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    Nerve Surgery St Louis

    Our vision at Neuropax Clinic is to be a leader in creating a health care delivery platform that works more effectively for patients suffering from chronic pain, peripheral diabetic neuropathy, carpal tunnel, tarsal tunnel, chronic migraines/headaches, cubital tunnel, radial tunnel and other serious complications related to peripheral nerve damage. We fulfill this vision by offering proven, advanced diagnostic and surgical techniques to help patients stop suffering and reclaim their quality of life.

    Neuropax Clinic is also dedicated to bringing relief to our patients through the education of patients and physicians. We advance science and public awareness about the benefits of our surgical procedures and the results of those procedures.

    How To Fix Proximal Median Nerve Damage In St. Louis

    Repetitive tasks involving: throwing, gripping, pronation (turning your hand to a palm down position), and sudden extension at the elbow can produce injury resulting in compression of the median nerve at the elbow and forearm level. Weight lifting may result in building muscle mass and can lead to nerve compression. Trauma to the upper forearm may also result in scarring and can induce compressive neuropathies at and around the elbow. Your own inherent anatomy may be a variant that makes you vulnerable to this condition.  Further, it is common to be predisposed to this nerve compression if you are diabetic.  Diagnosing this condition is very dependent upon the clinical evaluation and is often missed by electro-diagnostic studies ( nerve conduction, EMG). 
    The median nerve arises from the  cervical nerve roots C6 to T1 in the neck. After leaving the brachial plexus and crossing the shoulder it passes down the medial aspect of the arm, crosses the elbow and enters the forearm. 
    Median nerve compression in the elbow area can result in two conditions: pronator syndrome and anterior interosseus nerve syndrome.  It is not uncommon for both conditions to be present at the same time.


    Pronator Syndrome


    Pronator syndrome produces symptoms of aching of the proximal forearm, elbow and distal arm (just above elbow).  This aching may be aggravated by forceful use of the extremity, especially involving pronation. Sensory loss in the fingers and palmar components of the median nerve distribution and weakness or clumsiness in the hand are often noted, especially in the thumb and index finger.  
    Symptoms can be confusing with those seen in carpal tunnel syndrome. It is actually more common for proximal median nerve compression and carpal tunnel syndrome to both be present.  This is considered a double crush phenomenom which is when the same nerve is pinched at more than one level along its course.  
    In pronator syndrome, night pain is less common (but does occur) while carpal tunnel syndrome often wakes patients with complaints of aching and numbness in the hands.
    The physical examination may reveal tenderness and a Tinel sign over the pronator teres muscle. Weakness, if present, may involve the index finger, thumb flexion and pinch strength.  Atrophy in the thenar muscles (base of thumb in palm) may be noted in advanced cases. 
    Loss or decreased sensibility of the thumb and index/long fingers are consistent with both proximal median nerve compression and carpal tunnel syndrome.  Loss of sensation and/or pain in the palmar area on the thumb sites is suggestive of pronator syndrome. Provocative (exertional) tests on exam can be helpful in eliciting signs of pronator syndrome. 
    Plain x-rays are helpful to rule out a bony supracondylar process in the distal humerus or other post traumatic or degenerative pathology at the elbow as the cause for compression. Electrodiagnostic studies (EMG/NCS) are rarely conclusive but may be orderd to exclude or identify coexisting pathology.

    Anterior Interosseus Nerve Syndrome (AIN Syndrome)


    The anterior interosseus nerve (AIN) syndrome as an isolated compression syndrome is more rare.  AIN is a branch of the median nerve that branches from the median nerve after it passes through the pronator muscle.  The AIN has no cutaneous (skin) sensory component therefore numbness is not associated with this syndrome, it is purely a motor problem.
    Anterior interosseus nerve syndrome includes complaints of absent or decreased flexion (bending) of the thumb and index finger. For instance, it is difficult to make an OK sign.  A weakened index finger-thumb pinch is generally noted as well. 
    EMG/NCS may be diagnostic in AIN syndrome. MRI is useful to identify any mass or lesion that may be causing this 


    Treatment


    The initial treatment for proximal median nerve compressions is conservative. However, if severity and duration of symptoms are significant at the time of initial presentation to the physician, you may require surgery at that point.    
    Anterior interosseus nerve syndrome again is more rare, but usually resolves with time, particularly if it is secondary to minor trauma or irritation to the nerve. However proximal median compression in the diabetic limb usually, ultimately requires surgery and is generally found coexisting with other compressions in the same extremity. 
    If no improvement with time and therapy are noted or if a space occupying lesion/mass is identified on the MRI, surgical release is then recommended. 
    Postoperatively the arm, forearm and elbow are wrapped in a bulky dressing for one week.  After this point, flexion and extension exercises are started and slowly progressed. Return to full function and full duty work are fairly consistent but vary based on several factors but particularly the amount of deconditioning at the time of surgery.
    The prognosis for full recovery is generally very good, however one must consider the amount of deconditioning that was present at the time of surgery.  Full recovery may take as long as 6 months even after surgical decompression.  If there is severe nerve damage, recovery may take longer and may be incomplete. Risks of the surgery are very rare but include: the persistent symptoms or pain, motor weakness, nerve injury, loss of function, and other generalized surgical risks such as hematoma, 

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    Talking About Carpal Tunnel In St. Louis

    Carpal tunnel syndrome (CTS) is the most expensive of all work-related injuries. Over his or her lifetime, a carpal tunnel patient loses about $30,000 in medical bills and time absent from work.

    CTS typically occurs in adults, with women 3 times more likely to develop it than men. The dominant hand is usually affected first, and the pain is typically severe. CTS is especially common in assembly-line workers in manufacturing, sewing, finishing, cleaning, meatpacking, and similar industries. Contrary to the conventional wisdom, according to recent research, people who perform data entry at a computer (up to 7 hours a day) are not at increased risk of developing CTS.

    What Is CTS?

    CTS is a problem of the median nerve, which runs from the forearm into the hand. CTS occurs when the median nerve gets compressed in the carpal tunnel—a narrow tunnel at the wrist—made up of bones and soft tissues, such as nerves, tendons, ligaments, and blood vessels. The compression may result in pain, weakness, and/or numbness in the hand and wrist, which radiates up into the forearm. CTS is the most common of the “entrapment neuropathies”—compression or trauma of the body’s nerves in the hands or feet.

