What is the Phalen's test position and what is considered a positive symptom?

• A. Hand relaxed, maximally flex the wrist so the dorsal surfaces are in contact; hold for one minute. Positive is numbness or tingling
• B. Hands in neutral position with the wrists extended; hold for one minute. Positive is numbness
• C. Hands pressed together with palms facing each other; hold for one minute. Positive is tingling
• D. Hands clasped behind back with wrists extended; hold for one minute. Positive is numbness

Answer: (A)

Phalen's test evaluates median nerve compression at the carpal tunnel by placing the wrist in maximal flexion to increase pressure within the tunnel. In this position, the dorsal surfaces of the hands touch, and the patient holds the position for about a minute. A positive finding is numbness or tingling in the median nerve distribution (thumb, index, middle finger, and part of the ring finger), indicating possible carpal tunnel syndrome. The other positions described do not place the wrist in the same full flexion to provoke the median nerve symptoms, so they’re not considered the same test or not as diagnostically specific.