Provocative tests are examination maneuvers that can provide additional information about peripheral nerve injury. These adjuncts such as the Tinel’s sign, Phalen’s sign, pressure and positional provocative tests, the scratch collapse test, and other provocative maneuvers all provide stimulus at a site of nerve compression or other injury, and this leads to a variety of symptoms depending on the individual patient and degree of disease progression.
Tinel’s sign:
- Used to pinpoint sites of nerve compression.
- Useful to track nerve recovery over time — i.e. whether nerve regeneration occurring at all.
- Provides critical information that can affect clinical management in closed and gunshot wound injuries.
Phalen’s and other provocative tests that add additional compressive pressure at known anatomic sites of nerve compression provide information that might result in a decision of whether and where to perform a nerve decompression surgery.
The scratch collapse test will provide further confirmatory information regarding location of nerve injury, and can provide further information about multilevel injuries and corroborate a suspected double crush phenomenon.