Phalen's Test | Carpal Tunnel Syndrome Diagnosis
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- เผยแพร่เมื่อ 11 ธ.ค. 2015
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This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional. Kai demonstrates the Phalen's Test for carpal tunnel syndrome
Useful Links Below:
Article: www.ncbi.nlm.nih.gov/pubmed/12...
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I really appreciated the inclusion of sensitivity and specificity rates for the test, good job!
+Federica Manfroi awesome! It's standard for our videos whenever the stats are available
The research article is 22 years old though. According to the American Academy of Orthopedic Surgeons, "Strong evidence supports not using the Phalen Test, Tinel Sign, Flick Sign, or Upper limb neurodynamic/nerve tension test (ULNT) criterion A/B as independent physical examination maneuvers to diagnose carpal tunnel syndrome (CTS) , because alone, each has a poor or weak
association with ruling-in or ruling-out carpal tunnel syndrome." So this means it's a good idea to use multiple tests in addition to the phalen's test to rule in or rule out CTS. The phalen's test alone has a weak association in diagnosing CTS.
www.aaos.org/globalassets/quality-and-practice-resources/carpal-tunnel/cts_cpg_4-25-19.pdf
You guys are so amazing, thank you for uploading these :)
Great work... Always take help from your videos to get understanding for the exams:)
I watched this video when i was study for osce .. & now i pass it ♥️✨ THX for your work
Actually this maneuver relieved my numbness briefly.
My hands get painful with the numbness. It comes back frequently even if it gets better.
Keep going U R doing great work never stops 👍🏼👍🏼👍🏼
Thanks Aziz! We will surely keep going!
Thanks for making videos on special tests
Glad you like them!
Just found this! Great work. Thanks! :)
+juhi mittal Glad you found us and like our channel! You're welcome and spread the word!
great explanation
Thank you doctor. 👍
If i feel pain on the dorsal surface of the hand around the wrist when pressure is applied for example when doing pushups can this be indicative of CTS
I like your videos. Just as a sidenote there's 9 tendons within the carpal tunnel: 4 flexor digitorum superficialis (FDS), 4 flexor digitorum profundus (FDP) and the flexor pollicis longus (FPL) (plus the median nerve), not 10.
Thanks for the info! We've noticed that a while ago when we shot the video. Will do a remake pretty soon anyways!
Thank you sir. I am a student. Your videos are very helpful..
you are the best thanks
+María Fernanda Egüez Del Pozo thanks a lot Maria, we appreciate it!
Awesome ❤️❤️
Thanks. Liked the statistics
are you austrian? I love your accent. Your videos help me so much as a primary care NP. Thank you.
Haha, no German! Good to hear, no worries!
@@Physiotutors jawohl
I feel and sometimes also hear a slight popping when i bend my wrist.
Should i bee conserned or is it ok?
I know that my wrist always hurt with a tingling sensation, literally always and more the more I use my hands.
Although I'm not sure how much there directly responding to this test.
Your symptoms may be arising from further up the arm i.e. pronator teres syndrome, Ligament of Struther's, other tendionous causes, thoracic outlet or at the neck.
I think I got a positive on this test (but only mild, barely noticable tingling, less than without this test) and negative on Tinel test.. Do I have CTS?
I broke the base of my 4th metacarpal and I have had severe pain aching in wrist burning sensation and numb small and ring fingers also most days when I wake up in the morning my hand goes numb is there anything I can do plz help I broke my hand nearly 4 months ago I have been back the hospital and apparently I have healed which I dont feel healed at all
I did this test and my hands were feeling cold,tingly in my palm as well Plus my wrist was hurting a bit ..is it a pass ??
You sound like arnold schwarzenegger!!
He said He'll be back. So he's back.
like an aussie schwarzenegger lol
I felt nothing while doing this. But when I breathe and do shoulder like movements i feel pain in wrist like nerve pain. What that can be?
Did MRI have no discs.
