Tinel's Sign at the Wrist: How to Check for Carpal Tunnel Syndrome

Tinel's Sign is a common orthopedic test used to detect an irritated nerve. At the wrist, it is a primary test used by physiotherapists to assess for Carpal Tunnel Syndrome (median nerve compression).

1. Purpose

The primary purpose is to **test for** irritation or compression of the Median Nerve as it passes through the carpal tunnel. This condition is known as Carpal Tunnel Syndrome (CTS).

2. How to Perform

1. The patient is positioned in sitting, with their forearm supinated (palm up) and resting comfortably on a table.
2. The examiner locates the carpal tunnel at the base of the palm, over the median nerve.
3. The examiner firmly but gently taps over the median nerve within this tunnel (using their finger or a reflex hammer).
4. The examiner typically taps 4 to 6 times and asks the patient about their symptoms.

3. Positive & Negative Sign

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

• Reproduction of the patient's familiar symptoms, which is a tingling sensation, "pins and needles," or an "electric shock" feeling 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 any tingling or neurological symptoms when the nerve is tapped.