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Related Experiment Videos

The numb arm and hand

M D Bracker1, L P Ralph

  • 1Division of Family Medicine, University of California, San Diego, School of Medicine, La Jolla.

American Family Physician
|January 1, 1995
PubMed
Summary
This summary is machine-generated.

Nerve entrapment in the upper extremity, including carpal tunnel syndrome, causes pain and numbness. Risk factors include diabetes and smoking, but diagnosis and treatment vary by nerve and location.

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Area of Science:

  • Neurology
  • Orthopedics
  • Physical Medicine and Rehabilitation

Background:

  • Upper extremity nerve entrapment, including median, ulnar, and radial nerve compression, presents with diverse symptoms like pain, weakness, numbness, and tingling.
  • Common risk factors for nerve entrapment include diabetes, smoking, alcohol consumption, rheumatoid arthritis, and hypothyroidism, often leading to bilateral symptoms.
  • Carpal tunnel syndrome, the most prevalent nerve entrapment, involves median nerve compression at the wrist, characterized by sensory changes in the thumb, index, and middle fingers.

Purpose of the Study:

  • To review the causes, symptoms, diagnostic methods, and treatments for various upper extremity nerve entrapment syndromes.
  • To differentiate between conditions affecting the median, ulnar, and radial nerves, including carpal tunnel syndrome, cubital tunnel syndrome, and radial tunnel syndrome.

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  • To highlight the role of specific diagnostic tools and interventions in managing these neurological conditions.

    • Main Methods:

    • Review of literature on upper extremity nerve entrapments.
    • Clinical presentation analysis of median, ulnar, and radial nerve compression syndromes.
    • Discussion of diagnostic techniques such as physical examination, electromyography, and radiography.
    • Overview of treatment modalities including splinting, steroid injections, and nerve blocks.

    Main Results:

    • Carpal tunnel syndrome diagnosis is supported by sensory deficits in specific fingers and reproduction of symptoms with wrist hyperflexion and median nerve percussion.
    • Ulnar nerve compression (cubital or ulnar tunnel syndrome) and cervical radiculopathy can cause ulnar-sided finger sensory loss and intrinsic muscle weakness.
    • Radial tunnel syndrome may coexist with lateral epicondylitis, and a radial nerve block can aid in its exclusion.

    Conclusions:

    • Accurate diagnosis of upper extremity nerve entrapment relies on understanding the specific nerve involved, symptom distribution, and relevant risk factors.
    • A combination of clinical evaluation, electrodiagnostic studies, and imaging is often necessary for precise diagnosis and effective management.
    • Treatment strategies vary, ranging from conservative measures like splinting and injections to more specific interventions like nerve blocks.