I would always feel tingling about a week or so to my index finger on the left, sometimes it could be my left hand up to my left elbow it would go away after a couple of minute and be there longer at night time when i lay down and its like hard to ignore it and im getting anxious then i found carpal tunnel which is the closest to what im feelin upon lookin on the web but i tried this test and i dont feel anything at all which i think makes me negative of carpal and i did remember im about to have my period. Does anyone get the same before they get their period? Its kinda awful
I feel doing this test tingling in my palm is it something to worry about?
god damn im only 21 and i think i have this.
shit bro same xD how are you dealing with it now?
i am 14 and i have this. there is surgery you can do to stop the nerve from being blocked.
i did the test no numbness or tingling just bad pain on my ulnar side ?
thank you!
Here's the best treatment for carpal tunnel: HootHand.info
Here's the best treatment for carpal tunnel: HootHand.xyz
Medial half of ring finger not lateral
thanks
No worries, thanks for following!
I cant do that test it hurts to try doing it
Hi. Thanks for the test details. I tried this and the area between wrist and palm + under the thumb (inner side) started paining. What does that mean? Is it CTS only? Please confirm.
For any personal health or rehab questions we recommend to consult with our partners at yourphysio.online for a remote physiotherapy consultation.
0:57
Im here because I keep getting shooting pains in my veins. I googled it and somehow came here. Anyone know why I'm experiencing them?
Shouldn't it be medial half of the ring finger instead of the lateral half? Thanks
Hi , I am commenting in hope of a reply, I had 3 , 4 Metacarpal base fracture. Its been 8 weeks the doctor said that bones have healed. But i have developed CTS and the swelling on the back of hand near the intersection of thumb and index finger base... These were not injured, please help
Hey Cee Cee,
sorry to hear you got injured. Unfortunately we cannot conduct evals online, which is why we recommend you seek help from a physio
I have hand pain especially in the knuckles. I have not once gotten tingling during the phalens test but I played hours of video games about a year ago on the computer. I can’t tell if it is carpal and I got diagnosed for cubital tunnel syndrome but when I switched the mouse I used the symptoms for cubital went away. I don’t know what I have now plz help if you can.
Also it feels like my hands are tight especially if I’m lifting weights and my neck always feels tight when I massage it.
We'd suggest you to get in touch with our partner yourphysio.online to get individualized counseling for your complaint.
Thank for your videos, I have a question, what do you think of the carpal compression test (Durkan test) to diagnose the CTS instead of Phalen's or Tinel sign, as it has a Sensitivity of 87 % and a Specificity of 90%?
Do you have a link to the article with the sens and spec values?
One has to be very careful with the diagnostic values as it of course always depends on the reference/gold standard, the homogeneity of the cohort in which is tested etc.
But would be interesting to read!
A new diagnostic test for carpal tunnel syndrome
JA Durkan
J Bone Joint Surg Am. 1991;73:535-538
and this one
MacDermid JC and Wessel J (2004) Clinical diagnosis
of carpal tunnel syndrome: a systematic review.
J Hand Ther 17: 309-319
My wrist have always been extremely fragile and now my left wrist for some reason is more tender than my right one.. I’m right handed. My the pain in my left wrist is so bad that it doesn’t have words. It aches randomly but if I just barely hit my wrist against something it hurts so bad and it’s pain I can describe. It’s just feel extremely tender. But it’s more in my forearm than my wrist.
Please consult a therapist for a proper assessment. We take 1 hour for a first consultation and you can't expect this level of care through comments on TH-cam. It would be irresponsible from our side
Physiotutors I wasn’t expecting anything from comments. I was just commenting.
I also believe that a shirtless demo would have a positive impact on the learning outcome.. 🙄
Positive reinforcement
You can go for that kind of videos
I m sure you know the websites
fully agree
disgusting harlot
😂
I have atrophy in my right hand, what are some causes regarding the wrist? No pain or tingling
Could be several reasons from central neurological issues to cervical radiculopathy to peripheral nerve entrapment.
