When a patient presents with “Carpal Tunnel” like symptoms, first and foremost we need a correct diagnosis. Irritation of the median nerve typically affects the first three fingers on the front of the hand. Symptoms can include numbness, tingling, and pain along with hand grip and thumb weakness. Although these are symptoms on Carpal Tunnel Syndrome, other conditions can cause similar symptoms.
Pronator Teres Syndrome
The pronator teres is a deep forearm muscle which can also compress the median nerve. This is often found in assembly line workers, mechanics, weight lifters, and rowers.
Thoracic Outlet Syndrome (TOS)
The thoracic outlet is bordered by 1st rib and clavicle. Nerve and vascular compression can also take place at the scalene and pec minor musculature. This is common following head and neck trauma. Although it is more likely to produce ulna nerve symptoms, it can produce symptoms similar to carpal tunnel in some cases.
A radiculopathy is compression of nerve roots at the spine. Degenrative changes to joints and discs are the most common cause for this. A typical presentation of a radiculopathy will often include neck pain in addition to nerve symptoms.
With all of these conditions, a proper diagnosis is important to determine the most appropriate treatment. Orthopedic and Neurological tests are performed in the office and in some cases additional testing such as x-rays may be needed.
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