Entrapment neuropathies of the upper extremities

The incidence and treatment of nerve disorders affecting the arm vary. Carpal tunnel syndrome, caused by nerve compression at the wrist, results in numbness, tingling and pain in the hand. It is assessed by tests of strength, sensory loss, pain and nerve and motor conduction speed in the hand. Treatments include reduced use of the wrist, placing the wrist in a splint, taking anti-inflammatory drugs and injecting steroids into the area. Patients whose condition does not improve with these treatments may require ligament surgery. Ulnar neuropathy, or ulnar nerve compression as it passes through the elbow, results in numbness in the little finger and pain and tenderness at the elbow. Conduction, sensory and motor tests may establish the disorder, but rarely pinpoint its location. Treatment is limited to reducing elbow movement and external causes of injury. Only disabling cases are treated surgically. Thoracic outlet syndrome is characterized by hand tingling upon shoulder movement, hand muscle weakness and hand and forearm sensory loss. This syndrome responds well to physical therapy that strengthens the neck and shoulder muscles.