of your condition and can predict how well you might respond to surgery. For carpal tunnel syndrome, these tests are the best available indicator of overall disease severity. They also help identify if your symptoms are truly caused by nerve compression that could benefit from treatment.

You might wonder if your symptoms match the test results. There is often a gap between how you feel and what the tests show. Clinical signs and symptoms suggest mild-to-moderate carpal tunnel syndrome in 73% of cases. However, electrodiagnostic studies and ultrasound confirm the condition in only 51% of cases. This means some people with symptoms may not have nerve damage visible on tests, while others with mild symptoms might have significant nerve issues.

If your signs and symptoms suggest mild-to-moderate median neuropathy, additional testing can increase the chance of identifying actual nerve damage that surgery can fix. Even if these tests are normal, your surgeon may still offer carpal tunnel release for mild-to-moderate idiopathic median neuropathy. This means you can still receive treatment even if the test results are unclear.

For other nerves, such as the ulnar nerve at the elbow or the suprascapular nerve in the shoulder, different tests may be used. Ultrasound is a valid alternative to electrodiagnostic studies for detecting ulnar nerve issues. For shoulder conditions, these insights help predict functional outcomes and guide nerve preservation strategies. In some cases, like suprascapular nerve lesions from rotator cuff tears, standard electromyography may not be fully effective, so your surgeon will carefully evaluate nerve integrity using other methods.

Regardless of the test results, the goal is to determine the best path for your recovery. These tests provide critical information to help your surgeon plan your care. They help ensure that any treatment you receive is targeted and likely to improve your daily function. Your surgeon will use these results alongside your physical exam to give you a clear picture of what to expect from your treatment journey.


Evidence & references

Overview

  • Nerve conduction studies serve as a measure of impaired nerve function and the best available indicator of overall disease severity in carpal tunnel syndrome, with some prognostic value for surgical outcome [1].
  • Ultrasound is a valid alternative confirmatory test compared with electrodiagnostic studies in detecting ulnar neuropathy at the elbow [2].
  • There is severe discordance between the estimated prevalence of mild-to-moderate carpal tunnel syndrome based on clinical signs and symptoms (73%) versus electrodiagnostic studies and ultrasound (51%) [8].
  • When signs and symptoms suggest mild-to-moderate median neuropathy and surgery is being considered, additional testing such as electrodiagnostic studies or ultrasound may increase the probability of confirming actual median neuropathy that can benefit from surgery [3].
  • Distal motor latency and median nerve cross-sectional area are associated with each other and with clinical symptoms in carpal tunnel syndrome [9].
  • Ultrasound has comparable sensitivity and specificity to nerve conduction studies in patients two or more standard deviations above or below the mean age for presentation of carpal tunnel syndrome [15].
  • Chitosan phonophoresis demonstrated significant improvements in nerve conduction, pain reduction, and enhancement of hand function for mild to moderate cubital tunnel syndrome [4].
  • Ulnar nerve motor nerve conduction velocity at the upper arm should be measured alongside routine assessment of motor nerve conduction velocity at the elbow and forearm, especially in clinically severe cases considering surgery [6].
  • Electromyography does not show adequate effectiveness in diagnosis of suprascapular nerve lesions caused by rotator cuff tear in a rat model [12].
  • Radiological and electrodiagnostic insights into suprascapular nerve dysfunction are key predictors of poor functional outcomes in shoulder hemiarthroplasty [5].