    What Are the Symptoms?

    Burning, tingling, itching, and/or numbness in the palm of the hand and thumb, index, and middle fingers are most common. Some people with CTS say that their fingers feel useless and swollen, even though little or no swelling is apparent. Since many people sleep with flexed wrists, the symptoms often first appear while sleeping. As symptoms worsen, they may feel tingling during the day. In addition, weakened grip strength may make it difficult to form a fist or grasp small objects. Some people develop wasting of the muscles at the base of the thumb. Some are unable to distinguish hot from cold by touch.

    Why Does CTS Develop?

    Some people have smaller carpal tunnels than others, which makes the median nerve compression more likely. In others, CTS can develop because of an injury to the wrist that causes swelling, over-activity of the pituitary gland, hypothyroidism, diabetes, inflammatory arthritis, mechanical problems in the wrist joint, poor work ergonomics, repeated use of vibrating hand tools, and fluid retention during pregnancy or menopause.

    How Is It Diagnosed?

    CTS should be diagnosed and treated early. A standard physical examination of the hands, arms, shoulders, and neck can help determine if your symptoms are related to daily activities or to an underlying disorder.

    Your doctor of chiropractic can use other specific tests to try to produce the symptoms of carpal tunnel syndrome.  The most common are:

    • Pressure-provocative test. A cuff placed at the front of the carpal tunnel is inflated, followed by direct pressure on the median nerve.
    • Carpal compression test. Moderate pressure is applied with both thumbs directly on the carpal tunnel and underlying median nerve at the transverse carpal ligament. The test is relatively new.

     Laboratory tests and x-rays can reveal diabetes, arthritis, fractures, and other common causes of wrist and hand pain. Sometimes electrodiagnostic tests, such as nerveconduction velocity testing, are used to help confirm the diagnosis. With these tests, small electrodes, placed on your skin, measure the speed at which electrical impulses travel across your wrist. CTS will slow the speed of the impulses and will point your doctor of chiropractic to this diagnosis.

    What Is the CTS Treatment?

    Initial therapy includes:

    • Resting the affected hand and wrist
    • Avoiding activities that may worsen symptoms
    • Immobilizing the wrist in a splint to avoid further damage from twisting or bending
    • Applying cool packs to help reduce swelling from inflammations

    Some medications can help with pain control and inflammation. Studies have shown that vitamin B6 supplements may relieve CTS symptoms.

    Chiropractic joint manipulation and mobilization of the wrist and hand, stretching and strengthening exercises, soft-tissue mobilization techniques, and even yoga can be helpful. Scientists are also investigating other therapies, such as acupuncture, that may help prevent and treat this disorder.

    Occasionally, patients whose symptoms fail to respond to conservative care may require surgery. The surgeon releases the ligament covering the carpal tunnel. The majority of patients recover completely after treatment, and the recurrence rate is low. Proper posture and movement as instructed by your doctor of chiropractic can help prevent CTS recurrences.

    How Can CTS Be Prevented?

    The American Chiropractic Association recommends the following tips:

    • Perform on-the-job conditioning, such as stretching and light exercises.
    • Take frequent rest breaks.
    • Wear splints to help keep the wrists straight.
    • Use fingerless gloves to help keep the hands warm and flexible.
    • Use correct posture and wrist position.
    • To minimize workplace injuries, jobs can be rotated among workers. Employers can also develop programs in ergonomics—the process of adapting workplace conditions and job demands to workers’ physical capabilities.
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    St Louis Diabetic Neuropathy Treatment

    Diabetic Neuropathy Treatment

    Peripheral Diabetic Neuropathy (PDN) is a major, long-term complication of Type 1 and Type 2 Diabetes. Diabetic neuropathy often presents as tingling, loss of sensation, pain and numbness in the legs, feet, arms and hands. This loss of sensation can preclude sensation of injury, leading to development of wounds or ulcerations. When not adequately treated, the risks of infection and ultimately amputation are high.

    Diabetic neuropathy has been considered an irreversible disorder with traditional treatments focused on preventing the progression of the condition; or reducing the pain symptoms with drugs or specialized footwear.  However, treatment with nerve decompression surgery to address the symptoms of diabetic peripheral neuropathy now have an established clinical track record.  Many clinical studies have been published reporting the value of nerve decompression surgery in the treatment of peripheral diabetic neuropathy.

    Goals of the surgery are to restore sensation to the hands or feet, reduce or eliminate pain and to regain strength. If sensation is restored to the feet, the risk of having an ulceration or infection leading to an amputation is nearly eliminated.  Many patients are able to discontinue their medications relating to neuropathy after this procedure. 

    If you suffer from diabetic neuropathy, physicians from Neuropax Clinic can determine whether surgery might be appropriate for you. A comprehensive evaluation will be performed to determine whether you have compressed nerves that may respond to surgery. We have already helped many patients regain sensation and get relief from pain with this surgical approach.

    For more information on treatments for all nerve problems, visit www.neuropaxclinic.com and call 314-434-7784 to setup an appointment.

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    Proximal Median Nerve Compression In St Louis

    Many patients have come to me asking about problems with the Proximal Nerve, and how it can be affected and fixed.  Here are my thoughts on the nerve and what we can do for you!

    PROXIMAL MEDIAN NERVE COMPRESSION


    Repetitive tasks involving: throwing, gripping, pronation (turning your hand to a palm down position), and sudden extension at the elbow can produce injury resulting in compression of the median nerve at the elbow and forearm level. Weight lifting may result in building muscle mass and can lead to nerve compression. Trauma to the upper forearm may also result in scarring and can induce compressive neuropathies at and around the elbow. Your own inherent anatomy may be a variant that makes you vulnerable to this condition.  Further, it is common to be predisposed to this nerve compression if you are diabetic.  Diagnosing this condition is very dependent upon the clinical evaluation and is often missed by electro-diagnostic studies ( nerve conduction, EMG). 
    The median nerve arises from the  cervical nerve roots C6 to T1 in the neck. After leaving the brachial plexus and crossing the shoulder it passes down the medial aspect of the arm, crosses the elbow and enters the forearm. 
    Median nerve compression in the elbow area can result in two conditions: pronator syndrome and anterior interosseus nerve syndrome.  It is not uncommon for both conditions to be present at the same time.


