Symptoms of compression neuropathy in the arm include:
Loss of feeling in the arm and hands can cause:
- Increased clumsiness
- A tendency to drop things
Patients who suffer from this condition work in jobs in which they use their hands frequently and repetitively. Examples include occupations that involve the use of computer keyboards or the assembly of things.
The three nerves involved are:
- The median nerve—providing sensation to the thumb, index finger,
middle finger and half of the ring finger on the palm side of the hand.
- The ulnar nerve—providing feeling to the little finger and half
of the ring finger as well as the backs of these fingers and also
powering the small muscles in the hand that help spread the
fingers and grip with the little finger and ring finger.
- The radial nerve—providing feeling to the back of the hand including
the thumb, index finger, middle finger and half the ring finger. This
nerve compression is often missed because the patient does not
notice numbness on the back of the hand as readily
A neurosensory test can show us how much feeling the patient has
left in his or her hand using a two-prong testing device. It measures:
- The pressure needed to feel the two prongs
- The distance between the two prongs
A nerve conduction study may also performed to determine exactly
where the nerve is compressed by sending electrical currents
through the nerve and measuring where they slow down.
Nerves can be treated by:
- Wearing a wrist splint
- Injecting steroids into the carpal tunnel
- Performing surgery to decompress them by opening the tunnels
they go through
Outpatient carpal tunnel release can be performed:
- On the palm of the hand
- To release the radial nerve in the forearm about two inches above
the wrist using a one-inch incision
- To release the ulnar nerve at the back of the elbow in the groove
called the cubital tunnel
Nerves can be released under general anesthesia or under local
anesthesia (a nerve block) combined with some sedation.
- Patients go home with their hand wrapped in an Ace wrap
- The hand or arm should be kept elevated as much as possible
- The patient is encouraged to start bending the elbow, wrist
and fingers as soon as possible.
- Showering is allowed as long as the hand is covered
in a plastic bag
- Sutures are removed after two weeks
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