How It Works

  • Nerve conduction studies serve as a measure of impaired nerve function and the best available indicator of overall disease severity in carpal tunnel syndrome [1].
  • Nerve conduction studies have some prognostic value for surgical outcome in carpal tunnel syndrome [1].
  • Ultrasound is a valid alternative confirmatory test compared with electrodiagnostic studies for detecting ulnar neuropathy at the elbow [2].
  • Electrodiagnostic studies or ultrasound can increase the probability of identifying actual median neuropathy that may benefit from surgery when signs and symptoms suggest mild-to-moderate disease [3].
  • Chitosan phonophoresis significantly improves nerve conduction in patients with mild to moderate cubital tunnel syndrome [4].
  • Chitosan phonophoresis significantly reduces pain in patients with mild to moderate cubital tunnel syndrome [4].
  • Chitosan phonophoresis significantly enhances hand function in patients with mild to moderate cubital tunnel syndrome [4]
  • Electrodiagnostic studies provide insights into suprascapular nerve dysfunction, which is a key predictor of poor functional outcomes in shoulder hemiarthroplasty [5].
  • Ulnar nerve motor nerve conduction velocity (MNCV) at the upper arm should be measured alongside routine assessment of MNCV at the elbow and forearm in clinically severe cubital tunnel syndrome cases considering surgery [6].
  • Compound muscle action potential amplitude is predictive of functional outcomes after in situ decompression of the ulnar nerve [7].
  • Other conventional electrodiagnostic parameters, excluding compound muscle action potential amplitude, are not predictive of functional outcomes after in situ decompression of the ulnar nerve [7].
  • Distal motor latency and median nerve cross-sectional area (CSA) are associated with each other in carpal tunnel syndrome [9].
  • Distal motor latency and median nerve CSA are associated with clinical symptoms in carpal tunnel syndrome [9].
  • The overall usage of electrodiagnostic studies for carpal tunnel syndrome has been decreasing since at least 2014 [10].
  • The preoperative usage of electrodiagnostic studies for carpal tunnel syndrome has been decreasing since at least 2014 [10].
  • There is a significant association between increasing median nerve cross-sectional area and increasing electrodiagnostic severity at the distal wrist crease [11].
  • Patients with double-crush syndrome demonstrate shorter sensory nerve onset and peak latencies compared to patients with carpal tunnel syndrome alone [13].
  • Patients with double-crush syndrome demonstrate different patterns of wrist and elbow motor nerve conduction compared to patients with carpal tunnel syndrome alone [13].
  • As the severity of ulnar neuropathy at the elbow increases, the cross-sectional area of the ulnar nerve correspondingly increases at the elbow [16].

What the Evidence Shows

  • Nerve conduction studies serve as a measure of impaired nerve function and are the best available indicator of overall disease severity in carpal tunnel syndrome [1].
  • Nerve conduction studies have some prognostic value for surgical outcome in carpal tunnel syndrome [1].
  • Ultrasound is a valid alternative confirmatory test compared with electrodiagnostic studies in detecting ulnar neuropathy at the elbow [2].
  • There is severe discordance between the estimated prevalence of mild-to-moderate carpal tunnel syndrome based on clinical signs and symptoms (73%) versus electrodiagnostic studies and ultrasound (51%) [8].
  • When signs and symptoms suggest mild-to-moderate median neuropathy and surgery is being considered, additional testing such as electrodiagnostic studies or ultrasound may increase the probability of identifying actual median neuropathy that can benefit from surgery [3].
  • Distal motor latency and median nerve cross-sectional area are associated with each other and with clinical symptoms in diabetic and non-diabetic carpal tunnel syndrome [9].
  • There is a significant association between increasing median nerve cross-sectional area at the distal wrist crease and increasing electrodiagnostic severity [11].
  • The overall and preoperative electrodiagnostic study usage for carpal tunnel syndrome has been decreasing since at least 2014 [10].
  • Patients with double-crush syndrome demonstrated unique electrodiagnostic findings, including shorter sensory nerve onset and peak latencies, compared to carpal tunnel syndrome-only patients [13].
  • Patients with double-crush syndrome demonstrated different patterns of wrist and elbow motor nerve conduction compared to carpal tunnel syndrome-only patients [13].
  • Ulnar nerve motor nerve conduction velocity at the upper arm should be measured alongside routine assessment of motor nerve conduction velocity at the elbow and forearm, especially in clinically severe cases considering surgery [6].
  • Compound muscle action potential amplitude, but not other conventional electrodiagnostic parameters, was predictive of functional outcomes after in situ decompression of the ulnar nerve [7].
  • Electrodiagnostic severity does not predict short- to midterm outcomes of cubital tunnel release surgery [14].
  • Patient-reported preoperative disease severity may predict the expected postoperative change in ulnar nerve functional improvement [14].
  • Electrodiagnostic studies may not have prognostic value for patients undergoing cubital tunnel decompression [14].
  • Negative preoperative electrodiagnostic studies in the setting of strong clinical suspicion of cubital tunnel syndrome do not exclude diagnosis [18].
  • Negative preoperative electrodiagnostic studies in the setting of strong clinical suspicion of cubital tunnel syndrome may be a positive predictive factor for short-term postoperative functional improvement [18].
  • Chitosan phonophoresis demonstrated significant improvements in nerve conduction, pain reduction, and enhancement of hand function for mild to moderate cubital tunnel syndrome [4].
  • Radiological and electrodiagnostic insights into suprascapular nerve dysfunction highlight the importance of perioperative nerve preservation strategies and postoperative neurological assessments [5].
  • EMG-driven robotic treatment with 15 sessions of rehabilitation suggests that improvement may be possible for chronic stroke patients nine years after stroke [17].