We'd definitely recommend you to see a local physio to get this checked out!
interesting. ive been a gamer for my entire life and figured my wrist pain was carpal tunnel starting to happen, but i passed this test just fine. guess i might have to see an actual doctor lol
i hope you have booked an appointment, i certainly know someone with wrist issues that started similar and now they have to work their day around their wrist pain rather than what they want do to
For any personal health or rehab questions we recommend to consult with our partners at yourphysio.online for a remote physiotherapy consultation.
Please i need indonesia subtitle
Hello, im 15 and Im having some wrist pain. I tried this but I dont feel any tingling. I thought it was a carpal tunnel but in hurts on the outside of the hand a little above the wrist joint(closer to the hand) but it only hurtd when i point my hand down or sometimes up, but not as often. Its been like this for 4 days any help? :/
Hi Adam,
we cannot really help without examining you personally. The best thing is to see a local physio and get your case evaluated.
In any case, it doesn't sound like CTS, but could rather be a limitation in the proximal or distal carpal row. Get it checked!
Is wrists cracking normal? I can crack them every 3 seconds or 2 seconds if i rotate my wrist upwards there is no pain is this normal?
Yes
My wrist have simply had a constant ache for months. So I'm trying to figure out what condition I can say it has.
Unfortunately every doctor I go to has been really reluctant to help and it's hard to get out of the house right now. I'm looking to treat this at home for now to get the pain to subside before being ready to go out again.
Would really recommend to see a health professional to get your problem sorted out.
A single test is not really useful in most conditions.
nice
Thanks Bosco
Nope couldn't do it! It hurt to bad
Can be painful locally for the wrist as well
I have anxiety about cts so most of the times i do it i feel nothing, sometimes i think i make myself feel tingling like placebo but idk if i have it or not
And my right wrists been cracking when i rotate it but no real pain, what does this mean?
One single test doesn't say much about you having CTS or not. Cracking in joints is normal without pain and can be due to tendons, cavitation within the joints or synovial fluid moving along rough joint spaces.
i went to my doctors for numbness and pain in my fingers, (my fingers have been numb since monday) she told me to do this but didn’t tell me i needed to do it for 60 seconds and hold the back of my hands together like the guy did in the video, i did this test at home and hurts like a mf
Why can’t I concentrate?😂😂
What are it's remedies ?
Different options: casting and nerve gliding might be a start
Phew I passed the tests
Is the tingling supposed to be easily notifiable? I cant feel any tingling, what is that supposed to mean?
The tingling (feeling like ants crawling over your fingers) is easily notable. Compare it to the feeling that you get when you hit your funny bone. In your case, the test is negative then.
@@Physiotutors Interesting. I've been having some tingling/numbness in my left hand from climbing. Just did the test and it was negative. Any ideas?
Can be a lot of underlying reasons. We suggest to see a local physio to evaluate your individual situation
Idk what's hotter your accent or your arms. Thanks for letting me know I don't have carpel tunnel.... ;)
Hahaha 😜 thanks! Everyone has a carpal tunnel though 😅 just not the CTS
So here's my issue with mine, my right hand feels odd than my left hand, it feels cold and really odd that i can't explain it. I can still do basic stuff like beat the shit out of my classmates, throwing rocks, and flipping my table with no sweat whatsoever, but it just feels odd, and whenever i make a fist with strength, i can feel my hand cracks like whenever i crack my finger, and whenever i do the same thing but twisting it, my wrist makes an audible noise, i don't really know what to do at this point :/
Cracking without pain is normal and you should not worry about it.
the cracking is usually negative pressure forming in the joints when they joint surfaces are separated causing a gas bubble that explodes into smaller gas bubbles.
Kirigaya Kazuto it’s best you just take this to your local GP.
Kirigaya Kazuto did you figure it out? This sounds exactly the same as me!!!
@@Physiotutors I did this test. The ring finger of one hand turned achy (but almost negligible). Is it positive for carpal tunnel?
Is cracking in ankle(s) normal ?
