Hand Elevation Test

Context

The Hand Elevation Test is commonly used in the diagnosis of carpal tunnel syndrome (CTS). Nerve conduction studies (NCS) and/or EMG tests are considered the gold standard for diagnosing CTS (Werner and Andary, 2002).

However, these evaluations are not only costly and not always available to many clinicians, but they also present false negatives and false positives in identifying CTS (Witt et al., 2004). Consequently, numerous clinical tests have been proposed to reduce the likelihood of misdiagnosis.

Video of the Test

Execution

To perform this test, the patient is in a seated or standing position. Both hands are elevated above the head, and the therapist asks the patient to maintain the position until they experience paresthesia, numbness, or a dull ache in the median nerve distribution, that is the lateral palmar surface of the hand and the palmar surface of the lateral three and a half fingers.

The test is considered positive if the symptoms are reproduced within 2 minutes.

Clinical Value

In their 2012 study, Ma et al. concluded that the HanE elevation Test has higher sensitivity and specificity than Tinel’s Test, Phalen’s Test, and the Carpal Compression Test (videos of all these tests are available on the platform).

In their diagnostic study, the Hand Elevation Test showed a sensitivity of 86.7% and a specificity of 88.9%. However, to our knowledge, no more recent study has evaluated the clinical value of this test. Therefore, it is difficult to assert its relevance and usefulness in the diagnosis of CTS.