Practical Considerations

  • Nerve conduction studies serve as a measure of impaired nerve function and are the best available indicator of overall disease severity in carpal tunnel syndrome [1].
  • Nerve conduction studies have some prognostic value for surgical outcome in carpal tunnel syndrome [1].
  • Ultrasound is a valid alternative confirmatory test compared with electrodiagnostic studies for detecting ulnar neuropathy at the elbow [2].
  • There is severe discordance between the estimated prevalence of mild-to-moderate carpal tunnel syndrome based on clinical signs and symptoms (73%) versus electrodiagnostic studies and ultrasound (51%) [8].
  • Clinicians may not be able to confidently diagnose patients with mild-to-moderate carpal tunnel syndrome based on clinical signs and symptoms alone [8].
  • When signs and symptoms suggest mild-to-moderate median neuropathy and surgery is being considered, additional testing such as electrodiagnostic studies or ultrasound may increase the probability of identifying actual median neuropathy that can benefit from surgery [3].
  • The overall and preoperative usage of electrodiagnostic studies for carpal tunnel syndrome has been decreasing since at least 2014 [10].
  • The decrease in electrodiagnostic study usage for carpal tunnel syndrome predates the 2016 American Academy of Orthopaedic Surgeons Clinical Practice Guideline [10].
  • There is a significant association between increasing median nerve cross-sectional area at the distal wrist crease and increasing electrodiagnostic severity [11].
  • Ultrasound has comparable sensitivity and specificity to nerve conduction studies in patients two or more standard deviations above or below the mean age for presentation of carpal tunnel syndrome [15].
  • Chitosan phonophoresis demonstrated significant improvements in nerve conduction, pain reduction, and hand function for mild to moderate cubital tunnel syndrome [4].
  • Ulnar nerve motor nerve conduction velocity at the upper arm should be measured alongside routine assessment at the elbow and forearm, especially in clinically severe cases considering surgery [6].
  • Compound muscle action potential amplitude, but not other conventional electrodiagnostic parameters, was predictive of functional outcomes after in situ decompression of the ulnar nerve [7].
  • Electrodiagnostic severity does not predict short- to midterm outcomes of cubital tunnel release surgery [14].
  • Patient-reported preoperative disease severity may predict the expected postoperative change in ulnar nerve functional improvement [14].
  • Electrodiagnostic studies may not have prognostic value for patients undergoing cubital tunnel decompression [14].
  • Radiological and electrodiagnostic insights into suprascapular nerve dysfunction are key predictors of poor functional outcomes in shoulder hemiarthroplasty [5].
  • Perioperative nerve preservation strategies and postoperative neurological assessments are important in the context of suprascapular nerve dysfunction [5].
  • Electromyography does not show adequate effectiveness in diagnosing suprascapular nerve lesions caused by rotator cuff tear in a rat model [12].
  • Surgeons should carefully evaluate suprascapular nerve integrity in cases of rotator cuff tear [12].

