Execution
- 1Position the patient sitting with the wrist supinated or comfortably supported.
- 2Hold the wrist with both hands.
- 3Apply direct even pressure over the median nerve in the carpal tunnel.
- 4Maintain pressure for 30 to 60 seconds, with some descriptions extending to 1 to 2 minutes.
- 5Ask whether the patient’s familiar median nerve symptoms are produced and note symptom relief after release.
Positive outcome
Production of the patient’s familiar median nerve symptoms is positive. Magee also describes a wrist flexion and carpal compression variant, where the wrist is flexed to about 60° before pressure is applied. Symptom relief after release may take a few minutes.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| MacDermid & Wessel (2004) — systematic review | NA | 64 | 83 | 3.76 | 0.43 |
| Wiesman et al. (2003) | NA | 96 | NA | NA | NA |
CommentMagee lists this as Durkan’s carpal compression or pressure provocation test. It usually performs better than Tinel or Phalen in some studies, but protocol duration and pressure vary. Record whether the wrist was neutral or flexed because those are not identical tests.
Moderate Clinical Value