    Pronator Syndrome


    Pronator syndrome produces symptoms of aching of the proximal forearm, elbow and distal arm (just above elbow).  This aching may be aggravated by forceful use of the extremity, especially involving pronation. Sensory loss in the fingers and palmar components of the median nerve distribution and weakness or clumsiness in the hand are often noted, especially in the thumb and index finger.  
    Symptoms can be confusing with those seen in carpal tunnel syndrome. It is actually more common for proximal median nerve compression and carpal tunnel syndrome to both be present.  This is considered a double crush phenomenom which is when the same nerve is pinched at more than one level along its course.  
    In pronator syndrome, night pain is less common (but does occur) while carpal tunnel syndrome often wakes patients with complaints of aching and numbness in the hands.
    The physical examination may reveal tenderness and a Tinel sign over the pronator teres muscle. Weakness, if present, may involve the index finger, thumb flexion and pinch strength.  Atrophy in the thenar muscles (base of thumb in palm) may be noted in advanced cases. 
    Loss or decreased sensibility of the thumb and index/long fingers are consistent with both proximal median nerve compression and carpal tunnel syndrome.  Loss of sensation and/or pain in the palmar area on the thumb sites is suggestive of pronator syndrome. Provocative (exertional) tests on exam can be helpful in eliciting signs of pronator syndrome. 
    Plain x-rays are helpful to rule out a bony supracondylar process in the distal humerus or other post traumatic or degenerative pathology at the elbow as the cause for compression. Electrodiagnostic studies (EMG/NCS) are rarely conclusive but may be orderd to exclude or identify coexisting pathology.

    Anterior Interosseus Nerve Syndrome (AIN Syndrome)


    The anterior interosseus nerve (AIN) syndrome as an isolated compression syndrome is more rare.  AIN is a branch of the median nerve that branches from the median nerve after it passes through the pronator muscle.  The AIN has no cutaneous (skin) sensory component therefore numbness is not associated with this syndrome, it is purely a motor problem.
    Anterior interosseus nerve syndrome includes complaints of absent or decreased flexion (bending) of the thumb and index finger. For instance, it is difficult to make an OK sign.  A weakened index finger-thumb pinch is generally noted as well. 
    EMG/NCS may be diagnostic in AIN syndrome. MRI is useful to identify any mass or lesion that may be causing this 


    Treatment


    The initial treatment for proximal median nerve compressions is conservative. However, if severity and duration of symptoms are significant at the time of initial presentation to the physician, you may require surgery at that point.    
    Anterior interosseus nerve syndrome again is more rare, but usually resolves with time, particularly if it is secondary to minor trauma or irritation to the nerve. However proximal median compression in the diabetic limb usually, ultimately requires surgery and is generally found coexisting with other compressions in the same extremity. 
    If no improvement with time and therapy are noted or if a space occupying lesion/mass is identified on the MRI, surgical release is then recommended. 
    Postoperatively the arm, forearm and elbow are wrapped in a bulky dressing for one week.  After this point, flexion and extension exercises are started and slowly progressed. Return to full function and full duty work are fairly consistent but vary based on several factors but particularly the amount of deconditioning at the time of surgery.
    The prognosis for full recovery is generally very good, however one must consider the amount of deconditioning that was present at the time of surgery.  Full recovery may take as long as 6 months even after surgical decompression.  If there is severe nerve damage, recovery may take longer and may be incomplete. Risks of the surgery are very rare but include: the persistent symptoms or pain, motor weakness, nerve injury, loss of function, and other generalized surgical risks such as hematoma, seroma or neuroma.

    For more information on how to treat Poximal Median Nerve Compression, visit www.neuropaxclinic.com and call us at 314-434-7784 to set up an appointment!

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    When Surgery Is Needed For Carpal Tunnel In St Louis

    Carpal Tunnel Syndrome is an issue in the wrist where the median nerve is "pinched" at the wrist. It causes numbness, tingling, and pain in the arm, hand, and fingers. The wrist has an area called the carpal tunnel that houses the median nerve and 9 tendons, and allows them to pass into the hand. When the swelling gets too great, it causes pressure on this median nerve and causes the symptoms associated with carpal tunnel syndrome.

    There are a variety of treatments available to help with carpal tunnel, and surgery is the last option. There are medications and steroid injections to reduce inflammation, braces to align the wrist properly, and changes to lifestyle and work habits that can eliminate the problem entirely. However, that's not what we're talking about today. We're going to explain how the surgery works to correct it.

    During surgery, the ligament that forms the roof of the tunnel on the palm of the hand is cut back, which relieves the pressure on the nerve. The exact placement of the incision can vary by where the impingement lies, but the goal always is to relieve pressure on the nerve itself.

    The surgery relieves the numbness and tingling, but the time for recovery varies. Severe cases may not see the entire issue disappear, but nearly all surgeries result in relief.

    If you have any of these symptoms, please call Neuropax Clinic in St. Louis at 314-434-7784 to make an appointment and read more about us at www.neuropaxclinic.com to learn how we can help you.

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    St Louis Has A Diabetic Neuropathy Problem

    photo operationsWith Type 1 and Type 2 Diabetes rates climbing, the sufferers of diabetic neuropathy increase as well. These patients suffer from debilitating pain that radiates from the hands, feet, legs and arms. It has been referred to for years as an irreversible disease, and treated as such by physicians. They look to prevent the disease's progression, and minimize pain with medication, or specialized footwear.

    However, new breakthroughs in the field of nerve decompression have opened up pathways to new treatments for the pain of diabetic neuropathy. Nerve decompression works to ease the pain that inflamed tissue puts on the nerves in the extremities and has shown to be VERY effective in the fight against diabetic neuropathy. Clinical trials and studies back nerve decompression as a breakthrough treatment.

    The goals are simple for this surgery: restore sensation and eliminate the pain. When the sensation is restored, it severely reduces the risk for ulceration and infection that leads to amputation. Many patients find that their need for the medications is lessened after the surgery is complete.

