How to do phalens test for carpal tunnel syndrome

Carpal tunnel syndrome is due to the compression of median nerve in the carpal tunnel at the wrist.It usually occurs in a middle aged female,hypothyroidism,diabetes etc.In Carpal tunnel syndrome there is paraesthesia of lateral 31/2 fingers.Phalens test is a provocative test to produce the symptoms of median nerve compression in a patient who presents to the OPD.

How to perform Phalens test

Place the backs of both  hands of the patient together and hold the wrists in forced flexion for a full minute. (Stop at once if sharp pain occurs) . If this produces numbness or “pins and needles” along the thumb side half of the hand, the patient most likely have Median nerve entrapment (Carpal Tunnel Syndrome).

 

Initial treatment is analgesics, if not relieved steroid injections are given into the carpal tunnel.If the symptoms are not relieved still,the definitive treatment is surgical release flexor retinaculum to decompress the carpal tunnel.

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