Other carpal tunnel tests


These other carpal tunnel tests may help your doctor diagnose your carpal tunnel syndrome (CTS). Some of these other carpal tunnel exams or tests are less well known, so don't be suprised if your doctor is not that familiar with them, especially if he or she doesn't treat alot of CTS cases.

Also keep in mind that when a test is "Positive" that means the test is indicating you have the condition. IF the test is "Negative" then the test is indicating you don't have the condition.





The median nerve distribution includes the thumb, index, middle and half of the ring finger. See carpal tunnel anatomy
I can assure you that these tests are used by many practitioners and have been studied and compared to other tests, over and over.

The EMG /NCS tests remain the Gold standard for diagnosing CTS. They are generally about 90-95% accurate and it is what all other carpal tunnel tests are usually compared to.

Most of these other carpal tunnel exams or tests...including the popular TINELS and PHALENS TESTS , typically prove to be accurate about 50-60% of the time, with possibly the exception of the SQUARE WRIST SIGN which was correct in 69% of the cases (in one study).

The article Carpal tunnel test or exams will give you more general information on CARPAL TUNNEL TESTS

Other carpal tunnel tests


Flick sign

This is when you ask a patient "what do you actually do with your hand(s) when symptoms are at their worst"? IF the patient shows that they make a "flicking" movement of the wrist and hand (like when shaking down a thermometer) then that is a positive flick sign for CTS.

Closed-fist sign

This is where a patient experiences numbness and tingling maybe some pain or discomfort in the distribution of the median nerve, AFTER tightly flexing (bending) the fingers into a fist for 60 seconds.

Compression test (AKA Durkan's test, pressure provacation test

The examiner holds the wrist (palm-up) and applies direct even pressure over the transverse carpal ligament area with both thumbs for up to 30 seconds (some say 60 seconds). A positive test is indicated by numbness and tingling in the median nerve distribution.

Tourniquet test

Similar as above test, in that a positive test is when a patient experiences numbness and tingling of the median nerve distribution when a blood pressure cuff placed around the patients arm is inflated above their systolic pressure for 60 seconds.

Diminished 2-point discrimination test (AKA Weber's test)

The examiner uses a modified paper clip or a two-point discriminator and applies pressure along the finger tip pads. The patient must concentrate on feeling the points and must not be able to see the area being tested. The diminished ability to identify correctly the number of points whose points are set 4 to 6 mm (millimeters) is a positive test (i.e. the patient may have decreased sensation in finger tips due to CTS).

Abnormal monofilament testing (AKA Semmes-Weinstein test)

A test involving nylon string (resembles stiff fishing line) that collapses at specific amounts of force when pushed straight down against the palm or fingers. A positive test results when a string filament of greater than normal size is required in order for its application to be perceived by the patient (i.e. the patient may have decreased sensation in finger tips due to CTS).

Hopefully you now have a better understanding of some of these other carpal tunnel tests and how they may be used in diagnosing CTS.



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