Phalen's Test: How to Check for Carpal Tunnel Syndrome

Phalen's Test (also known as the wrist flexion test) is a primary diagnostic test for Carpal Tunnel Syndrome (CTS). It is used to provoke symptoms by compressing the median nerve at the wrist.

1. Purpose

The primary purpose of Phalen's Test is to **test for** Carpal Tunnel Syndrome (CTS). It is designed to provoke symptoms by maximally flexing the wrist, which compresses the Median Nerve within the carpal tunnel.

2. How to Perform

1. The patient is positioned in sitting or standing.
2. The patient is asked to place the backs of their hands together, forcing both wrists into maximal flexion.
3. The elbows should be pointing down or slightly out.
4. The patient is instructed to hold this position for 30 to 60 seconds.
5. The examiner asks the patient to report any symptoms that appear.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test (indicating CTS) is:

• Reproduction of the patient's familiar symptoms of tingling, numbness, or "pins and needles" in the median nerve distribution (the thumb, index, middle, and radial half of the ring finger).

Negative Sign (Test is NEGATIVE):
A negative test is the absence of these neurological symptoms within the 60-second hold. Minor discomfort or stretching is not a positive sign.