What is Tinel’s sign?
Tinel’s sign, previously known as the Hoffman-Tinel sign, is something doctors use to check for nerve problems. It’s commonly used to diagnose carpal tunnel syndrome. However, the test can also be used to test for other nerve conditions, such as cubital tunnel syndrome, tarsal tunnel syndrome, or radial nerve injuries.
How is it tested?
To check for Tinel’s sign, your doctor will lightly tap over the affected nerve. If the nerve is compressed or damaged, you’ll feel a tingling sensation that radiates outward. This sensation is also called paresthesia.
The nerve that your doctor tests will depend on what your symptoms suggest. Some examples of nerves tested for common conditions include:
- carpal tunnel syndrome: the median nerve running through your forearm and wrist
- cubital tunnel syndrome: the ulnar nerve, located at your elbow
- tarsal tunnel syndrome: the posterior tibial nerve, located in your inner foot, above your heel
What does a positive result mean?
If you feel a tingling sensation when your doctor taps on your nerve, it’s considered a positive result. This means that the nerve is likely being compressed by nearby tissue. Such nerve compression can be due to many things, including:
What does a normal result mean?
If you don’t feel a tingling sensation when your doctor taps on your nerve, it’s considered a normal result.
Keep in mind that you can still have a compressed nerve even with a normal Tinel’s sign test result. Your doctor may choose to do some additional testing, especially if you have any of the following symptoms near the nerve:
- radiating pain that’s sharp, aching, or burning
- muscle weakness
- frequent “pins and needles” sensation
How accurate is it?
There’s some debate within the medical community about how effective testing for Tinel’s sign really is.
A recent study of 100 people with carpal tunnel syndrome found that only 25 percent of participants had a positive result for Tinel’s sign. However, another study of 50 people with carpal tunnel syndrome found that 72 percent of them had a positive result for Tinel’s sign
As a result, your doctor will likely use some additional tests to confirm whether or not your nerve is compressed. These might include:
Phalen test (wrist flexion test)
This involves resting your flexed elbows on a table and allowing your wrists to fall freely into a flexed position. You’ll hold this position for at least one minute. If you have carpal tunnel syndrome, you’ll likely experience tingling or numbness in your fingers within a minute’s time.
If you also have a limited range of motion associated with your symptoms, your doctor may order an X-ray to check for signs of injury or arthritis.
Nerve conduction velocity test
This test helps your doctor evaluate how well your nerves function. They’ll stimulate several areas along the affected nerve using electrodes on your skin. It will measure the speed of the nerve and determine if there are areas where the impulse is slowed. This can demonstrate the location of the block and the severity of the problem.
The bottom line
The Tinel’s sign test is often used to help diagnose carpal tunnel syndrome, cubital tunnel syndrome, or tarsal tunnel syndrome. A positive result means you feel a tingling sensation when your doctor taps the affected nerve. However, you can have a normal result, meaning you don’t feel any tingling, while still having a nerve injury.