Physical examination maneuver

Physical Exam

Phalen Test

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Video coming September 2026

How to Perform

Have the patient hold both wrists in full flexion by pressing the backs of the hands together (fingers pointing down) and maintain the position for about 60 seconds. A positive test is tingling or numbness in the thumb, index, middle, and radial half of the ring finger (the median-nerve distribution).

How to Interpret

Showing all 1 finding

Carpal Tunnel Syndrome

Phalen test positive
Rule in
Minimally helpful
Rule out
Minimally helpful
Evidence:Strong

References

  • Dabbagh A, MacDermid JC, Yong J, Packham TL, Grewal R, Boutsikari EC. Diagnostic Test Accuracy of Provocative Maneuvers for the Diagnosis of Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis. Phys Ther. 2023 Jun 5;103(6):pzad029. doi:10.1093/ptj/pzad029. PMID 37366626. PRISMA systematic review with random-effects meta-analysis and QUADAS-2 risk-of-bias assessment; electrodiagnostic reference standard. (D'Arcy & McGee 2000 JAMA Rational Clinical Examination, PMID 10865306, retained as corroboration in the notes.)
  • Phalen GS. The carpal-tunnel syndrome. Seventeen years' experience in diagnosis and treatment of six hundred fifty-four hands. J Bone Joint Surg Am. 1966;48(2):211-228.

Related Diagnoses

Carpal Tunnel Syndrome

Related Systems / Regions

NeurologicalUpper Extremities

Related Bedside Tests

🎬Video coming Sept 2026
Tinel Test of the Wrist
aka Hoffmann-Tinel sign
Rule in:SHCarpal Tunnel Syndrome
🎬Video coming Sept 2026
Hand Strength
Rule in:MHCarpal Tunnel Syndrome (Median Neuropathy), IEUlnar Neuropathy (Cubital Tunnel Syndrome)
Rule out:SHCarpal Tunnel Syndrome (Median Neuropathy), IEUlnar Neuropathy (Cubital Tunnel Syndrome)
🎬Video coming Sept 2026
Tinel Test of the Elbow
Rule in:NHCubital Tunnel Syndrome (Ulnar Neuropathy at the Elbow)
Rule out:NHCubital Tunnel Syndrome (Ulnar Neuropathy at the Elbow)
🎬Video coming Sept 2026
Wrist and Hand Palpation
Rule in:IEDe Quervain Tenosynovitis, IEHand Osteoarthritis, IERheumatoid Arthritis (Inflammatory Arthritis)
Rule out:HScaphoid Fracture, IEDe Quervain Tenosynovitis, IEHand Osteoarthritis +1 more
🎬Video coming Sept 2026
Allen Test
aka Modified Allen test
Rule in:VHInadequate Hand Collateral Circulation (Incomplete Palmar Arch), IEHand Ischemia Following Radial Artery Puncture or Cannulation, IERadial or Ulnar Arterial Occlusion (E.g., Thromboangiitis Obliterans, Post-cannulation Occlusion)
Rule out:SHInadequate Hand Collateral Circulation (Incomplete Palmar Arch), IEHand Ischemia Following Radial Artery Puncture or Cannulation, IERadial or Ulnar Arterial Occlusion (E.g., Thromboangiitis Obliterans, Post-cannulation Occlusion)
🎬Video coming Sept 2026
Finkelstein Test
Rule in:NHDe Quervain Tenosynovitis
Rule out:NHDe Quervain Tenosynovitis