Physical examination maneuver

Physical Exam

Sharp Sensation

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Video coming September 2026

How to Perform

With the patient's eyes closed, touch the skin with a clean sharp object (a disposable neurological pin or a freshly broken wooden applicator), interspersing dull touches, and ask the patient to report 'sharp' or 'dull.' Compare sides and regions.

How to Interpret

Showing 3 of 8 findings

Carpal Tunnel Syndrome

Hypalgesia (reduced pinprick sensation in the median nerve distribution)
Rule in
Somewhat helpful
Rule out
Not helpful
Evidence:Strong

Peripheral Neuropathy

Decreased or absent sharp (pin-prick) sensation in a stocking-glove distribution
Rule in
HelpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Limited

Radiculopathy

Dermatomal band of decreased sharp (pinprick) sensation following a single nerve-root distribution
Rule in
Not helpfulNo CI
Rule out
Not helpfulNo CI
Evidence:Strong

References

  • Abraham A, Alabdali M, Alsulaiman A, Albulaihe H, Breiner A, Katzberg HD, Aljaafari D, Lovblom LE, Bril V. The sensitivity and specificity of the neurological examination in polyneuropathy patients with clinical and electrophysiological correlations. PLoS One. 2017;12(3):e0171597. PMID: 28249029.
  • Suri P, Rainville J, Katz JN, et al. The accuracy of the physical examination for the diagnosis of midlumbar and low lumbar nerve root impingement. Spine. 2011;36(1):63-73. PMID: 20543768.
  • D'Arcy CA, McGee S. The rational clinical examination. Does this patient have carpal tunnel syndrome? JAMA. 2000;283(23):3110-3117. PMID: 10865306
  • Roth EJ, Park T, Pang T, Yarkony GM, Lee MY. Traumatic cervical Brown-Sequard and Brown-Sequard-plus syndromes: the spectrum of presentations and outcomes. Paraplegia. 1991;29(9):582-589. doi:10.1038/sc.1991.86. PMID: 1787982.
  • Al Nezari NH, Schneiders AG, Hendrick PA. Neurological examination of the peripheral nervous system to diagnose lumbar spinal disc herniation with suspected radiculopathy: a systematic review and meta-analysis. Spine J. 2013;13(6):657-674. PMID: 23499340.
  • 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.

Related Systems / Regions

Neurological

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