Symptom Recovery Time After the Phalen Test in Carpal Tunnel Syndrome

Carpal tunnel syndrome can cause numbness, tingling, pain, and reduced hand function. The Phalen test is commonly used during clinical examination, but it is usually recorded only as positive or negative. The time needed for the symptoms caused by the test to return to their pre-test level may provide additional information about the clinical severity of carpal tunnel syndrome. This study will investigate the clinical meaning of symptom recovery time after the Phalen test in adults with electrodiagnostically confirmed carpal tunnel syndrome. During the test, participants will keep their wrists fully flexed for up to 60 seconds. If typical symptoms appear or clearly increase, the test will be stopped and the wrists will be returned to a neutral position. The time required for symptoms to return to their pre-test level will be recorded. Participants will also complete the Boston Carpal Tunnel Questionnaire and will be evaluated for nighttime symptoms and nerve conduction findings. The study will examine whether recovery time is related to hand function, symptom severity, nighttime complaints, symptom onset time during the Phalen test, and electrodiagnostic severity. A subgroup of participants with a positive Phalen test will repeat the test after 3-7 days to evaluate its test-retest reliability. No treatment will be assigned as part of this observational study.

Inclusion Criteria: * Age between 18 and 75 years * Clinical symptoms consistent with carpal tunnel syndrome * Carpal tunnel syndrome confirmed by nerve conduction studies * Ability to complete the Boston Carpal Tunnel Questionnaire and study assessments * Provision of written informed consent Exclusion Criteria: * Polyneuropathy * Clinical or electrodiagnostic evidence of cervical radiculopathy or brachial plexopathy * Previous carpal tunnel surgery in the evaluated hand * Local injection into the evaluated hand within the previous 3 months * Another neurological or musculoskeletal disorder that substantially affects hand or upper-extremity function * Inflammatory arthritis or severe rheumatologic disease affecting the wrist * Acute hand or wrist trauma * Marked restriction of wrist range of motion preventing performance of the Phalen test * Pregnancy, postpartum period, or breastfeeding * Cognitive or communication problems preventing completion of the study assessments