Tinel’s test in the wrist assesses for the presence of irritated or compressed nerves, in particular, carpal tunnel syndrome. The carpal tunnel is a channel in the wrist through which nerves and tendons pass. Tinel’s test aims to compress this channel by tapping on the inside of the wrist. The test is positive if as a result, it reproduces neural symptoms.
How to perform Tinel’s test for the wrist
Position the patient seated or standing comfortably with their arm extended and palm facing upwards. Support the wrist which one hand and lightly tap or press along the course of the median nerve. This area is typically just above the wrist crease on the palm side of the hand.
Observe the patient’s response to the tapping or pressure. The test is positive if the patient experiences tingling, pins and needles sensation, or numbness radiating into the thumb, index finger, middle finger, and half of the ring finger.
A positive Tinel’s test or sign suggests potential nerve compression, such as in carpal tunnel syndrome. However, it’s important to note that a positive Tinel’s sign doesn’t confirm a specific diagnosis on its own. It is important to use this test in conjunction with other clinical assessments and diagnostic tests.
Overall, Tinel’s test is a simple yet effective way to help diagnose nerve compression or irritation in the wrist and guide further evaluation and treatment.
Anatomy
The carpal tunnel is a narrow channel in the wrist where the nerve and tendons of the flexor digitorum superficialis and flexor pollicis longus muscles pass. If the tunnel narrows for any reason then this increases pressure on nerves. As a result you feel symptoms of tingling, numbness (parasthesia) and pins and needles.
Tinel’s test reproduces symptoms by compressing the carpal tunnel when you tap on on the wrist. Specifically, it reproduces symptoms in the thumb, first two fingers and half of the ring finger.