    If you suffer from diabetic neuropathy, physicians from Neuropax Clinic can determine whether surgery might be appropriate for you. A comprehensive evaluation will be performed to determine whether you have compressed nerves that may respond to surgery. We have already helped many patients regain sensation and get relief from pain with this surgical approach.

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    Peripheral Nerve Decompression In St Louis

    While many people know about the benefits of peripheral nerve decompression surgery for Carpal Tunnel, Cubital Tunnel, Tarsal Tunnel, Radial Tunnel, Foot Drop/Common Peroneal Nerve, Meralgia Paresthetica/Lateral Femoral Nerve, Winged Scapula/ Long Thoracic Nerve, and Proximal Median Nerve Compression, some don't know the causes of the conditions that warrant them. Learning this can help pinpoint where decompression can help.

    Axon -mediumNerve Compression can come from a variety of places. There are many ailments, including diabetes, trauma to the area, abnormal anatomy (the nerves/joints are in an unusual configuration). Knowing that these ailments can cause compression in nerves can help your physician determine what is causing your issues, and lead to steps to remedy them.

    For example, we know that diabetes causes significant changes to the nerve architecture including swelling and stiffness. A good analogy might be a situation much like placing a balloon in a napkin ring and blowing up the balloon. The napkin ring does not expand but crimps or "compresses" the balloon (the nerve). In cases of trauma, the tissue in the area of the nerve as it passes through the tunnel can be damaged. The result is swelling and inflammation that eventually goes away but leaves behind tightened fibrotic tissue that essentially contracts the tunnel and its surrounding tissue.

    There are common, vulnerable anatomic points that are evaluated to see if there are focal nerve compressions at these sites. The most common type or most well known nerve compression syndrome is carpal tunnel syndrome. Amazingly, there are approximately 44 sites (22 on each side) of nerve compression throughout the body.

    When performing nerve decompression, the surgeon is releasing the surrounding tissue from the nerve without damaging the nerve. Scar tissue and/or perinueral fibrosis are removed and the nerve is completely mobilized resulting in relief of pressure on the nerve, thus relieving pain. Also, reestablishment of blood flow occurs to that segment of the nerve and a smooth gliding surface for the nerve is provided.

    To learn more about how your nerve compression can be treated, visit www.neuropaxclinic.com and call 314-434-7784 for an appointment with Dr. Robert Hagan.

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    Diabetic Neuropathy Treatment in St Louis

    Diabetic Neuropathy St Louis

    Peripheral Diabetic Neuropathy (PDN) is a major, long-term complication of Type 1 and Type 2 Diabetes. Diabetic neuropathy often presents as tingling, loss of sensation, pain and numbness in the legs, feet, arms and hands. This loss of sensation can preclude sensation of injury, leading to development of wounds or ulcerations. When not adequately treated, the risks of infection and ultimately amputation are high.

    Diabetic neuropathy has been considered an irreversible disorder with traditional treatments focused on preventing the progression of the condition; or reducing the pain symptoms with drugs or specialized footwear. However, treatment with nerve decompression surgery to address the symptoms of diabetic peripheral neuropathy now have an established clinical track record. Many clinical studies have been published reporting the value of nerve decompression surgery in the treatment of peripheral diabetic neuropathy.

    Goals of the surgery are to restore sensation to the hands or feet, reduce or eliminate pain and to regain strength. If sensation is restored to the feet, the risk of having an ulceration or infection leading to an amputation is nearly eliminated. Many patients are able to discontinue their medications relating to neuropathy after this procedure.

    If you suffer from diabetic neuropathy, physicians from Neuropax Clinic can determine whether surgery might be appropriate for you. A comprehensive evaluation will be performed to determine whether you have compressed nerves that may respond to surgery. We have already helped many patients regain sensation and get relief from pain with this surgical approach. To schedule an appointment, visit www.neuropaxclinic.com and call 314-434-7784 for more information.

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    Like to know more.
    Sunday, 10 May 2015 19:32
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    The Process Towards Carpal Tunnel Surgery in St Louis

    Carpal Tunnel St LouisWhen we have patients in for carpal tunnel surgery, we like to explain the various treatments that we go through before we start surgery.  Just because you are diagnosed with carpal tunnel, it doesn't mean that you necessarily need surgery immediately.  We have a full course of procedures that we like to employ to start the patient down the road to recovery.

    Step 1 - Recognizing and correction of mechanical issues.

    The wrist is a very versatile and dexterous part of the human anatomy, offering a full range of motion that enables it to perform the various tasks that are required of it.  However, this can lead to stress on the joint that, with repetitive motions and cramped positions from a job.  This can cause stress on the joint, leading to inflammation and pain.  The first course of action is a splint that will help keep the joint in the proper position.  This can be worn at work and during sleeping hours.  The brace makes sure that the wrist stays straight, and can start the healing process.

    Step 2 - Steroid Injection

    This is a step beyond the brace.  The steroid injection is designed to reduce swelling in the joint to hopefully reduce the pain and give range of motion back to the wrist.  The injection is given straight to the carpal tunnel.

    Step 3 - Surgery

    If these treatments fail, the next step is surgery.  Pressure on the nerve is decreased by cutting the ligament that forms the roof (top) of the tunnel on the palm side of the hand (see Figure 3). Incisions for this surgery may vary, but the goal is the same: to enlarge the tunnel and decrease pressure on the nerve. 

    Following surgery, soreness around the incision may last for several weeks or months. The numbness and tingling may disappear quickly or slowly. It may take several months for strength in the hand and wrist to return to normal. Carpal tunnel symptoms may not completely go away after surgery, especially in severe cases.

    For more information and to schedule an appointment for Carpal Tunnel consultation and surgery in St. Louis with Dr. Robert Hagan, call 314-434-7784, email us at This email address is being protected from spambots. You need JavaScript enabled to view it. and visit www.neuropaxclinic.com to learn more.

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    What Happens When You Have Carpal Tunnel Syndrome In St Louis

    The symptoms of carpal tunnel syndrome usually develop gradually. Symptoms often improve if you stop or change an activity that is helping to cause the condition.

     

    Most mild cases of carpal tunnel syndrome get better with treatment. Usually there is no permanent damage to the median nerve. Your symptoms may improve by themselves when:

     

    Fluid buildup decreases, such as after pregnancy.

    You change or stop the activity that has caused your carpal tunnel syndrome.

