5 Tests To Diagnose CTS

About CTS or Carpal Tunnel Syndrome

When an individual feels weakness and numbness along with a tingling sensation due to the pressure exerted on the median nerve, which can be found in the wrist, then this condition is called CTS or carpal tunnel syndrome.

There are many tendons along with the median nerve which run to your hand from the forearm via the carpal tunnel, which is a small space in your wrist. It is this nerve that controls feeling and movement in your thumb along with the first 3 fingers excluding the little finger.

The major cause of CTS or carpal tunnel syndrome is the pressure on the median nerve, which can be from swelling thereby making the tunnel smaller in size. Pregnancy, making same wrist movements repeatedly and illnesses like diabetes, rheumatoid arthritis and hypothyroidism are some of the major causes of such a swelling leading to CTS or Carpal Tunnel Syndrome.

When you visit your doctor to get diagnosed for CTS, your doctor will first ask you if you are pregnant or not and/or if you are suffering from the above-mentioned illnesses. He will also inquire if you have recently hurt your neck, arm or wrist. After checking the strength, appearance and feeling of your hands, wrist, arms and shoulders, physician might suggest the 5 tests for CTS to be sure about the same.

List of 5 Tests for Carpal Tunnel Syndrome

#1. Phalen’s Test

This test for CTS or Carpal Tunnel Syndrome is also known as wrist-flexion test. During the first test which is known as Phalen’s Test, the patient is asked to flex his wrist for about 60 seconds and ask to report all the symptoms patient experiences. This CTS test has been described in several positions. G.A. Phalen reported in the year 1966 that when the patient held his forearm vertically and let his wrist drop at 90 degrees. Alternately, the wrist can be made to hang down while the arm is held horizontally.

Another way of performing this test is to hold both the wrists at 90 degrees flexion against each other with the elbows being flexed too. The fingers will also be pointing in the patient’s direction. The Reverse Phalen’s test is one where the patient is made to hold their wrist and fingers, which are fully extended and experiences symptoms which indicate or confirm the diagnosis of CTS or carpal tunnel syndrome.

#2. Tinel’s Sign

This second test to diagnose CTS consists of the examiner using a tendon hammer to tap on the inside of the wrist on the medial nerve at the carpal tunnel level. If the patient is suffering from carpal tunnel syndrome, then patient will not feel pain, but will experience a tingling sensation in their hand.

#3. Hand Elevation Test

This is another one of the 5 tests for diagnosing CTS. To perform hand elevation test, the patient holds the arm right above head keeping it absolutely straight and holds this position for at least 120 seconds. If the patient feels carpal tunnel syndrome symptoms such as pain or stiffness in the fingers, numbness or tingling sensation, then the test is considered positive or else it is not. However, this CTS test is considered authentic only if the results are the same with the other tests for diagnosis of carpal tunnel syndrome.

#4. Scratch Collapse Test

Introduced in the year 2008, this test helps to diagnose CTS and differentiate it from other syndromes. During this scratch collapse test for carpal tunnel syndrome, the patient faces the examiner and adducts the arms, outstretches hands, flexes elbows and keeps wrists in a neutral position. The examiner makes an external rotation movement, which the patient has to resist with the help of pushing both forearms out. In the next stage, this exercise is repeated while the examiner scratches the median nerve right at the carpal tunnel level. The test is considered positive if the patient loses resistance even for a short while when the examiner continues to scratch the median nerve.

#5. Durkan’s Carpal Compression Test

This is the last amongst the 5 tests for diagnosing CTS and also a simple one. In this test, external pressure is applied by the examiner directly over the carpal tunnel. If the patient complains of the typical carpal tunnel symptoms while the pressure is being applied, then the Durkan’s test is considered positive for carpal tunnel syndrome.


Once these tests for CTS are carried out and the doctor is sure of the problem, he will offer the best treatment option for you. The aim of the treatment plan for carpal tunnel syndrome is to help you achieve normal functioning of your hands once again. Treatment for CTS or carpal tunnel syndrome also aims to prevent any nerve damage and muscle strength loss in your hands and fingers in the future. Treatment plans for carpal tunnel syndrome may include wearing a wrist splint, physical therapy, occupational therapy, certain medications and even surgery in severe cases.

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:February 16, 2018

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