Reverse Phalen's maneuver as an aid in diagnosing carpal tunnel syndrome.

A reverse Phalen's maneuver involves wrist and finger extension held for 1 minute. We showed that this maneuver results in a significantly higher intracarpal canal hydrostatic pressure as compared to a traditional Phalen's or a modified Phalen's maneuver. Additionally, 31 individuals with complaints of carpal tunnel syndrome symptoms and 20 normal controls were evaluated to see what effect the reverse Phalen's maneuver would have on median sensory latency and amplitude. Both groups demonstrated a prolongation of the median sensory revoked response after 1 minute of this maneuver. The control group had a prolongation of 0.05 ms compared to 0.13 ms in the carpal tunnel syndrome group. The difference between the two groups was significant at a p = 0.05 level. This may add to the sensitivity of conventional screening methods.