Carpel Tunnel Syndrome

Carpel Tunnel Syndrome .

✴️Physical Examination:

May include testing for sensory and motor deficits and evidence of thenar wasting. There are several special tests with varying degrees of sensitivities and specificities.

1️⃣Compression Test:

➡️The best of these include the carpal compression test. This is done by applying firm pressure directly over the carpal tunnel for 30 seconds. The test is positive when paresthesias, pain, or other symptoms are reproduced.

2️⃣Square Sgin Test:

➡️The square sign test is an evaluation to determine the risk of developing carpal tunnel syndrome. The test is positive if the ratio of the thickness of the wrist divided by the width of the wrist is great than 0.7.

3️⃣Palpation :

♿Another test is a palpatory diagnosis. In this test, the health care provider examines soft tissue over the median nerve for mechanical restriction.

4️⃣Phalen Test:

♿The Phalen’s test or ‘reverse prayer’ is performed by having the patient fully flex their wrists by placing dorsal surfaces of both hands for one minute. A positive test is when symptoms (numbness, tingling, pain) are reproduced.

5️⃣Reverse Phalen Test:

♿The reverse Phalen’s, or ‘prayer test,’ is done by having the patient extend both of their wrists by placing palmar surfaces of both hands together for 1 minute (as if praying). Again a positive test is with reproduction of symptoms.

6️⃣Tinel Sgin:

♿Although a low sensitivity and specificity, the Hoffmann-Tinel sign is another test commonly performed. In this test the healthcare professional taps immediately over the carpal tunnel to stimulate the median nerve. Like the above tests, a positive test is when symptoms are reproduced.