Hand elevation test

Provocative test for carpal tunnel syndrome described by Ahn in 2001: the patient raises both hands above the head and holds them there until symptoms appear or the time limit is reached; median-distribution paraesthesia is positive. In the original series it was 75.5 per cent sensitive and 98.5 per cent specific, and a 2022 meta-analysis gave it the highest pooled diagnostic odds ratio of the common provocative manoeuvres.

Related terms

• Investigation

  Phalen test

  Provocative test for carpal tunnel syndrome described by George Phalen (1966). The patient holds the wrist in maximal volar flexion for 60 seconds; reproduction of paraesthesia in the median distribution is a positive result.

• Investigation

  Durkan compression test

  Direct pressure applied by examiner thumbs over the median nerve at the carpal tunnel for 30 seconds; reproduction of paraesthesia in the median distribution is a positive result. Described by Durkan (1991); generally considered the most sensitive of the provocative tests.

• Condition

  Carpal tunnel syndrome

  Compressive neuropathy of the median nerve at the wrist, the most common entrapment neuropathy. Presents with nocturnal paraesthesia in the median distribution, positive provocative tests, and — in advanced disease — fixed sensory loss and thenar atrophy.

Articles mentioning this term

1. FESSH preparation · 26 September 2026

   Clinical examination of the hand and wrist

   Hand and wrist examination for FESSH candidates: how accurate the Phalen, Tinel, scratch collapse, Elson, Watson, grind, fovea and Allen tests really are.

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