Key Evidence

  • [L5] Nerve conduction studies should be understood not as a test that determines the diagnosis but as a measure of impaired nerve function, serving as the best available indicator of overall disease severity with some prognostic value for surgical outcome. [1] (10.1177/17531934231191685)
  • [L4] Ultrasound is a valid alternative confirmatory test compared with electrodiagnostic studies in detecting ulnar neuropathy at the elbow. [2] (10.1016/j.jhsa.2023.08.014)
  • [L3] When signs and symptoms suggest mild-to-moderate median neuropathy and surgery is being considered, patients and clinicians might consider additional testing, such as EDS or US, to increase the probability of actual median neuropathy that can benefit from surgery. [3] (10.1097/corr.0000000000002751)
  • [L1] This approach demonstrated significant improvements in nerve conduction, pain reduction, and enhancement of hand function. [4] (10.1016/j.jht.2024.02.006)
  • [L3] These findings highlight the importance of perioperative nerve preservation strategies and postoperative neurological assessments. [5] (10.1016/j.jse.2025.07.001)
  • [L3] Ulnar nerve MNCV at the upper arm should be measured alongside routine assessment of MNCV at the elbow and forearm, especially in clinically severe cases considering surgery. [6] (10.1177/17585732241293360)
  • [L2] Compound muscle action potential amplitude, but not other conventional electrodiagnostic parameters, was predictive of functional outcomes after in situ decompression of the ulnar nerve. [7] (10.1016/j.jhsa.2022.10.008)
  • [L5] There is a severe discordance between the estimated prevalence of mild-to-moderate carpal tunnel syndrome based on clinical signs and symptoms (73%) versus electrodiagnostic studies and ultrasound (51%), calling into question whether clinicians can confidently diagnose patients with mild-to-moderate CTS. [8] (10.1097/corr.0000000000002822)
  • [L4] Distal motor latency and median nerve CSA were not only associated with each other, but also with clinical symptoms. [9] (10.1186/s12891-023-06881-1)
  • [L3] The overall and preoperative electrodiagnostic study usage for carpal tunnel syndrome has been decreasing since at least 2014, predating the 2016 AAOS CPG, reflecting the rapid implementation of evidence into practice. [10] (10.1016/j.jhsa.2022.09.019)
  • [L3] There was a significant association between increasing cross-sectional area and increasing electrodiagnostic severity. [11] (10.1177/15589447211066349)
  • [L5] This underscores the need for surgeons to carefully evaluate suprascapular nerve integrity in such cases. [12] (10.1186/s12891-025-09195-6)
  • [L3] Patients with double-crush syndrome (DCS) demonstrated unique electrodiagnostic findings, including shorter sensory nerve onset and peak latencies and different patterns of wrist and elbow motor nerve conduction compared to CTR-only patients. [13] (10.5435/jaaos-d-24-00056)
  • [L3] Patient-reported preoperative disease severity may predict the expected postoperative change in ulnar nerve functional improvement, and EDS may not have prognostic value for patients undergoing cubital tunnel decompression. [14] (10.1016/j.jse.2024.01.055)
  • [L4] Ultrasound has comparable sensitivity and specificity to NCS in patients two or more standard deviations above or below the mean age for presentation of CTS. [15] (10.1016/j.jhsg.2024.01.008)
  • [L2] As the severity of ulnar neuropathy at the elbow increases, the CSA of the ulnar nerve correspondingly increases at the elbow. [16] (10.1016/j.jhsa.2024.12.004)
  • [L5] The improvement achieved 9 years later with 15 sessions of rehabilitation suggests that improvement may be possible for chronic stroke patients. [17] (10.1016/j.jht.2021.04.022)
  • [L4] However, negative preoperative EDX studies in the setting of strong clinical suspicion of CuTS do not exclude diagnosis and may in fact be a positive, rather than a negative, predictive factor for short-term postoperative functional improvement. [18] (10.1016/j.jhsg.2024.08.013)