Yes, it's very common and when experienced without pain it is nothing to worry about. Watch our video on knee cracking which has similar underlying mechanisms
Direct pressure on carpal tunnel is better than phalen or tinel
Source?
@@Physiotutors Bickel KD carpal tunnel synd. 2010. i saw it current Medical diagnosis & treatment page 1689
That just hurts my wrists some what
That can be the case if you have somewhat limited dorsiflexion. But it's only positive for CTS if you have tingling, numbness, shooting pain in the fingers
I couldn’t do it. It hurt
There are ways to cure yourself of carpal tunnel without surgery. Go here to learn those methods: CarpalTunnel.club
Apperication 👍
I am an artist and after i draw just a little bit both of my bands go numb. Also I work as a maid so I sweep and mop everyday. My hands always tingle and dall asleep. So do my ankles.
I notice very very faint buzzing in the middle finger, I have to really concentrate to feel it. Am I just overthinking?
For any health-related questions, we would advise you to get in touch with our colleague from Yourphysio.online where you can find great information for patients. You can also book an online consultation in order to work on your problem!
Were you overthinking it? Same thing happened to me
@@seanscott1308 Yeah bro I was overthinking. I did feel the buzzing but It was probably psychological.
I just overused my tendons, I elevated my hands on a pillow, strict rest and relaxation, found some finger and wrist stretching on NHS TH-cam channel. It went away by itself but kept coming back even up my shoulders....
I later found out after that I was _severely_ vitamin D deficient/even potassium deficient (didn't know that was a thing) which both contributed to the bone/muscle aching and tingling.
Both got taken care of and bam, fine.
Might be worth getting your blood checked
Did this and it actually improved my new tingly-sensation symptom... Hopefully it's just a pinched nerve then! Lol
Update, it’s gone now, must have been a pinched nerve
@@pastooleo1 was there pain
what if I feel nothing
I tried it BTW
First 40 seconds - That's easy for you to say. 😁
No need to hold it for longer if symptoms are reproduced earlier
Messiahs !
🙏😂
I feel pins and needles in my thumb so im fucked
Damn I have this in my left hand..but only when I do this test...normally I don't have any problems with it.
Then don’t do the test 😉 if you’re symptom free otherwise. It’s not unlikely that someone experiences discomfort as it puts compression on the carpal tunnel
@@Physiotutors ok
Where is the Reverse Phalen test ?
Maybe one to add on the list! thanks for the input!
♥️🙏
Can he be my personal tutor? 😂
Aren’t we that already ? 😉
You lost me at "Hello." 😂
t
This guy's little jacked.
Can you demonstrate this without a shirt? TIA
Best carpal tunnel treatment: bit.ly/2rXOTfh
If you want a treatment for your carpal tunnel condition then go here now: CarpalTunnel.club
I know I am fucked after watching this video
Just a positive result on the Phalen's test does not confirm 100% that you are suffering from Carpal Tunnel Syndrome yet. Our advice is to see a local physio who will take your patient-history and signs&symptoms into account as well. You can also have a look at out "Tine's sign video", which is another useful test for CTS.
On top of that CTS is a condition that can be treated effectively - so no need to worry too much!
DOC looks like Rooney 😄
Haha
Doctor told me I have carpal tunnel but dhsjsnjd just wanted to check and yup ahaaaa.... I'm 12...
what is the treatment for this case?
Uh oh guys...
!!
Nothinn happen thanks god 😅
Rubbish have got carpel tunnel and this test is negative
stop self diagnosing. get back to work.
The more u know medicine, the more u become Sick 🤢
Dude my arm hurts like hell for playing this shit game called osu!, let’s hope I didn’t develop this
I bet 1000 dollars that you're German
Jep not a secret
if anyone know the name of my disease please text here :
i m suffering from index, thumb pain ,wrist pain and numbness burning sensation for 2 years but now my shoulder,neck also start to pain i m a mechanical engineering student age 19,i vist so many doctors none of them find some tell writehandcramp.