Do you sometimes wake up at night with a numb hand? Or do your fingers go numb while working on the computer, using your phone, or driving a car? One of the main reasons for this can be a condition called Carpal Tunnel Syndrome . So when you go to the doctor to tell him about this kind of discomfort, today we are talking about a very simple and easy test to find out if you have this. This is called the Phalen's Test.
What is Phalen's Test?
Simply put, this is a very simple physical test that your doctor performs in-office, without any special equipment. It's also called Phalen's sign. Your doctor will guide you to hold your hand and wrist in certain positions.
These positions put a little pressure on the Median Nerve, a very important nerve that runs through your wrist. Think of it like squeezing a water pipe. So, if you really have Carpal Tunnel Syndrome, when this nerve is squeezed a little, you will experience tingling or numbness in your fingers. If these symptoms occur, it will give your doctor a good idea that you may have this condition.
Remember, this is only one step in the diagnosis. After this test, other tests may be done to confirm the diagnosis.
Why is this test done? Let's talk a little about Carpal Tunnel Syndrome.
To understand this test, we need to know a little about what Carpal Tunnel Syndrome is.
Imagine that there is a small tunnel through your wrist. This is what we call the Carpal Tunnel . This tunnel is made up of a small bone and ligament in the wrist. Inside this tunnel, the tendons that help us bend our fingers and the Median Nerve that provides sensation to the hand pass.
So, if for some reason there is swelling inside this tunnel, or if for some other reason the space inside decreases, the median nerve that I mentioned starts to get compressed and pinched. That's what we call Carpal Tunnel Syndrome.
When this nerve becomes pinched, symptoms such as numbness, tingling, pain, and sometimes loss of strength in the hand, mainly in the thumb, index finger, middle finger, and half of the ring finger, may occur.
How exactly do you do the Phalen's Test?
This is very simple. You don't need any special preparation. The doctor will clearly show you how to do it.
1. First, take your hands at about waist level, and place them on the dorsal side of your hands. To be precise, turn your palms outwards and place the backs of your hands together.
2. Next, keeping both hands in the same position, raise both elbows until they are at chest level. At this point, the wrists will be fully bent.
3. Now the doctor will tell you to stay in this position for about a minute .
4. The doctor will ask you if you are experiencing any numbness, burning, or other discomfort in your fingers at this time.
Is this also the case with the Reverse Phalen's Test?
Yes, this is another way to check for Carpal Tunnel Syndrome. Sometimes the doctor may do both of these tests.
Do this on the other side. Place your palms together as if you were bowing and spread your elbows out to the sides. Then, in the same way, lower your hands to your stomach level. The doctor will tell you to stay in this position for about a minute. At this point, they will also check to see if the symptoms you mentioned earlier appear.
What are the results of the test and what happens after that?
The doctor will classify your result as either "Positive" or "Negative" .
- Positive Phalen's Test: This means that you experienced symptoms (such as numbness and pain) related to Carpal Tunnel Syndrome during the test.
- Negative Phalen's Test: This means that you did not feel any discomfort during the test.
But remember, sometimes even if the result is negative, you could still have Carpal Tunnel Syndrome. That's why the doctor will be very careful about the symptoms and other things you're describing.
After this examination, the doctor may recommend several more tests to confirm the diagnosis or to see exactly what damage has been done to the nerve.
- MRI (Magnetic Resonance Imaging) scan: To clearly see the structures inside the wrist.
- Ultrasound scan: To see the size of the median nerve and whether it is compressed.
- EMG (Electromyogram) test: Measures the speed at which electrical signals travel through the nerve to determine exactly whether the nerve is damaged.
After these tests, if it is confirmed that you have Carpal Tunnel Syndrome, your doctor will start treatment that is appropriate for you. This may include a splint, medication, or in some cases, a referral to an orthopedic specialist (orthopaedist) for minor surgery.
What is the difference between Phalen's Test and Tinel's Sign?
Both of these are simple tests that doctors perform in their rooms to diagnose Carpal Tunnel Syndrome. However, there is a slight difference in the way these two are performed. Let's understand it clearly with a table.
| Characteristic | Phalen's Test | Tinel's Sign |
|---|---|---|
| How to do it | Bend the wrist tightly, apply pressure to the nerve, and hold for about a minute. | The doctor gently taps with his finger where the median nerve passes through the wrist. |
| What you feel (if positive) | Numbness or loss of sensation in the fingers while maintaining the posture. | A pins-and-needles sensation along the fingers when tapped. |
| Main objective | Provoking symptoms by pressing on the nerve. | Stimulating the pinched nerve to elicit symptoms. |
With both of these tests, the doctor is trying to determine whether your median nerve is compressed or if it is sensitive.
Take-Home Message
- Phalen's Test is a very simple, painless, and safe test to diagnose Carpal Tunnel Syndrome.
- Don't ignore numbness, pain, or loss of feeling in your hand or fingers. These could be symptoms of Carpal Tunnel Syndrome.
- This test is only one part of a complete diagnosis. It is very important to tell your doctor a complete description of your symptoms.
- The results of this test will help your doctor decide what next steps you need to take.
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