References

[1] Use of nerve conduction studies in carpal tunnel syndrome. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231191685 [2] Diagnosis of Ulnar Neuropathy at the Elbow Using Ultrasound — A Comparison to Electrophysiologic Studies. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2023.08.014 [3] Diagnosis of Mild-to-moderate Idiopathic Median Neuropathy at the Carpal Tunnel Based on Signs and Symptoms is Discordant From Diagnosis Based on Electrodiagnostic Studies and Ultrasound. Clinical Orthopaedics & Related Research. 2023. DOI: 10.1097/corr.0000000000002751 [4] Effectiveness of chitosan phonophoresis on ulnar nerve conduction velocity, pain relief, and functional outcomes for mild to moderate cubital tunnel syndrome: A double-blind randomized controlled trial. Journal of Hand Therapy. 2024. DOI: 10.1016/j.jht.2024.02.006 [5] Radiological and electrodiagnostic insights into suprascapular nerve dysfunction: a key predictor of poor functional outcomes in shoulder hemiarthroplasty. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2025.07.001 [6] Clinical significance of upper arm motor nerve conduction velocity in cubital tunnel syndrome. Shoulder & Elbow. 2024. DOI: 10.1177/17585732241293360 [7] Electrodiagnostic Predictors of Outcomes After In Situ Decompression of the Ulnar Nerve. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2022.10.008 [8] CORR Insights®: Diagnosis of Mild-to-moderate Idiopathic Median Neuropathy at the Carpal Tunnel Based on Signs and Symptoms is Discordant From Diagnosis Based on Electrodiagnostic Studies and Ultrasound. Clinical Orthopaedics & Related Research. 2023. DOI: 10.1097/corr.0000000000002822 [9] Characteristics of diabetic and non-diabetic carpal tunnel syndrome in terms of clinical, electrophysiological, and Sonographic features: a cross-sectional study. BMC Musculoskeletal Disorders. 2023. DOI: 10.1186/s12891-023-06881-1 [10] Has the Use of Electrodiagnostic Studies for Carpal Tunnel Syndrome Changed After the 2016 American Academy of Orthopaedic Surgeons Clinical Practice Guideline?. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2022.09.019 [11] Ultrasound Measurements of the Median Nerve at the Distal Wrist Crease Correlate With Electrodiagnostic Studies. HAND. 2022. DOI: 10.1177/15589447211066349 [12] Electromyography does not show adequate effectiveness in diagnosis of suprascapular nerve lesions caused by rotator cuff tear in rat model. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09195-6 [13] Preoperative Electrodiagnostic Study Findings Differ Between Patients With Double-crush Syndrome and Carpal Tunnel Syndrome: A Propensity Matched Analysis. Journal of the American Academy of Orthopaedic Surgeons. 2024. DOI: 10.5435/jaaos-d-24-00056 [14] Electrodiagnostic severity does not predict short- to midterm outcomes of cubital tunnel release surgery. Journal of Shoulder and Elbow Surgery. 2024. DOI: 10.1016/j.jse.2024.01.055 [15] The Diagnostic Utility of Ultrasound and Electrodiagnostic Studies in The Young and Old. Journal of Hand Surgery Global Online. 2024. DOI: 10.1016/j.jhsg.2024.01.008 [16] Association of Ultrasound and Electrodiagnostic Studies in Patients Evaluated for Ulnar Neuropathy. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2024.12.004 [17] The effect of Electromyography (EMG)-driven Robotic Treatment on the recovery of the hand Nine years after stroke. Journal of Hand Therapy. 2023. DOI: 10.1016/j.jht.2021.04.022 [18] Electrodiagnostic Testing Predicts Postdecompression Outcomes in Patients With Cubital Tunnel Syndrome. Journal of Hand Surgery Global Online. 2024. DOI: 10.1016/j.jhsg.2024.08.013

Creative Commons BY-NC 4.0

CC Creative Commons licence
BY Attribution — you must credit the source
NC NonCommercial — not for commercial use

Attribution-NonCommercial 4.0 International


Creative Commons Corporation ("Creative Commons") is not a law firm and does not provide legal services or legal advice. Distribution of Creative Commons public licenses does not create a lawyer-client or other relationship. Creative Commons makes its licenses and related information available on an "as-is" basis. Creative Commons gives no warranties regarding its licenses, any material licensed under their terms and conditions, or any related information. Creative Commons disclaims all liability for damages resulting from their use to the fullest extent possible.

Using Creative Commons Public Licenses

Creative Commons public licenses provide a standard set of terms and conditions that creators and other rights holders may use to share original works of authorship and other material subject to copyright and certain other rights specified in the public license below. The following considerations are for informational purposes only, are not exhaustive, and do not form part of our licenses.

Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees


Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.


Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.