Clinical tests for carpal tunnel syndrome in contemporary practice

Arch Orthop Trauma Surg. 2011 Apr;131(4):471-4. doi: 10.1007/s00402-010-1150-z. Epub 2010 Aug 6.


Introduction: A study conducted to establish the most accurate combination of questionnaire and physical signs for the diagnosis of carpal tunnel syndrome.

Method: Nerve conduction studies confirmed 70 patients with having carpal tunnel syndrome who were enrolled along with 70 age- and sex-matched controls. Patients were assessed using a symptom questionnaire, Phalen's test, Hoffmann-Tinel's sign, hand elevation test, carpal compression test, tourniquet test, pressure aesthesiometry and two-point discrimination.

Results: Through multivariate analysis, the best combination of tests was tourniquet, carpal compression and Phalen's tests but the difference between these and hand elevation test alone was negligible.

Conclusion: The hand elevation test may be used in isolation and is superior to questionnaires and other physical signs in the clinical diagnosis of carpal tunnel syndrome.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carpal Tunnel Syndrome / diagnosis*
  • Carpal Tunnel Syndrome / physiopathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neural Conduction
  • Physical Examination
  • ROC Curve
  • Surveys and Questionnaires