A median nerve injury is the cause of several problems like carpal tunnel syndrome, median nerve palsy, ape-hand deformity, etc. Adequate rest and physiotherapy are the primary measures used to treat this problem. Let’s look into the details of different types of median nerve injuries…
The median nerve originates from the brachial plexus and runs along the length of upper limbs. This nerve originates from spinal cord and travels to the arms through shoulders. The implications of a median nerve injury can be understood by studying the resulting symptoms. Get an overview of the symptoms, causes and treatment measures in case of such injury.
Carpal Tunnel Syndrome
Damage to the median nerve which passes through carpal tunnel results into carpal tunnel syndrome. In this syndrome the thumb, long finger, index finger and ring finger (its radial half) experience numbness at regular intervals. Feeling of numbness is generally experienced at night because of the tendency to flex wrists while sleeping. Carpal tunnel syndrome is an idiopathic disorder. There are few causes considered to be closely associated with carpal tunnel syndrome. Some of these include wrist overuse, hypothyroidism, pituitary gland over-activity, rheumatoid arthritis, etc. The treatment depends on the underlying cause. Physiotherapy is the commonly used treatment measure for carpal tunnel syndrome. However, some of the other practices used are bracing, activity modification, steroid injections, etc.
Pronator Teres Syndrome
The compression neuropathy (damage caused to nerves) associated with median nerve (which affects the elbow) is referred to as pronator teres syndrome. In this condition, numbness or pain in the distal median nerve is experienced. There is a feeling of weakness in the muscles near anterior interosseous nerve. The pronator teres syndrome might result from the median nerve getting caught between heads of pronator teres muscle. R.I.T.E. (Rest Ice Therapy Elevation) therapy used for the treatment of pronator teres syndrome. In this therapy, the injury is treated by means of rest, ice i.e. use of cold pack and elevation. The ‘elevation therapy’ involves placing the injured body part in an elevated position.
Median Nerve Palsy
It is a kind of paralysis characterized by inability of thumb to ‘abduct’ and ‘oppose’. Thenar muscles get paralyzed and thereby result into the condition of median nerve palsy. Injury at the wrist or forearm, and neuropathy are the main causes of median nerve palsy. Weakness while carrying out pronation of forearm is one of the symptoms of median nerve palsy. Anti-inflammatory drugs are prescribed for those who suffer from median nerve palsy. Physical therapy proves to be useful in strengthening the muscles affected by median nerve palsy. A surgery is performed in case the above mentioned treatment measures do not bring relief to the patient. The surgery for median nerve palsy is aimed at removal of those bony or muscle tissues which lead to the injury.
Anterior Interosseous Syndrome
Damage caused to the anterior interosseous nerve results into the anterior interosseous syndrome. Primary symptom exhibited by patients is that of pain in the forearm. Pincer movement of index finger and thumb also is an important sign in anterior interosseous syndrome. The diagnosis of this medical condition is conducted by means of electrophysiological testing. Massage, stretching exercises and surgery are the treatment measures being used for anterior interosseous syndrome. Decompression of the affected nerve by means of surgery is the treatment measure being used for neuropathy.
Ape Hand Deformity
In ape hand deformity, damage is caused to the part of the median nerve which passes through wrist and elbow region. Working of thenar muscles is hampered by injury caused to the median nerve. This deformity is characterized by the inability to bring about proper movements of thumb (especially the abduction movements).
Median Claw Hand
This condition results from the median nerve getting severed in the upper arm region. One can also suffer from median claw hand if the nerve positioned just above elbow gets damaged. The digits, 2 and 3 of metacarpophalangeal joints are hyperextended, and the proximal interphalangeal joints (of the digits, 4 and 5) are flexed. This causes a claw-hand deformity.
The study of median nerve injury is complex and vast due to many underlying and interrelated causes. Depending on the severity of injury caused to the median nerve, a medical practitioner would suggest different treatment measures. Physiotherapy is generally suggested for minor injuries or those which recover in a short span of time. Surgical treatment is implemented for major problems.