What is Phalen Test?

The Phalen test, also known as Phalen’s maneuver or the wrist-flexion test, is a simple clinical test used to help diagnose carpal tunnel syndrome (CTS). Carpal tunnel syndrome is a condition characterized by compression of the median nerve as it passes through the carpal tunnel in the wrist. The Phalen test is performed to assess for symptoms that might indicate the presence of CTS. 

How Does a Phalen Test Work?

  1. Preparation: The individual being tested should sit comfortably with their elbows flexed and their wrists extended.
  2. Performing the Test:
    • The person flexes their wrists by pressing the backs of their hands together, fingers pointing downward. The wrists are held in this position for about 60 seconds.
    • Alternatively, the person can hold their wrists in a flexed position by resting them on a table or surface, with the fingers pointing toward the floor.
  3. Observation: The healthcare provider observes the individual’s response during and after holding the wrist flexion position.

How is the Phalen Test Interpretated?

  • If the test elicits tingling, numbness, or pain in the median nerve distribution, which includes the thumb, index, middle, and part of the ring fingers, it can suggest a positive result for carpal tunnel syndrome.
  • Symptoms may be felt in the palm of the hand, the fingers, or even radiate up the forearm.

What are Some Limitations to a Phalen Test?

  • The Phalen test is a screening tool and not a definitive diagnostic test for carpal tunnel syndrome.
  • A positive result does not confirm CTS but indicates the need for further evaluation and testing.
  • Some false positives and false negatives can occur due to various factors, including hand anatomy and the presence of other conditions.

    It’s important to note that while the Phalen test can provide valuable information, its results should be interpreted in conjunction with the individual’s medical history, physical examination findings, and possibly additional diagnostic tests. If someone is experiencing symptoms suggestive of carpal tunnel syndrome, they should consult a healthcare provider for a proper evaluation and diagnosis.