Recurrent Median Nerve Injury in a Weight Lifter

Recurrent median neuropathy is an uncommon injury that can be commonly mistaken for other pathological causes. It is important to be aware of the potential causes and symptoms of injury as delay in diagnosis can lead to permanent decrease in hand function and disability. This case is a description of a 33-year-old male patient who previously presented with radicular symptoms and had complete resolution of his pain after a C7 selective nerve root block. Several months after presentation, he developed significant thenar atrophy, localized pain, and weakness associated with weight lifting activities. He was originally diagnosed with a recurrence of his C7 symptoms and a wrist sprain and was treated with a prednisone taper and wrist splint. After no improvement, he was referred to a physiatrist at an outpatient orthopedic clinic where he was examined and found to have a recurrent median neuropathy on electrodiagnostic studies. A left hand MRI was ordered which demonstrated no anatomical evidence of a compressive nerve lesion, and it was concluded that his injury was secondary to direct compression from high intensity weight lifting.