The hand surgeon has a variety of clinical tests at his or her disposal to use when sorting out whatвЂ™s going on. Getting to the bottom of the problem and making sure the correct location of compression has been found can be a challenge. ThereвЂ™s a lot of overlap in symptoms among the many neuropathies. And that can take some time and a bit of sleuthing along with additional studies. What can be done about these problems? Well, truly, the first step is to make sure the diagnosis is correct. Tumors, bone spurs, or other space-occupying lesions can also contribute to the development of either of these neuropathies. In the case of pronator syndrome, the median nerve gets the pinch when it passes through two sides of the pronator teres muscle, which helps explain the name. The ligament of Struthers is a fibrous band that isnвЂ™t part of everyoneвЂ™s anatomy. If the nerve passes close to this bump and gets trapped between the unusual shaped-bone and the ligament of Struthers, nerve entrapment occurs.

For example, a larger or wider bony bump along the inside of the elbow might be a factor. Nerve entrapment from some type of odd anatomical variation is a common cause of peripheral neuropathies. There may be differences in the bone, muscle, and tendon structures that can put pressure on the median nerve in various locations.

One explanation for the anterior interosseous nerve syndrome rests again with the anatomy. For example, why do some people develop one type of neuropathy but not the other? Why do some people have either problem when others have no trouble with compression? The hows and whys of median nerve compression in the forearm arenвЂ™t fully understood. This nerve gives the palm of your thumb and first two fingers sensation. Here it forms the palmar cutaneous sensory nerve. The median nerve divides again at the wrist crease just past the carpal tunnel. ItвЂ™s this nerve that makes it possible for you to make the OK sign with your thumb and index finger or hold a piece of paper between the thumb and index finger. It only controls movement of the flexor muscles on the inside of the forearm. The anterior interosseous nerve has no sensory branch. To appreciate how these syndromes develop, itвЂ™s helpful to know that midway down the forearm, the median nerve divides to form a branch called the anterior interosseous nerve (AIN). The pathway of the median nerve from upper arm to hand is described in detail with drawings to illustrate its location along the way. To help us understand these two peripheral neuropathies, the authors provide a mini-anatomy lesson. These peripheral neuropathies are the focus of this review article. The result can be one of two other median nerve entrapments: pronator syndrome and anterior interosseous nerve syndrome. Less often, compression of the median nerve occurs in the forearm. It occurs when the nerve is compressed in the wrist. Compression or irritation of the median nerve causing pain, numbness, tingling and other symptoms of peripheral neuropathies can occur anywhere along its path.Д¬arpal tunnel syndrome just happens to be one of the most common median nerve entrapments. It travels all the way down to the wrist and continues on to the hand.

But the median nerve thatвЂ™s involved with carpal tunnel syndrome actually starts way up in the upper arm. Many people have heard of the median nerve because when it is compressed or injured, carpal tunnel syndrome (CTS) occurs.

Media nerve tonalis