Tinel's Sign

Test Procedure:
• Tap with a finger or reflex hammer along the path of the nerve, from distal (mid-palm) to proximal (proximal wrist crease)

Positive results:
• The patient reports a shocking or zinging sensation into the median nerve innervated fingertips, usually with tapping at the proximal edge of the transverse carpal ligament

Negative Results:
• No zinging; or pain at the site of tapping

Implications of positive test result:
• Tinel’s will be positive only once some axonal damage has occurred, i.e., in moderate to severe carpal tunnel syndrome (MacDermid & Doherty, 2004)

Psychometric Properties (MacDermid & Wessel, 2004)
Sensitivity: 0.50 Specificity: 0.77
LR+: 2.2 LR-: 0.6

MacDermid, J. C., & Doherty, T. (2004). Clinical and electrodiagnostic testing of carpal tunnel syndrome: a narrative review. J Orthop Sports Phys Ther, 34(10), 565-588. doi:10.2519/jospt.2004.34.10.565
MacDermid, J. C., & Wessel, J. (2004). Clinical diagnosis of carpal tunnel syndrome: a systematic review. J Hand Ther, 17(2), 309-319. doi:10.1197/j.jht.2004.02.015