Wrist & Hand Nerve Compression Evidence: confirmed

Phalen's Test Special Test

Orthopedic Physical Examination & Clinical Assessment Guide

Phalen's Test Orthopedic Special Test

What is it used for?

  • Diagnosing Carpal Tunnel Syndrome.

How to Perform

  • Action: Patient flexes both wrists maximally by pushing the backs of hands together. Hold for 60 seconds.

Interpretation of Results

  • Positive Test: Numbness or tingling in the median nerve distribution within 60 seconds.
  • Why: Flexion increases pressure inside the carpal tunnel, compressing the nerve.

Diagnostic Accuracy

  • Sensitivity: 66%
  • Specificity: 88%

Clinical Context & Limitations

The Phalen's Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.

Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Wrist & Hand region, combining the Phalen's Test with complementary examination tests significantly improves overall diagnostic confidence.

References

Further Clinical Exploration

CMC Grind Test
Wrist & Hand Examination

CMC Grind Test

Lunotriquetral Ballottement Test
Wrist & Hand Examination

Lunotriquetral Ballottement Test

Watson Test (Scaphoid Shift)
Wrist & Hand Examination

Watson Test (Scaphoid Shift)

Ulnocarpal Abutment Test
Wrist & Hand Examination

Ulnocarpal Abutment Test