The Tinel sign is used to identify nerve irritation. When performed at the wrist, the Tinel’s sign is used to identify irritation of the median nerve, a key symptom of carpal tunnel syndrome.
How to Perform Tinel’s Sign
Performance: To perform the tinel test, the examiner should tap over the carpal tunnel at the patient’s wrist. The examiner may also perform the tapping along the distribution of the median nerve, from the index or middle finger along the carpal tunnel towards the medial aspect of the elbow.
How to Interpret Tinel’s sign
Positive Finding: The test is considered positive for carpal tunnel syndrome if the patient experiences tingling or paresthesia into the thumb, index finger, middle finger or the lateral half of the ring finger.
The test may also provide insight on the rate of median nerve regeneration as the most distal point of abnormal sensation indicates the degree to which the nerve has healed.
Test Accuracy / Reliability / Evidence:
Intrarater k = 0.80
interrater k = 0.77
Source: Marx RG, Hudak PL, Bombardier C, et al: The reliability of physical examination for carpal tunnel syndrome. J Hand Surg Br 1998; 23: pp. 499-502