Tinel Sign

The syndrome is characterized by pain or paresthesias such as tingling in the hand, particularly along the distribution of the median nerve. Numbness may be the presenting symptom. Weakness of the hand frequently occurs. On examination, the thenar eminence may be atrophied. The flexor tendons might be slightly swollen. The Tinel sign and a positive Phalen test are valuable diagnostic clues. 

Fig. 10.10 a,b. Clinical tests for evaluation of carpal tunnel syndrome, a The Tinel sign elicits paresthesias by tapping the median nerve at the palmar crease, b The Phalen sign provokes paresthesias at the end of the range of flexion of the wrist... 

Compression of the web space between the index finger (from above) and the thumb (from below) can also trigger pain (Tinel sign). 

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