Finding	Sensitivity (%)	Specificity (%)	Technique
Flick sign	93	96	History of awakening with symptoms and shaking the hand to provide relief
Positive findings on both the median nerve compression test and the Phalen maneuver	80	92	See individual maneuvers
Classic or probable pattern on hand symptom diagram	64 to 75	73	See Figure 2
Nighttime or morning symptoms	70	43	—
Positive findings on the Phalen maneuver	57 to 68	58 to 73	Flex the patient's wrist 90 degrees with the elbow in full extension; pain or paresthesias in the fingers innervated by the median nerve within 60 seconds are a positive result
Thumb abduction weakness	29 to 65	65 to 80	Ask the patient to raise the thumb perpendicular to the palm, then apply downward pressure on the distal phalanx while the patient resists
Median nerve compression test	64	83	Apply direct pressure over the transverse carpal ligament; sensory symptoms within 30 seconds are a positive result
Square-shaped wrist	53	80	Increased depth-to-width ratio
Tinel sign	36 to 50	77	Repeatedly tap the volar surface of the patient's wrist over the transverse carpal ligament; pain or paresthesias in the fingers innervated by the median nerve are a positive result
Hypalgesia	39	88	Decreased sensation to pain on the palmar aspect of the index finger compared with the ipsilateral little finger on the affected hand
Thenar atrophy	12 to 16	90 to 94	—