A positive Phalen test indicates the presence of carpal tunnel syndrome.
The Phalen test is a diagnostic maneuver used to assess for carpal tunnel syndrome. It involves having the patient hold their wrists in a fully flexed position for a specific duration, typically about 60 seconds. The test is considered positive (abnormal) when the patient experiences symptoms characteristic of carpal tunnel syndrome.
Symptoms of a Positive Phalen Test:
- Pain: The patient may feel pain in the wrist and hand.
- Paresthesias: This refers to abnormal sensations like tingling, numbness, or prickling. Specifically, these sensations occur along the distribution of the median nerve.
Median Nerve Distribution:
The median nerve is responsible for sensation in the following areas of the hand:
- Thumb
- Index finger
- Middle finger
- Radial (thumb) side of the ring finger
A positive Phalen test suggests that the median nerve, which passes through the carpal tunnel in the wrist, is being compressed. This compression results in the characteristic pain and paresthesias experienced by the patient.
Table: Phalen Test Interpretation
| Test Result | Description |
|---|---|
| Positive | Patient experiences pain and paresthesias in the median nerve distribution. |
| Negative | Patient experiences no symptoms or only minimal discomfort. |
Practical Insights
- The Phalen test is just one tool in diagnosing carpal tunnel syndrome. Other tests and a clinical examination are needed for a comprehensive diagnosis.
- Symptoms may not occur immediately upon starting the test, and may gradually increase over the 60-second period.
- The intensity of the symptoms in a positive test can vary.
In summary, a positive Phalen test is a physical examination finding indicating that the patient's hand symptoms, such as pain and paresthesias, are aggravated when the wrists are held in a flexed position, which supports a diagnosis of carpal tunnel syndrome, based on the reference information that "The test is positive (abnormal) if the patient experiences characteristic symptoms of carpal tunnel syndrome (pain and paresthesias along the distribution of the median nerve, i.e., thumb, index finger, and middle finger)".
