Hand Elevation Test | Carpal Tunnel Syndrome

Ma et al. (2012) argue that the hand elevation test is the most accurate physical examination for Carpal Tunnel Syndrome yielding higher sensitivity and specificity than common tests such as the Tinel sign, Phalen’s test, and carpal compression test that you can watch on our channel as well. In their diagnostic study, the test had a sensitivity of 86.7% and specificity of 88.9% however these values have not been reproduced in other studies which is why we regard the clinical value as moderate for now.

To conduct the test the patient is in standing or sitting position and then both hands are elevated above the head and maintained in position until the patient feels paresthesia, numbness, and dull pain in the median nerve territory, meaning the lateral aspect of the palm as well as the palmar surface of the lateral three and a half fingers.

The test is considered positive if symptoms occur within 2 minutes.

Other common tests to assess Carpal Tunnel Syndrome are:

• Tinel’s Sign at the Wrist
• Flick Sign
• Clinical Prediction Rule for CTS
• Phalen’s Test
• Upper Limb Neurodynamic Test 1 (ULTT1)
• Carpal Compression Test

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Ma, H., & Kim, I. (2012). The diagnostic assessment of hand elevation test in carpal tunnel syndrome. Journal of Korean Neurosurgical Society, 52(5), 472-475.