Tinels Test

Other Names

Tinels Test

Tinel's test performed with a reflex hammer

Clinical demonstration of Tinel's Test for Carpal Tunnel Syndrome

• Tinels Test
• Tinel Sign
• Tinel’s Test
• Hoffman-Tinel sign

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Purpose

• Used to evaluate nerves as an etiology of patients symptoms
• Most commonly used to evaluate for carpal tunnel syndrome
• Can be used on many peripheral nerves

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Description

Carpal Tunnel Syndrome

• Patient is seated, elbow flexed and forearm supinated
• Examiner holds patients affected wrist in hand
• The examiner gently taps finger over area of flexor retinaculum on the median nerve
• Continue percussing and move up towards the palmar creases.
• Return back to the flexor retinaculum
• Positive test:
  • Reproduction of the patients symptoms (pain, numbness, tingling)

Ulnar Nerve

• The ulnar nerve can be compressed at the cubital tunnel or at Guyon's canal

Lateral Femoral Cutaneous Nerve (LFCN)

• The LFCN can be palpated as it exits the inguinal ligament region

Tarsal Tunnel Syndrome

• Tap the tibial nerve directly over the flexor retinaculum posterior to the medial malleolus.
• Proximal radiation of symptoms towards calf is called Valleix phenomenon

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Pathology

Upper Extremity

• Median Nerve
  • Carpal Tunnel Syndrome
  • Pronator Teres Syndrome
• Radial Nerve
  • Wartenbergs Syndrome
• Ulnar Nerve
  • Guyon Canal Syndrome
  • Cubital Tunnel Syndrome

Lower Extremity

• Meralgia Paresthetica
• Peroneal Nerve Injury
• Tarsal Tunnel Syndrome

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Evidence

Tarsal Tunnel Syndrome

• Schiweterman et al
  • Sensitivity: 53%
  • Specificity: no reported

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See Also

• Neuropathies (Main)

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