    Other health problems that cause or contribute to your carpal tunnel symptoms improve.

    Long-term carpal tunnel syndrome can cause:

     

    A loss of feeling and coordination in the fingers and hand. The thumb muscles can become weak and waste away (atrophy).This can make it hard to grip or hold objects.

    Permanent damage to the median nerve. You may have trouble using the hand.

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    Nerve Compression in St Louis

    Nerves extend from your brain and spinal cord, sending important messages throughout your body. If you have a pinched nerve (nerve compression) your body may send you warning signals such as pain. Don't ignore these warning signals.

     

    Damage from a pinched nerve may be minor or severe. It may cause temporary or long-lasting problems. The earlier you get a diagnosis and treatment for nerve compression, the more quickly you'll find relief.

     

    In some cases, you can't reverse the damage from a pinched nerve. But treatment usually relieves pain and other symptoms.

     

    Causes of Pinched Nerves

    A pinched nerve occurs when there is "compression" (pressure) on a nerve.

     

     

    The pressure may be the result of repetitive motions. Or it may happen from holding your body in one position for long periods, such as keeping elbows bent while sleeping.

     

    Nerves are most vulnerable at places in your body where they travel through narrow spaces but have little soft tissue to protect them. Nerve compression often occurs when the nerve is pressed between tissues such as:

     

    Ligament

    Tendon

    Bone

    For example, inflammation or pressure on a nerve root exiting the spine may cause neck or low back pain. It may also cause pain to radiate from the neck into the shoulder and arm (cervical radiculopathy). Or pain may radiate into the leg and foot (lumbar radiculopathy or sciatic nerve pain).

     

    These symptoms may result from changes that develop in the spine's discs and bones. For example, if a disc weakens or tears -- known as a herniated disc -- pressure can get put on a spinal nerve.

     

    Nerve compression in your neck or arm may also cause symptoms in areas such as your:

     

    Elbow

    Hand

    Wrist

    Fingers

    This can lead to conditions such as:

     

    Peripheral neuropathy

    Carpal tunnel syndrome

    Tennis elbow

    If nerve compression lasts a long time, a protective barrier around the nerve may break down. Fluid may build up, which may cause:

     

    Swelling

    Extra pressure

    Scarring

    The scarring may interfere with the nerve's function.

     

    Symptoms of Pinched Nerves

    With nerve compression, sometimes pain may be your only symptom. Or you may have other symptoms without pain.

     

    These are some of the more common symptoms of compressed nerves:

     

    Pain in the area of compression, such as the neck or low back

    Radiating pain, such as sciatica or radicular pain

    Numbness or tingling

    "Pins and needles" or a burning sensation

    Weakness, especially with certain activities

    Sometimes symptoms worsen when you try certain movements, such as turning your head or straining your neck.

     

    Treatment for Pinched Nerves

    How long it takes for symptoms to end can vary from person to person. Treatment varies, depending on the severity and cause of the nerve compression.

     

    You may find that you benefit greatly from simply resting the injured area and by avoiding any activities that tend to worsen your symptoms. In many cases, that's all you need to do.

     

    If symptoms persist or pain is severe, see your doctor. You may need one or more types of treatment to shrink swollen tissue around the nerve.

     

    In more severe cases, it may be necessary to remove material that's pressing on a nerve, such as:

     

    Scar tissue

    Disc material

    Pieces of bone

    Treatment may include:

     

    NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen may reduce swelling.

     

    Oral corticosteroids. These are used to reduce swelling and pain.

     

    Narcotics. These are used for brief periods to reduce severe pain.

     

    Steroid injections. These injections may reduce swelling and allow inflamed nerves to recover.

     

    Physical therapy. This will help stretch and strengthen muscles.

     

    Splint. A splint or soft collar limits motion and allows muscles to rest for brief periods.

     

    Surgery. Surgery may be needed for more severe problems that don't respond to other types of treatment.

     

    Contact Neuropax Clinic for more information, and to set up an appointment.

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    How Is Diabetic Neuropathy Diagnosed in St. Louis

    Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness—loss of feeling—in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs.

    About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight.

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    How Do I Know If I Have Carpal Tunnel In St Louis?

    Carpal tunnel syndrome is usually diagnosed using:

     

    Medical history. The doctor will ask about any medical problems or illnesses, prior injuries, current symptoms, or daily activities that may be causing your symptoms.

    Hand diagram. You may be asked to help fill in a diagram of your hand to show where you have numbness, tingling, or pain.

    Physical exam, including comparing the strength of both hands.

    More testing

    If your symptoms are severe, if nonsurgical treatment has not improved symptoms, or if your symptoms aren't clearly caused by carpal tunnel syndrome, your doctor may recommend:

     

    Nerve testing, which checks the median nerve.

    X-rays. These can check for bone problems caused by past injury, arthritis, recently broken or dislocated bones, or tumors. X-rays aren't used to diagnose carpal tunnel syndrome. But they can be helpful for finding signs of arthritis or an old or new wrist or neck injury that may be adding to your symptoms.

    Ultrasound, to look at the size of the median nerve. It is inexpensive, comfortable, and quick. But its use for carpal tunnel syndrome diagnosis is still unproven and fairly uncommon.

    MRI. This imaging test can find swelling of the median nerve, narrowing of the carpal tunnel, or problems with circulation of blood through the carpal tunnel.

    Blood tests. These are sometimes done to check for a thyroid problem, rheumatoid arthritis, or another medical problem.

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    Proximal Median Issues in St Louis

    Compression neuropathies of the median nerve in the proximal forearm are unusual lesions. Many patients have vague symptoms for many months or even years prior to confirming the diagnosis of either pronator syndrome or anterior interosseous syndrome of the forearm. Serial examinations clinically and electrodiagnostically may be necessary at intervals of 6 to 8 weeks as required for the evaluation of the patient's symptoms.

    As with other compression neuropathies, the diagnosis is solely dependent on the diagnosis of neuropathy of the median nerve using whatever parameter satisfies the surgeon's diagnostic criteria and then having made that diagnosis, localizing the site of that neuropathy by physical examination or electrodiagnosis with the support of radiographic techniques as appropriate. Surgical exploration of proximal median nerve compression is normally followed by prompt and predictable recovery from the median neuropathy and clinical symptoms between 8 and 12 weeks after surgical exploration.

