The reverse prayer test, also known as the Phalen's test, is a physical examination technique used to assess for carpal tunnel syndrome by reproducing symptoms.
Understanding the Reverse Prayer Test
The core of the reverse prayer test involves a specific wrist position to elicit potential symptoms associated with carpal tunnel syndrome. Here's a breakdown:
Procedure
- Patient Positioning: The patient is instructed to bring both hands together, placing the dorsal surfaces (backs of the hands) against each other. This creates full flexion of the wrists.
- Holding the Position: The patient maintains this position for approximately one minute.
Interpreting Results
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Positive Test: A positive reverse prayer test occurs if the patient experiences the reproduction or worsening of carpal tunnel syndrome symptoms. These symptoms typically include:
- Numbness
- Tingling
- Pain
These sensations usually manifest in the areas of the hand innervated by the median nerve.
-
Negative Test: If no symptoms are produced or exacerbated during the test, it is considered negative.
Why it Works
The reverse prayer position causes significant flexion of the wrists, which can increase pressure within the carpal tunnel. This pressure may compress the median nerve, which can lead to the symptoms associated with carpal tunnel syndrome.
Practical Insights
- Duration: The test is usually performed for one minute. However, symptoms may manifest sooner in some cases.
- Severity: A positive result often suggests compression of the median nerve within the carpal tunnel, but doesn't definitively diagnose carpal tunnel syndrome.
- Complementary Test: The reverse prayer test is often performed alongside other diagnostic tests like the Tinel's test and nerve conduction studies to confirm a diagnosis.
Summary of the Reverse Prayer Test
| Feature | Description |
|---|---|
| Purpose | To evaluate for carpal tunnel syndrome. |
| Procedure | Dorsal surfaces of hands are pressed together to fully flex the wrists for one minute. |
| Positive Result | Reproduction of numbness, tingling, or pain in the median nerve distribution within one minute. |
| Negative Result | Absence of symptoms or no worsening of existing symptoms. |
| Other Names | Phalen's test |
The reverse prayer test serves as a useful initial assessment tool for suspected carpal tunnel syndrome, by causing median nerve compression and thus eliciting or worsening of symptoms.
