The Tourniquet Test is a wrist examination procedure to detect compressive neuropathty of the median nerve or the posterior interosseous nerves. It is one of the provocative tests for carpal tunnel syndrome.
The patient must be awake and cooperative while the tourniquet test is being done.
- Patient should be seated during the test.
- The examiner uses his hand to manually compress the wrist up to 3 minutes. He may also use a blood pressure cuff. When a blood cuff is used for this test, a resting blood pressure reading should be taken. During the test, the blood pressure cuff should not be inflated > 20 mmHg above the patient’s resting diastolic pressure. The cuff is applied for 3 minutes as well.
- The examiner takes note of any numbness, tingling or shooting pain during the test.
- After the 3-minute mark, the examiner releases his grip or the blood pressure cuff and lets the patient relax his arm before any other procedure is done.
Positive Tourniquet Test
There is positive Tourniquet Test when there is paresthesia or numbness, tingling or shooting pain during the procedure. Muscle weakness could also be a positive sign. These results could indicate the presence of compressive neuropathy of the median nerve or posterior interosseous nerves.
If peripheral neuropathies are suspected, nerve conduction velocity testing should be done together with a tourniquet test. This test is also a diagnostic test for other conditions; in this case, the goal is nerve compression and not occlusion of the blood vessels.