Hoffman Sign: Understanding the Test

The Hoffman sign is related to the Hoffman test’s results. This checks if your fingers/thumbs flex automatically due to certain triggers. The test’s results can be a sign of whether you have a condition that affects the central nervous system.

black and white photo of eyes a hoffman sign

The Hoffman sign is the result of the test known as Hoffman’s test. This tests the reflexes of a person’s upper-body parts like the hands and fingers. Sometimes nerve problems can affect things like the spinal cord, which is part of the central nervous system. This is a fast and effective way to test whether or not damage has taken place. For example, it helps doctors to determine whether or not your fingers/thumbs are moving for no apparent reason based on particular triggers. This test is important because it could show that your upper body has experienced damage. Your doctor might require this test.

It’s important to note that Hoffman’s sign isn’t 100% reliable by Itself. In fact, doctors often run other tests based on the test’s results to determine what conditions or damages might be causing the results. Hoffman’s reflex is quite basic and involves flicking one fingernail then watching the results. It’s believed the results could be a sign of different conditions and diseases, which can be diagnosed through other tests. In fact, due to the test being very basic doctors will usually decide whether or not other tests should be run. The test is quick, easy, and cheap so many doctors use it.


What’s the Hoffman Sign?

This test is also known by various other names like Hoffman’s reflex and sometimes just “Hoffman’s.” Who in the world is Hoffman? This refers to a German brain doctor named Johann Hoffman.

This test is quite quick and easy to perform. A doctor can perform it in his office to determine whether or not nerve damage has happened. However, sometimes the test can be positive even if a person hasn’t experienced serious conditions or injuries that would normally cause it.

The test itself is very basic. The goal is to check the patient’s reflexes and their body’s reaction to stimulation that’s done to the nervous system. They often do this test when they think nerve damage has taken place. They can then determine how serious the injury is.

This test doesn’t require any equipment so it’s cheap (free) and the results are instant. This can be critical in the case of possible nerve damage. It’s important to know whether the patient should undergo certain treatments.

Here’s how the test is performed. The doctor holds the patient’s middle finger. This is at the joint that’s right under the fingernail. The doctor uses the patient’s other hand to “flick” the middle finger’s fingernail. That’s all there is to the test.

When the doctor does the flicking movement the fingertip must flex/relax quickly. This results in the hand’s flexor muscles getting stretched. That, in turn, can cause the thumb and index finger to flex automatically.

The results are based on whether the index finger/thumb move after the flicking motion. If they haven’t moved then Hoffman’s sign is negative. Meanwhile, the test is positive if the index finger/thumb actually move.

The test is done quickly but might be conducted multiple times to check the hand’s response. The doctor might also do the test on the patient’s other hand to check both sides of the body.


What’s the Meaning of a Positive Result?

A positive result takes place when your thumb and finger flex quickly/involuntarily immediately after the middle finger gets flicked. The feeling is like the finger and thumb are attempting to move closer to each other. The fancy name for the movement “opposition.”

Sometimes the body reacts this way to the test and there’s no particular health condition that’s causing the reflex. This is one of the reasons doctors don’t rely only on Hoffman’s test to detect nerve damage.

Meanwhile, a positive result can show that you have a nervous system or neurological health condition that affects the brain or spine. In some cases, the positive result is only on one side of the body, and in other cases it’s on both sides.

These are some of the conditions that can cause a positive result:

  • Over-active thyroid
  • Muscle Sclerosis (MS)
  • Anxiety
  • Arthritis


What Happens after a Positive Result?

In the case the doctor thinks a nerve-related problem is causing a positive Hoffman’s sign then they might require you to undergo other tests. That can include blood tests and imaging tests like MRI scans.

These tests can help to determine whether or not you have certain conditions that could result in a positive test result. For example, blood tests can show signs that you have an over-active thyroid.

On the other hand, an imaging test can show signs of other conditions. One example is osteoarthritis. There’s also an imaging test that can check other spine-related problems related to conditions like osteoarthritis and spinal cord compression.

A doctor will also look for other symptoms besides Hoffman’s sign. They include:

  • Numbness
  • Dizziness
  • Blurred vision
  • Pain in the eyes, neck, or back.
  • Fatigue
  • Stiffness

These symptoms can show that you have a certain condition that’s causing the positive results. It’s important to look for 2+ symptoms.


Negative Results and Related Test

This is the other result you can get from Hoffman’s sign. It takes place when the index finger/thumb don’t cause any results after the doctor flicks it.

You might be wondering what happens next if you get a negative result. In this case, the doctor will likely determine that no other tests are required.

There’s an exception. If the test’s result is negative and there are other symptoms/signs usually linked to health conditions like MS these are mixed results. The doctor might order extra tests before he/she provides you with a diagnosis.

One other test a doctor might run is something called the Babinski sign. This is actually a different test but is similar to Hoffman’s sign. Babinski test is used for evaluating a person’s neuron function. It’s done by stroking the bottom of a person’s foot then watching the toes’ response.

It’s important to note that the tests can have different meanings based on various factors. They include your body and brain/nervous system.

You might get a positive result form Hoffman’s sign even if you don’t have spinal cord conditions. Meanwhile, Babinski sign is quite normal among infants. However, it usually disappears by 2 years old as the “upper motor neurons” develop.

How about a positive Hoffman/Babinski test? This might show signs of a condition involving the patient’s (upper) motor neuron system. That includes different conditions like ALS.

It’s important to talk to your doctor after either or both of these tests are conducted. Your physician can sort things out and explain how the results affect issues like possible nerve damage. Other tests might be required.

These are very basic tests but are a starting point for testing for nerve damage. The key is to learn the meaning of positive/negative results. There’s a chance no other tests are required after a negative Hoffman sign.

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