    Prolonged symptom complexes after surgical exploration of the proximal median nerve are, in my experience, due to either (1) extremely severe median nerve injury secondary to pronator syndrome with prolonged recovery and distal nerve axomnetic recovery into the hand, or (2) sensory nerve dysesthesis of the small sensory nerves on the proximal volar surface of the forearm. The symptoms of either of these postoperative findings normally improve with time.  For more information, visit www.neuropaxclinic.com today.

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    Do You Need Carpal Tunnel Surgery In St Louis

    Most people with carpal tunnel syndrome are treated without surgery. Surgery is considered only when:

    Symptoms haven't improved after several weeks to months of nonsurgical treatment. This assumes that you are having ongoing symptoms but no sign of nerve damage. Nerve damage would make surgery more urgent.

    Severe symptoms restrict normal daily activities, such as when:

    There is a persistent loss of feeling or coordination in the fingers or hand.

    There is decreased strength in the thumb.

    Sleep is severely disturbed by pain.

    There is damage to the median nerve (shown by nerve test results and loss of hand, thumb, or finger function) or a risk of damage to the nerve.

    Carpal Tunnel Syndrome: Should I Have Surgery?

    Surgery choices

    The most common surgery for relieving carpal tunnel symptoms involves cutting the transverse carpal ligament camera.gif to relieve pressure on the median nerve in the wrist. Two approaches for this surgery are:

    Open carpal tunnel release surgery. Open surgery requires a longer recovery period and leaves a larger scar than endoscopic surgery. But there may be less chance of other complications.

    Endoscopic carpal tunnel release surgery. Recovery is quicker than with open surgery. The scars heal more quickly, are smaller, and tend to be less painful at 3 months after surgery. But there may be a slightly higher chance of needing another surgery later.

    Some surgeons are now doing small- or mini-open release surgery. This requires a smaller incision than standard open carpal tunnel release surgery. It may reduce healing time and scarring. But it also allows the surgeon to view the ligament directly during the surgery to minimize danger to the nerve itself. This procedure may be promising. But there are few studies comparing it to the open carpal tunnel or endoscopic procedures at this time.

    What to think about

    Nerve tests (nerve conduction velocity test and electromyogram) are often completed before surgery is done. Surgery is more likely to be successful if the results from nerve testing point to carpal tunnel syndrome.

    Your decision about whether to use open or endoscopic surgery depends on your doctor's experience with the procedures. Endoscopic carpal tunnel surgery uses very technical equipment and is most successful when the doctor has done the procedure many times.

    After surgery, it is important to avoid any activities that may have caused carpal tunnel syndrome. Or you can change the way you do them.

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    Carpal Tunnel Surgery Information In St Louis

    During open carpal tunnel release surgery, the transverse carpal ligament is cut, which releases pressure on the median nerve and relieves the symptoms of carpal tunnel syndrome.

    An incision is made at the base of the palm of the hand. This allows the doctor to see the transverse carpal ligament. After the ligament is cut, the skin is closed with stitches. The gap where the ligament was cut is left alone and eventually fills up with scar tissue.

    If you have open carpal tunnel release surgery, you typically do not need to stay in the hospital. It is usually done under local anesthetic, and you can go home on the same day.

    What To Expect After Surgery

    After surgery, the hand is wrapped. The stitches are removed 10 to 14 days after surgery. The pain and numbness may go away right after surgery or may take several months to subside. Try to avoid heavy use of your hand for up to 3 months.

    When you return to work depends on whether the dominant hand (the hand you use most) was involved, what your work activities are, and how much effort you put into rehabilitative physical therapy.

    If you have surgery on your nondominant hand and do not do repetitive, high-risk activities at work, you may return to work within 1 to 2 days, although 7 to 14 days is most common.

    If you have surgery on your dominant hand and do repetitive activities at work, you may require 6 to 12 weeks for a full recovery before you can return to previous work duties. Physical therapy may speed your recovery.

    Why It Is Done

    Open carpal tunnel surgery is considered when:

    Symptoms are still present after a long period of nonsurgical treatment. In general, surgery is not considered until after several weeks to months of nonsurgical treatment. But this assumes that you are having ongoing symptoms but no sign of nerve damage. Nerve damage would make surgery more urgent.

    Severe symptoms (such as persistent loss of feeling or coordination in the fingers or hand, or no strength in the thumb) restrict normal daily activities.

    There is damage to the median nerve (shown by nerve test results and loss of hand or finger function), or a risk of nerve damage.

    Tumors or other growths need to be removed.

    How Well It Works

    Most people who have surgery for carpal tunnel syndrome have fewer or no symptoms of pain and numbness in their hand after surgery.1

    In rare cases, the symptoms of pain and numbness may return (the most common complication), or there may be temporary loss of strength when pinching or gripping an object, due to the cutting of the transverse carpal ligament.

    If the thumb muscles have been severely weakened or wasted away, hand strength and function may be limited even after surgery.

    Risks

    The risk and complication rates of open surgery are very low. Major problems such as nerve damage happen in fewer than 1 out of 100 surgeries (less than 1%).2 There is a small risk that the median nerve or other tissues may be damaged during surgery. After open surgery, recovery may be slower than after endoscopic surgery. And there may be some pain in the wrist and hand. You may also have some tenderness around the scar. There are also the risks of any type of surgery, including possible infection and risks of general anesthesia. But most open carpal tunnel surgery is done with local anesthesia or regional block rather than with general anesthesia.

     

    What To Think About

    Open carpal tunnel surgery cuts open the base of the palm and requires a longer recovery period than endoscopic surgery. Temporary nerve problems may be less likely with open surgery. But painful scar tissue may be more likely to develop after open surgery than after endoscopic surgery.1

     

    Both endoscopic and open carpal tunnel release have benefits and risks. Studies do not show that one procedure is better than the other.2 Talk to your doctor about your options.  For more information, visit www.neuropaxclinic.com today.

    Citations

    Ashworth N (2011). Carpal tunnel syndrome, search date July 2011. Online version of BMJ Clinical Evidence (10).

     

    Scholten RJPM, et al. (2007). Surgical treatment options for carpal tunnel syndrome. Cochrane Database of Systematic Reviews (4).

