A positive carpal tunnel test indicates the presence of carpal tunnel syndrome (CTS). It's not one single test, but rather a positive result from any of several physical examinations designed to detect compression of the median nerve within the carpal tunnel. Several tests exist, and a positive result means that the test triggered symptoms consistent with CTS.
Types of Carpal Tunnel Tests and Positive Results:
Several tests can be used to diagnose carpal tunnel syndrome. A positive result for any of these generally means the patient experiences characteristic symptoms, such as numbness, tingling, and pain, during or immediately after the test. These symptoms typically affect the fingers innervated by the median nerve (thumb, index, middle, and radial half of the ring finger).
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Carpal Compression Test: Applying pressure over the median nerve in the carpal tunnel elicits numbness and tingling within 30 seconds. [Source: Carpal Compression Test (Apply pressure with thumbs over the median nerve within the carpal tunnel, located just distal to the wrist crease. The test is positive if the patient responds with numbness and tingling within 30 seconds.)17-Jul-2018; Three Tests for Carpal Tunnel Syndrome | UAMS Department of ... https://medicine.uams.edu/familymedicine/three-tests-for-carpal-tunnel-syndrome/]
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Phalen's Test: Holding wrists in a flexed position for a period of time (e.g., pressing the backs of hands together) reproduces CTS symptoms. A positive test means symptoms appeared during the test. [Source: Phalen's Test: What It Is & How It's Performed https://my.clevelandclinic.org/health/diagnostics/25133-phalens-test] The reverse Phalen's test, or "prayer test," involves pressing palms together and extending the wrists. A positive result is the reproduction of symptoms. [Source: Carpal Tunnel Syndrome - Physiopedia https://www.physio-pedia.com/Carpal_Tunnel_Syndrome]
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Tinel's Sign: Gently tapping over the median nerve at the wrist causes tingling or paresthesia in the median nerve distribution. A positive test means this tapping produces tingling in the affected fingers. [Source: Tinel Sign: Carpal Tunnel Test Procedure & Results https://www.webmd.com/pain-management/carpal-tunnel/what-is-tinel-sign; Carpal tunnel syndrome: Clinical manifestations and diagnosis ... https://www.uptodate.com/contents/carpal-tunnel-syndrome-clinical-manifestations-and-diagnosis]
It's important to note that a positive result on one or more of these tests suggests, but doesn't definitively confirm, carpal tunnel syndrome. Further diagnostic testing, such as nerve conduction studies, might be necessary for a conclusive diagnosis. Also, false positives can occur in individuals without CTS. [Source: False positive electrodiagnostic tests in carpal tunnel syndrome https://pubmed.ncbi.nlm.nih.gov/3374521/]
