You may experience some or all of the following: pain, weakness, sensation changes in the absence of bone, soft tissue or vascular injuries. 

Theses injuries may be confused with others from elbow, shoulder or wrist and may come on suddenly or gradually. We won’t require and Xray or mri initially, only if conservative treatment doesn’t work, a referral will be considered. You are more likely to recover nerve function with a mild injury or a short duration of compression and you are advised to decrease the activities that trigger the symptoms or stop them altogether. If you leave it untreated it can result in altered function so it’s important you get diagnosed and treated early for a chance of a favourable resolution.

Carpal tunnel:

Compression of median nerve and forearm tendons at wrist near palm, more common in women 30-50. It can be caused by low thyroid function, rheumatoid arthritis, pregnancy, repetitive strain, use of vibratory tools. You will experience numbness and tingling, weakness and /or atrophy, pain in thumb, index, middle finger, forearm. You must rest, avoid repetitive activity.  

Cubital tunnel:  compression of ulnar nerve at elbow. It may be compressed at multiple points during its course. You will experience numbness, tingling in ring and little finger, difficulty gripping, weakness, pain, tenderness over elbow, muscle wasting. It can be mild with intermittent altered sensation, moderate with altered sensation and intermittent pressure and weakness, severe with persistent altered sensation, pressure and weakness. It can be caused by hitting the funny bone at the elbow, resting on wooden arm chair, driving with arm resting on door, ganglion, repeated flexion extension of arm, childhood fracture with developmental deformity. 

Radial tunnel: compression of radial nerve, not common. You can damage this by using a crutch incorrectly, having a hard punch on you lateral upper arm, hanging over the back of a chair or edge of bed, fractures. You will experience numbness, tingling back of thumb, index, top of forearm.

Pronator syndrome: compression of median neve between heads of pronator teres in forearm, usually gradual. You will experience aching of forearm above palm, sensation changes to lateral palm, index, middle lateral half of ring finger, pain, worse for elbow twisting movements. 

Medical

If you see a GP you will likely be prescribed a combination of anti-inflammatories and /or steroid drugs. If there is no improvement you may need an MRI to see the extent of the injury and if nothing works surgery is the last resort.

Hands on treatment

Manual therapy: You can try Physiotherapy, Osteopathy, Acupuncture. These are evidence based interventions proven to work.

A combination of manual therapy techniques will be selected by our experts after taking into account your past medical history, spinal mechanics, aggravating and maintaining factors, lifestyle. All techniques will be aimed at attempting to decompress and freeing the nerve as quickly as possible. 

You will be given self-care advice on natural anti-inflammatories and nerve gliding exercises to free the nerve from entrapment sites. Further more, you will be reviewed at follow up appointment to monitor improvement and referred if necessary.

You may need to make some lifestyle modifications addressing correct sitting posture at desk, sleeping position. We have specialist therapists to advise you on this.

With the correct intervention you may be back doing all your usual activities within 6-8 weeks or less.