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    Treatment For Carpal Tunnel Syndrome in St Louis

    Carpal Tunnel Syndrome is a condition in which increased pressure on the median nerve in the wrist causes pain, numbness, tingling, or a combination of all three in the wrist.  These are most often experienced at night, but can be felt through day-to-day experiences like driving or reading a newspaper.  Patients have complained of weaker grip, occasional clumsiness, and a tendency to drop things.  In the most severe cases, sensation can be permanently lost.  What can be done in the treatment of this problem?

    Treatment options include:

    Home treatment, which includes wearing a wrist brace and changing the way certain actions are performed to relieve stress of the nerve.

    Physical therapy. This includes ultrasound, stretching, and range-of-motion exercises. 

    Medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce inflammation. In some cases, oral corticosteroids or corticosteroid injections into the carpal tunnel may be considered.

    Surgery. Surgery is often only recommended if this is a long-term problem or if there is a real risk of nerve damage if left untreated.  

    b2ap3_thumbnail_Figure-2-Carpal-Tunnel.jpg

    How do you know if surgery is right for you?  The treatment for Carpal Tunnel Syndrome can vary from person to person, as it's not a "one-size-fits-all" injury.  For some people, 1-2 weeks of rest will fix the issue.  For others, medicine may reduce the swelling and relieve the pressure on the joint and nerve.  Physical therapy and braces, or just a change in posture or how you arrange your desk can spell relief.  In the case of severe pain or risk of permanent loss of sensation, surgery may be needed to relieve the pressure on the nerve.  In any case, if you feel that you are experiencing Carpal Tunnel Syndrome, and have experienced any of the symptoms listed above, please visit Neuropax Clinic at www.neuropaxclinic.com and call 314-434-7784 to setup an appointment.  

     

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    Meralgia Paresthetica: a Very Treatable Nerve Compression Syndrome

    Meralgia Paresthetica / Lateral Femoral Nerve Compression

    Meralgia Paresthetica is a constellation of symptoms caused by a compression neuropathy (pinched nerve) of the Lateral Femoral Nerve (LFN). The LFN arises from the second and third lumbar spinal levels (L2,L3). As the LFN travels from the spine to the thigh region, the nerve can be pinched at the anterior pelvic tunnel. This tunnel is made by the bone of anterior superior iliac spine, the dense fibers of the inguinal ligament and overlaying musculature. Pressure on this nerve causes feelings of burning, pain and numbness along the front and lateral part of the thigh, extending all the way from anterior and lateral hip, groin and gluteal area to the knee. In some, there can even be very deep groin and testicular or labial pain.

    It is not uncommon for the severity of symptoms to be significantly debilitating, especially if the problem is not addressed. It is important to understand that this a very treatable problem. Its like having carpal tunnel of your hip. Early or old teachings that suggest there is nothing to do, still permeate the medical community regarding this problem.

    This compression neuropathy (pinched nerve condition) can be caused by several different mechanisms. Anatomical studies have shown that at least 5% of the population has an abnormal nerve tunnel. This anatomic variant is highly vulnerable for compression but any nerve can become compressed or damaged. History of pelvic fracture, Blunt trauma in or near the nerve and tunnel, can cause direct trauma to the nerve or trauma to the surrounding tissues that leads to compression of the nerve as well.

    Even just having surgery in the area of the hip, groin or abdomen can lead to changes in the tissue surrounding the nerve and lead to compression. Prior hip surgery, hernia surgery, bone graft harvest, cesarean sections are some of the most common.

    Some professional activities (i.e. police officers, firefighters and construction workers, etc.) require wearing heavy and loaded belts around the waist. This exposes the nerve to excess and repetitive pressure, especially if anatomical nerve path abnormalities already exist. Various sports like karate/kickboxing, football, soccer, rugby and others can all produce injuries that result in this problem. Body habitus such as abdominal obesity or pregnancies can also contribute to repetitive stress and stretching of the nerve.

    It is also important to recognize the affects of diabetes on this clinical problem. Diabetic patients, due to abnormal glucose metabolism, may develop swelling of the nerve, as well as narrowing of the tunnel itself. This alters the normally perfect relationship between the nerve and its tunnel, making it now too narrow for the more swollen nerve, resulting in lateral femoral cutaneous nerve neuropathy. Therefore, diabetic patients are at much higher risk for experiencing symptoms of Meralgia Paresthetica than the general population.

    Once you have been identified to have symptoms consistent with Meralgia Paresthetica or compression of the Lateral Femoral Nerve (LFN) several diagnostic points should be addressed. In some cases, lower spine or lumbar spine pathology should be ruled out with an MRI. This study can also include a study of the pelvis to rule out any mass or tumor causing compression to the nerve along its course. Ultrasound guided, site specific, diagnostic injections are routinely utilized for confirming the diagnosis. In some cases, the addition of steroid to this injection can provide symptomatic relief for some variable length of time. If there is no spinal or pelvic pathology and the severity of symptoms are not too severe, conservative care is a very appropriate initial treatment. This may include: nerve modulator medicines (i.e. neurontin, amitriptyline, etc. ), topical compound cream, lifestyle changes, weight loss and physical therapy. If conservative therapies have been tried and fail after 3 months, surgical decompression should be considered. Accessory treatment modalities such as radio frequency ablation(RFA), sclerosing or spinal cord stimulators do not treat the problem and should not be utilized for this clinical problem.

    Surgical decompression of the nerve is successful in 80-85% of cases. In the residual population that fail decompression, 80% of these patients will respond to going back and resecting (neurectomy) the nerve.

    The success of the surgery depends on how long the nerve has been compressed, the severity of the compression, the extent of nerve damage due to injury and the possible presence of underlying medical or spine problems.

    The surgery performed in an outpatient setting. The surgical incision is generally very small, however body habitus can dictate a larger incision. The post-operative course is consistent but is affected by the amount of decompression required. In general, people can return to light duty work after 2 to 3 weeks and unlimited/unrestricted activity at 6 weeks.  For more information on Meralgia Paresthetica and ways it can be treated, visit www.neuropaxclinic.com and call 314-434-7784 for more information.

