Phalen's test

Last reviewed 07/2023

Phalen's test is used in carpal tunnel syndrome where forcible palmar flexion of the wrist causes venous engorgement of the canal and an exacerbation of the symptoms.

In the modified Phalen's test the wrist is palmar flexed and direct pressure is applied by the examiner's finger on the median nerve at the level of the carpal tunnel. This may make it a more reliable method of reproducing symptoms than Tinel's test (1).

When Phalen's test was compared with electrodiagnosis it was positive in 3/4 of patients and falsely positive in 20% of controls (2).

Reference:

  • Nichol, F (1992). Update, 15th July, 142
  • Gellman, H et al (1986). Carpal Tunnel Syndrome: an evaluation of the provocative diagnostic tests. J. Bone Joint Surg.(Am), 68:734-7