Phalen's Test for Carpal Tunnel

Описание: Phalen’s Test was developed by Dr. George S Phalen sometime in the 1950’s who was a very well known clinician working with carpal tunnel syndrome. He discusses this wrist flexion test as a way to diagnose carpal tunnel syndrome based upon his years of experience and the number of people he has seen (Phalen G. S. The carpal tunnel syndrome - 17 years’ experience in diagnosis and treatment of 654 hands. J. Bone Joint Surg., 1966, 48A, 211-228). He even felt that nerve condition studies were not needed because he felt a clinical assessment was good enough to make a diagnosis but these types of tests were good in people who did not improve after surgery.

How to perform it
-The person is sitting or standing
-Have them put the back of their hands together so the wrists are in flexion
-Hold for 30-60 seconds.
A positive is a reproduction of symptoms.

There have been many research papers published on this test over the years. In a meta-analysis (Ozdag, Y., Hu, Y., Hayes, D. S., Manzar, S., Akoon, A., Klena, J. C., & Grandizio, L. C. (2023). Sensitivity and specificity of examination maneuvers for carpal tunnel syndrome: a meta-analysis. Cureus, 15(7)) they looked at 36 studies. It was found to have a median sensitivity of 70% and specificity of 80% so when it’s positive it’s most likely carpal tunnel. The researchers in this meta-analysis did say that using a combination of tests along with a patient history should be done.

What do you think of this test? Do you use it? How often do you find it’s positive? Let me know in the comments.


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