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PRONATOR SYNDROME


WHAT YOU SHOULD KNOW

Pronator SyndromePronator syndrome is compression of the median nerve by the forearm muscles. This is the same nerve as in carpal tunnel syndrome. The difference besides location is that with muscular compression of the nerve is an on and off phenomenon occurring with use of the forearm muscles for powerful gripping and especially twisting activities.

MEDICAL HISTORY

Patients complain of a deep ache in the forearm with radiation down towards the wrist and hand. Numbness and tingling can occur in the thumb, index, long, and ring fingers. Patients often feel weak, and symptoms are made worse with forceful gripping and twisting.

EXAMINATION

Compression added over the forearm muscles by the examiner or forceful contraction of the muscles may reproduce pain, numbness, or tingling. The doctor will test the functions of the nerve for strength and feeling ability.

ADDITIONAL TESTS: None are needed. Electrical nerve tests will routinely be normal in this form of muscular nerve compression as opposed to carpal tunnel and cubital tunnel syndromes.

TREATMENT OPTIONS

 NON-OPERATIVESURGICAL RELEASE
CONSISTS OFStretching and ergonomic trainingEliminating bands in the muscle that trap the nerve
FEATURESMakes the muscle group more elastic with less pressure on nerveShort incision, outpatient, immediate use for light activities
ADVANTAGESAvoids surgeryDefinitive solution to problem
DISADVANTAGESOnly works on mild casesTemporary period of weakness where arm cannot be used for heavy activity

RECOVERY

Light everyday activities are allowed immediately. Sutures are removed in the office at 2 weeks. Rehabilitation begins soon after surgery with the same stretching exercises done during the non-operative treatment program. Strengthening comes next along with endurance as the patient prepares to return to heavy activities. Powerful use of the arm doesn't usually occur until several months after surgery as the healing tissues become more mature.
 
 
 
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