What does a positive Phalen test indicate during a physical assessment?

A positive Phalen test is specifically used to diagnose carpal tunnel syndrome, a condition that occurs when the median nerve is compressed as it travels through the wrist. During the test, the patient is asked to press the backs of their hands together and hold the position for a minute. If this maneuver elicits symptoms such as tingling, numbness, or pain in the area innervated by the median nerve (which includes parts of the thumb, index, middle finger, and half of the ring finger), it suggests the presence of carpal tunnel syndrome.

The reason this test is focused on carpal tunnel syndrome is due to its ability to reproduce symptoms associated with median nerve compression. Symptoms in this area are caused by the narrowing of the carpal tunnel, leading to increased pressure on the nerve. Other conditions, such as nerve damage, joint inflammation, or muscle weakness, do not specifically provoke the characteristic symptoms related to the median nerve in the same manner that a positive Phalen test does. This specificity highlights the importance of the test in the context of diagnosing carpal tunnel syndrome.