Mr Andersson

Median Nerve Entrapment

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MEDICAL DISCLAIMER: The following information is my personal notes about PTS. It is intended for informational purposes only. Consult a physician to help you diagnose and treat injuries of any kind.

In my last post I wrote about something called Pronator Teres Syndrome (PTS or just Pronator Syndrome). So what is this fuzz about? Who is this Pronator Teres guy and why is he bothering me?
When you are seeing a doctor he/she will use a lots of words that you probably doesn’t understand and can’t refer to. So after seeing the doctor you search the web to find more about these new words. In this blog post I will try sort out some of the words/sounds I learned so far which relates to PTS.

Release your hands from your computer for a while and look at your palm, also known as the volar side. Now turn your hands 180 degrees so your palms face down. What you just did is called pronation.

I found this great illustration at TheFreeDictionary.com which also shows the opposite act of pronation, which is called supination:

Illustration: Pronation and supination

Mosby’s Dictionary of Complementary and Alternative Medicine. (c) 2005, Elsevier.

So to get back where I started; Pronator Teres is a muscle in the forearm which makes the arm pronate:

Pronator Teres Muscle
APMSurgery.com

The median nerve can be entrapped at several sites in the forearm. Most common seems to be the carpal tunnel syndrome (carpal = wrist), CTS. More uncommon is the pronator teres syndrome, or PTS, which is caused by hypertrophy in the muscle.

When a nerve is entrapped you get parasthesia and in the case of PTS, pain occurs in the palm at the thumb and at the elbow (more specifically at the pronator teres muscle).
Pronator Teres Pain
Pain can also be present in other parts of the arm with PTS present. These muscles are overused because of compensation for the decreased capacity of signals to the lower arm in the median nerve.
This decreasion can easily be discovered by a orthopedic specialist by using different algorithms during a manual examination of the arm. As far as I have understood (I’m not a M.D.) these algorithms are built up as decision trees consisting of several manual tests. Each “exit point” of these algorithms indicates different diagnoses.
During my search for information about PTS I found a great book named Functional Soft-Tissue Examination and Treatment by Manual Methods by Warren Hammer.
A more common diagnose caused by median nerve entrapment in the fore arm are the Carpal Tunnel Syndrome, CTS.

Nucleus Medical Media has a pretty good illustration covering some of the surgical incisions used when treating CTS and PTS.

Treatment for PTS includes, but is not limited to, massage, pain killers and surgical treatment. As I have been told – also nerve glide excercises have shown good results in some cases.
For people spending most of the day at a desk/computer, ergonomic planning of the workplace is a must!
Tips and checklists: Physical Therapy: Ergonomics and preventing work injuries

More reading:

  • Median Nerve Compression at Pronator Teres
  • Pronator Teres and Massage Therapy
  • Pronator Teres Syndrome by Whitney Lowe [Excerpt, Massage Today, May 2007]
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Written by anderssonjohan

March 7, 2011 at 07:00

Posted in life

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