Physical examination maneuver

Physical Exam

Hand Strength

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How to Perform

Test hand and finger strength against resistance, comparing sides: grip strength (squeezing your fingers), finger abduction, and the pinch between thumb and fingers. Grade the strength and note any pain or give-way weakness.

How to Interpret

Showing 5 of 7 findings

Carpal Tunnel Syndrome

Weakness of thumb abduction (and opposition)
Rule in
Minimally helpful
Rule out
Somewhat helpful
Evidence:Moderate

Cervical Radiculopathy

Weak wrist extension
Rule in
Somewhat helpfulWide CI
Rule out
Not helpfulDerived CI
Evidence:Moderate
Weak finger flexion
Rule in
Somewhat helpfulDerived CI
Rule out
InconclusiveWide CI
Evidence:Moderate

Functional Neurologic Disease

Give-way (collapsing) weakness on resisted strength testing
Rule in
Very helpfulNo CI
Rule out
Somewhat helpfulNo CI
Evidence:Moderate

Malnutrition

Reduced grip strength
Rule in
Not helpfulDerived CI
Rule out
InconclusiveWide CI
Evidence:Moderate

Related Bedside Tests

Phalen TestMembers
Sign in
Phalen Test
Rule in:MHCarpal Tunnel Syndrome
Rule out:MHCarpal Tunnel Syndrome
Tinel Test of the WristMembers
Sign in
Tinel Test of the Wrist
aka Hoffmann-Tinel sign
Rule in:SHCarpal Tunnel Syndrome
Rule out:MHCarpal Tunnel Syndrome
🎬Video coming soon
Elbow Strength
Rule in:VHFunctional Neurologic Disease, HCervical Radiculopathy, NHDistal Biceps Tendon Rupture +1 more
Rule out:SHCervical Radiculopathy, SHFunctional Neurologic Disease, ICDistal Biceps Tendon Rupture +1 more
🎬Video coming soon
Shoulder Strength
Rule in:VHFunctional Neurologic Disease, HInfraspinatus Tear, SHSupraspinatus Tear +3 more
Rule out:HSupraspinatus Tear, SHFunctional Neurologic Disease, NHInfraspinatus Tear +3 more
Tinel Test of the ElbowMembers
Sign in
Tinel Test of the Elbow
aka Hoffmann-Tinel sign
Rule in:NHCubital Tunnel Syndrome
Rule out:NHCubital Tunnel Syndrome
Biceps Deep Tendon ReflexMembers
Sign in
Biceps Deep Tendon Reflex
aka Biceps jerk
Rule in:VHPeripheral Neuropathy, SHCervical Radiculopathy, IECervical Myelopathy +2 more
Rule out:MHPeripheral Neuropathy, NHCervical Radiculopathy, IECervical Myelopathy +2 more

Related Systems / Regions

MusculoskeletalNeurologicalUpper ExtremitiesWrist and Hand

Related Diagnoses

Brachial PlexopathyCarpal Tunnel SyndromeCervical RadiculopathyCubital Tunnel SyndromeFunctional Neurologic DiseaseMalnutrition

Related Chief Complaints

Arm NumbnessArm PainArm WeaknessDropping ObjectsElbow PainHand ClumsinessHand NumbnessHand PainHand TinglingHand WeaknessLittle Finger NumbnessMuscle WastingNeck PainNight-time Hand NumbnessNumbness of the Ring and Little FingersThumb WeaknessTingling in the FingersWeak GripWeight LossWrist Pain

References

Research in progress on one or more findings above; ratings may change.

  • D'Arcy CA, McGee S. The rational clinical examination. Does this patient have carpal tunnel syndrome? JAMA. 2000 Jun 21;283(23):3110-3117. doi:10.1001/jama.283.23.3110. PMID 10865306. (Erratum JAMA. 2000;284(11):1384.)
  • Andrews K, Rowland A, Pranjal A, Ebraheim N. Cubital tunnel syndrome: anatomy, clinical presentation, and management. J Orthop. 2018 Aug 16;15(3):832-836. doi:10.1016/j.jor.2018.08.010. PMID 30140129. (Erratum J Orthop. 2020;23:275.)
  • Kori SH, Foley KM, Posner JB. Brachial plexus lesions in patients with cancer: 100 cases. Neurology. 1981;31(1):45-50. PMID: 6256684.
  • Yoss RE, Corbin KB, MacCarty CS, Love JG. Significance of symptoms and signs in localization of involved root in cervical disk protrusion. Neurology. 1957;7(10):673-683. PMID: 13477342.
  • Alamri SH, Simbawa MM. The clinical utility of handgrip strength as a malnutrition screening tool in hospitalized older adults: a cross-sectional study in Saudi Arabia. Front Med (Lausanne). 2024;11:1436977. doi:10.3389/fmed.2024.1436977. PMID: 39109223. PMCID: PMC11301408 (open access).
  • Daum C, Hubschmid M, Aybek S. The value of 'positive' clinical signs for weakness, sensory and gait disorders in conversion disorder: a systematic and narrative review. J Neurol Neurosurg Psychiatry. 2014 Feb;85(2):180-190. doi:10.1136/jnnp-2012-304607. PMID 23467417.
  • Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
  • Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 9, 2026.