Unilateral Pushup-Induced Acute Median Neuritis

Acute median nerve neuropathy is most often due to trauma; acute carpal tunnel syndrome is considered a surgical emergency and must be ruled out. A right-hand dominant male presented to the emergency department with progressive unilateral pain and numbness in the median nerve distribution after experiencing a pop while doing pushups. The evaluation was limited to pain, but there was no gross deformity, and the distal right upper extremity was neurovascularly intact. All imaging was unremarkable. The patient received adequate pain control and complete resolution of symptoms. Despite presenting with symptoms congruent with possible carpal tunnel syndrome, the patient's physical exam and imaging findings were inconsistent with the diagnosis. Acute median nerve neuritis is less commonly described, and no cases have been reported secondary to push-ups, but it should be considered in nontraumatic patients. With conservative management, patients can have complete resolution and no reoccurrence of symptoms.