Wrist & Hand
Nerve Tests
Evidence: suggestive
Reverse Phalen's Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Carpal Tunnel Syndrome.
How to Perform
- Action: Patient extends both wrists (Prayer position) for 60 seconds.
Interpretation of Results
- Positive Test: Numbness/tingling in the median nerve distribution.
- Note: Increases carpal tunnel pressure more than standard Phalen's in some patients.
Clinical Context & Limitations
The Reverse Phalen's Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Wrist & Hand region, combining the Reverse Phalen's Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
