Carpal tunnel syndrome physical examination

Physical Examinations

Thenar atrophy  

Carpal tunnel compression test (Durkan's test) 

• is the most sensitive test to diagnose carpal tunnels syndrome
• performed by pressing thumbs over the carpal tunnel and holding pressure for 30 seconds and pain or paresthesia in the median nerve distribution considered as positive result.

Phalen test 

• wrist volar flexion for 60 sec produces symptoms

Tinel's test

• provocative tests performed by tapping the median nerve over the volar carpal tunnel

Semmes-Weinstein testing

• most sensitive sensory test for detecting early carpal tunnel syndrome 
• measures a single nerve fiber innervating a receptor or group of receptors

innervation density test

• static and moving two-point discrimination
• measures multiple overlapping of different sensory units and complex cortical integration