Median Nerve Entrapment aka Carpal Tunnel Syndrome
The median nerve is a major peripheral nerve of the brachial plexus and is formed by the spinal branches of the C5-C6 and C8-T1 nerve roots. It supplies most of the superficial and deep flexors of the forearm. It also gives sensation to certain areas of the hand. It is located deep to the pectoralis musculature and travels down the forearm until it reaches the carpal tunnel of the wrist.
Like any nerve in the body, it can become entrapped, injured, or lack proper nerve mobility. Any and all of these issues can cause pain, numbness, tingling or weakness. Specific symptoms to this area includes:
Neck, shoulder blade, wrist and shoulder pain
Weakness with wrist flexion
Numbness across the forearm and inside of the first 3 digits on the hand
Burning
Tingling
Common reasons for median nerve pain are varied. Carpal tunnel syndrome (CTS) is commonly associated with median nerve entrapment. Compression to the nerve within the carpal tunnel causes nerve swelling and pain in the wrist and fingers. However, it is important to rule out other entrapment sites such as at the neck. Other common causes of median nerve entrapment area and conditions that mimic median nerve entrapment are:
Scarring or fascial density in the fascial sheath surrounding the nerve
Tight forearm flexors, pec, and scalenes
Trauma to the inside of the wrist
Foraminal stenosis
Disc bulge or herniation
If left untreated, this can lead to permanent dysfunction in the hand such as: loss of sensation in the fingers and weakness in the wrist. So how do we treat this common form of nerve entrapment? To ensure no potential cause from the neck, McKenzie Method can be a great starting point. End-range motions are assessed to determine its effect on pain and symptoms. Myofascial release via Active Release Technique, Graston, or dry needling can be utilized to reduce muscle tightness and increase proper fascia function. In addition, a rehab treatment for several causes of median nerve entrapment is Neurodynamics. Through specific neck and shoulder movements, neuroinflammation can be decreased and proper nerve mobility can increase.
Do you have carpal tunnel syndrome or think you have median nerve entrapment? Time to get rid of your pain. Here at Indy Muscle & Joint Clinic we have qualified professionals that deliver the best possible treatment for your nerve-related pains. Schedule an appointment with one of our doctors now!
-Alec Domjan, DC