Distal median nerve dysfunction

Alternative names:

neuropathy - distal median nerve

Treatment:

Treatment is aimed at maximizing independence and ability to function at work and home. The cause should be identified and treated as appropriate. In some cases, no treatment is required and recovery is spontaneous.

If there is no history of trauma to the area, conservative treatment is indicated by sudden onset, minimal sensation changes and no difficulty in movement, and no test results indicating degeneration of the nerve axon (nerve fiber). Corticosteroids injected into the area may reduce swelling and pressure on the nerve in some cases.

Surgical intervention is indicated if the disorder is chronic (long term) or symptoms are worsening, if there is difficulty with movement, or if there is test evidence that nerve axon degeneration is present. Surgical decompression may be recommended if the symptoms are caused by entrapment of the nerve. Surgical removal of lesions that press on the nerve may benefit some cases.

CONTROL OF SYMPTOMS:
Over-the-counter or prescription analgesics may be needed to control pain (neuralgia). Other medications, including phenytoin, carbamazepine, or tricyclic antidepressants such as amitriptyline, may reduce the stabbing pains that some persons experience. Whenever possible, their use should be avoided or minimized to reduce the risk of developing medication side effects.

Physical therapy exercises may be appropriate for some persons to maintain muscle strength. Orthopedic assistance may maximize the ability to use the hand. This may include use of braces, splints, or other appliances. Vocational counseling, occupational therapy, occupational changes, job retraining, or similar interventions may be recommended.

Expectations (prognosis):

If the cause of the nerve dysfunction can be identified and successfully treated, there is a possibility of full recovery. In some cases, there may be partial or complete loss of movement or sensation, resulting in various extent of disability. Nerve pain may be severe and persist for a prolonged period of time.

Complications:

• partial or complete loss of hand movement
• partial or complete loss of sensation in the fingers
• recurrent or unnoticed injury to the hand

Calling your health care provider:

Call your health care provider if symptoms of distal median nerve dysfunction are present. Early diagnosis and treatment increase the chance of controlling symptoms.