Nerve compression syndromes in the hand are a common cause of pain, numbness, and weakness. These conditions occur when a nerve in the hand or wrist is compressed, often due to repetitive motion, injury, or swelling. Left untreated, nerve compression can lead to long-term damage, affecting daily activities and overall quality of life. At Lake Country Plastic and Hand Surgery in Waukesha, WI, Dr. Tracy McCall specializes in diagnosing and treating nerve compression syndromes to restore function and relieve discomfort. In this blog, we’ll explore the most common types of nerve compression syndromes in the hand and their management options.

Understanding Nerve Compression Syndromes

Nerve compression syndromes in the hand develop when pressure is placed on one of the three main nerves: the median, ulnar, or radial nerve. These nerves provide sensation and motor function to different parts of the hand. When compressed, the nerves cannot function properly, leading to various symptoms that range from mild discomfort to significant disability.

The most common nerve compression syndromes in the hand are carpal tunnel syndrome, cubital tunnel syndrome, and radial tunnel syndrome. Each affects a different nerve and presents with distinct symptoms, but all can be effectively managed with early diagnosis and appropriate treatment.

1. Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is the most widely recognized nerve compression syndrome of the hand. It occurs when the median nerve, which runs through the carpal tunnel in the wrist, becomes compressed. The carpal tunnel is a narrow passageway surrounded by bones and ligaments. Repetitive hand movements, wrist injuries, or conditions like arthritis can cause swelling and pressure in this area, compressing the median nerve.

Symptoms:

• Numbness or tingling in the thumb, index, middle, and half of the ring finger
• Weakness in the hand, particularly when gripping objects
• Pain that may radiate up the arm
• Symptoms worsening at night or after using the hand for repetitive tasks

Management:
Early-stage carpal tunnel syndrome can often be managed with non-surgical approaches, including wrist splinting, especially at night, and anti-inflammatory medications. In more severe cases, corticosteroid injections may help reduce swelling and alleviate pressure on the median nerve. If conservative measures are not effective, Dr. Tracy McCall may recommend a surgical procedure called carpal tunnel release, which involves cutting the ligament pressing on the median nerve to relieve compression.

2. Cubital Tunnel Syndrome

Cubital tunnel syndrome affects the ulnar nerve as it passes through the cubital tunnel at the elbow. The ulnar nerve is responsible for sensation in the little finger and part of the ring finger and provides motor control to the hand muscles. Compression of the ulnar nerve can occur from leaning on the elbow, repetitive bending, or injury, leading to uncomfortable symptoms that can worsen over time.

Symptoms:

• Numbness or tingling in the ring and little fingers
• Weakness in hand grip
• Pain in the elbow, forearm, and hand
• Difficulty with fine motor tasks like buttoning a shirt

Management:
Non-surgical treatments for cubital tunnel syndrome include activity modification to avoid pressure on the elbow, wearing a splint to keep the elbow straight, and physical therapy exercises to improve nerve function. In cases where the compression is more severe, ulnar nerve release surgery may be necessary to relieve pressure on the nerve and prevent permanent damage.

3. Radial Tunnel Syndrome

Radial tunnel syndrome occurs when the radial nerve, which runs from the neck through the arm and into the hand, is compressed. This condition is less common than carpal tunnel or cubital tunnel syndromes but can still cause significant pain and discomfort. Radial tunnel syndrome is often caused by repetitive overuse or trauma to the forearm muscles, leading to inflammation and compression of the nerve as it passes through the radial tunnel near the elbow.

Symptoms:

• Aching pain in the forearm
• Weakness in hand grip
• Difficulty extending the wrist or fingers
• Tenderness over the radial tunnel

Management:
Initial treatment for radial tunnel syndrome typically includes rest, physical therapy, and anti-inflammatory medications to reduce swelling and pain. Stretching and strengthening exercises may also help improve muscle flexibility and decrease pressure on the radial nerve. If conservative treatments do not provide relief, surgery may be needed to release the compressed nerve.

Diagnosis of Nerve Compression Syndromes

Accurate diagnosis of nerve compression syndromes requires a comprehensive evaluation by a specialist like Dr. Tracy McCall. During your consultation at Lake Country Plastic and Hand Surgery, Dr. McCall will review your medical history, discuss your symptoms, and conduct a physical examination to assess nerve function.

In some cases, diagnostic tests such as electromyography (EMG) or nerve conduction studies (NCS) may be used to evaluate the extent of nerve damage and pinpoint the compression location. Imaging studies, such as X-rays or MRIs, may also help identify any structural issues contributing to the nerve compression.

Treatment Options for Nerve Compression Syndromes

The treatment for nerve compression syndromes in the hand depends on the severity of the condition and how long it has been present. Early intervention is key to preventing permanent nerve damage and improving outcomes. Below are some of the common treatment approaches:

1. Non-Surgical Treatments

For mild to moderate cases of nerve compression, non-surgical treatments are often effective in relieving symptoms. These include:

• Splinting or bracing: Wearing a splint or brace can help keep the affected nerve in a neutral position and reduce pressure.
• Activity modification: Avoiding repetitive motions or prolonged pressure on the nerve can give it time to heal.
• Medications: Over-the-counter and anti-inflammatory pain relievers can help manage pain and reduce swelling.
• Physical therapy: Targeted exercises can strengthen the muscles around the affected nerve and improve flexibility.

2. Surgical Treatments

When non-surgical methods do not provide sufficient relief or when the compression is severe, surgery may be required to release the pressure on the nerve. Surgical options vary depending on the type of nerve compression but generally involve decompressing the nerve by releasing ligaments or removing structures that are causing the pressure.

Carpal Tunnel Release: This procedure involves cutting the ligament that forms the top of the carpal tunnel to relieve pressure on the median nerve.

Ulnar Nerve Transposition: In cases of cubital tunnel syndrome, surgery may involve relocating the ulnar nerve to a new position to relieve compression.

Radial Tunnel Release: For radial tunnel syndrome, surgery involves releasing the structures that are compressing the radial nerve to alleviate pain and improve function.

Long-Term Management and Prevention

Once nerve compression has been treated, ongoing management is essential to prevent recurrence. Dr. Tracy McCall guides patients on avoiding activities that can aggravate the condition and recommends exercises to maintain strength and flexibility in the hand and wrist.

Preventive strategies include maintaining good posture, avoiding prolonged pressure on the elbows or wrists, and taking regular breaks from repetitive hand movements. Ergonomic adjustments to workstations and daily activities can also reduce the risk of developing nerve compression syndromes.

Achieving Lasting Relief with Personalized Care

Nerve compression syndromes in the hand can significantly affect your quality of life, but with timely intervention and proper management, it is possible to achieve lasting relief. At Lake Country Plastic and Hand Surgery in Waukesha, WI, Dr. Tracy McCall provides personalized care tailored to each patient’s unique needs. Whether through non-surgical treatments or surgical intervention, Dr. McCall is committed to helping you restore function and reduce pain for a more comfortable and active life.

Sources

Martin, J. A., & Sanders, P. T. (2021). Carpal Tunnel Syndrome: Diagnosis and Management. The Journal of Hand Surgery.

Katz, R. L., & Levine, J. D. (2020). Cubital Tunnel Syndrome and Ulnar Nerve Compression: Current Treatments. Journal of Orthopedic Research.

Watson, J. D., & Porter, S. S. (2019). Radial Tunnel Syndrome: An Overlooked Cause of Forearm Pain. Clinical Orthopedics.