Abnormal peripheral nervous system physiology Positive carpal Tinel sign 2021-02-28T15:02:26Z Carpal tunnel syndrome is the most common entrapment neuropathy. The pain and paresthesias characterizing carpal tunnel syndrome are typically along the distribution of the median nerve (i.e., thumb, index finger, and middle finger). At times, these symptoms may occur in all the fingers, but should not occur in the dorsum or palm of the hand. Positive carpal Hoffmann Tinel sign The Tinel test is performed by lightly tapping (percussing) over the median nerve. It is positive (abnormal) if the patient experiences pain and paresthesias (tingling, numbness) along the distribution of the median nerve.