     

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    Guest — don graham sr 314 691 6211----barnhart mo 63012
    i have had this pain going on 8 mo -one doctor said it is meralgia paresthetic-pain medicine gets me through the day my doctor is ... Read More
    Thursday, 22 January 2015 18:29
    Guest — Janis Mezatis
    This information has been most helpful to me. I had a total hip replacement done a year and a half ago and have been suffering wit... Read More
    Wednesday, 01 April 2015 00:38
    Guest — Janis Mezatis
    This information has been most helpful to me. I had a total hip replacement done a year and a half ago and have been suffering wit... Read More
    Wednesday, 01 April 2015 00:38
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    What Can Be Done For My Diabetic Neuropathy in St Louis?

    Diabetic Neuropathy Treatment

    Peripheral Diabetic Neuropathy (PDN) is a major, long-term complication of Type 1 and Type 2 Diabetes. Diabetic neuropathy often presents as tingling, loss of sensation, pain and numbness in the legs, feet, arms and hands. This loss of sensation can preclude sensation of injury, leading to development of wounds or ulcerations. When not adequately treated, the risks of infection and ultimately amputation are high.

    Diabetic neuropathy has been considered an irreversible disorder with traditional treatments focused on preventing the progression of the condition; or reducing the pain symptoms with drugs or specialized footwear.  However, treatment with nerve decompression surgery to address the symptoms of diabetic peripheral neuropathy now have an established clinical track record.  Many clinical studies have been published reporting the value of nerve decompression surgery in the treatment of peripheral diabetic neuropathy.

    Goals of the surgery are to restore sensation to the hands or feet, reduce or eliminate pain and to regain strength. If sensation is restored to the feet, the risk of having an ulceration or infection leading to an amputation is nearly eliminated.  Many patients are able to discontinue their medications relating to neuropathy after this procedure. 

    If you suffer from diabetic neuropathy, physicians from Neuropax Clinic can determine whether surgery might be appropriate for you. A comprehensive evaluation will be performed to determine whether you have compressed nerves that may respond to surgery. We have already helped many patients regain sensation and get relief from pain with this surgical approach.

    For more information on treatments for all nerve problems, visit www.neuropaxclinic.com and call 314-434-7784 to setup an appointment.

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    Proximal Median Nerve Compression In St Louis

    Many patients have come to me asking about problems with the Proximal Nerve, and how it can be affected and fixed.  Here are my thoughts on the nerve and what we can do for you!

    PROXIMAL MEDIAN NERVE COMPRESSION


    Repetitive tasks involving: throwing, gripping, pronation (turning your hand to a palm down position), and sudden extension at the elbow can produce injury resulting in compression of the median nerve at the elbow and forearm level. Weight lifting may result in building muscle mass and can lead to nerve compression. Trauma to the upper forearm may also result in scarring and can induce compressive neuropathies at and around the elbow. Your own inherent anatomy may be a variant that makes you vulnerable to this condition.  Further, it is common to be predisposed to this nerve compression if you are diabetic.  Diagnosing this condition is very dependent upon the clinical evaluation and is often missed by electro-diagnostic studies ( nerve conduction, EMG).
    The median nerve arises from the  cervical nerve roots C6 to T1 in the neck. After leaving the brachial plexus and crossing the shoulder it passes down the medial aspect of the arm, crosses the elbow and enters the forearm.
    Median nerve compression in the elbow area can result in two conditions: pronator syndrome and anterior interosseus nerve syndrome.  It is not uncommon for both conditions to be present at the same time.


    Pronator Syndrome


    Pronator syndrome produces symptoms of aching of the proximal forearm, elbow and distal arm (just above elbow).  This aching may be aggravated by forceful use of the extremity, especially involving pronation. Sensory loss in the fingers and palmar components of the median nerve distribution and weakness or clumsiness in the hand are often noted, especially in the thumb and index finger.  
    Symptoms can be confusing with those seen in carpal tunnel syndrome. It is actually more common for proximal median nerve compression and carpal tunnel syndrome to both be present.  This is considered a double crush phenomenom which is when the same nerve is pinched at more than one level along its course.  
    In pronator syndrome, night pain is less common (but does occur) while carpal tunnel syndrome often wakes patients with complaints of aching and numbness in the hands.
    The physical examination may reveal tenderness and a Tinel sign over the pronator teres muscle. Weakness, if present, may involve the index finger, thumb flexion and pinch strength.  Atrophy in the thenar muscles (base of thumb in palm) may be noted in advanced cases.
    Loss or decreased sensibility of the thumb and index/long fingers are consistent with both proximal median nerve compression and carpal tunnel syndrome.  Loss of sensation and/or pain in the palmar area on the thumb sites is suggestive of pronator syndrome. Provocative (exertional) tests on exam can be helpful in eliciting signs of pronator syndrome.
    Plain x-rays are helpful to rule out a bony supracondylar process in the distal humerus or other post traumatic or degenerative pathology at the elbow as the cause for compression. Electrodiagnostic studies (EMG/NCS) are rarely conclusive but may be orderd to exclude or identify coexisting pathology.

     

    Anterior Interosseus Nerve Syndrome (AIN Syndrome)


    The anterior interosseus nerve (AIN) syndrome as an isolated compression syndrome is more rare.  AIN is a branch of the median nerve that branches from the median nerve after it passes through the pronator muscle.  The AIN has no cutaneous (skin) sensory component therefore numbness is not associated with this syndrome, it is purely a motor problem.
    Anterior interosseus nerve syndrome includes complaints of absent or decreased flexion (bending) of the thumb and index finger. For instance, it is difficult to make an OK sign.  A weakened index finger-thumb pinch is generally noted as well.
    EMG/NCS may be diagnostic in AIN syndrome. MRI is useful to identify any mass or lesion that may be causing this 


    Treatment


    The initial treatment for proximal median nerve compressions is conservative. However, if severity and duration of symptoms are significant at the time of initial presentation to the physician, you may require surgery at that point.    
    Anterior interosseus nerve syndrome again is more rare, but usually resolves with time, particularly if it is secondary to minor trauma or irritation to the nerve. However proximal median compression in the diabetic limb usually, ultimately requires surgery and is generally found coexisting with other compressions in the same extremity.
    If no improvement with time and therapy are noted or if a space occupying lesion/mass is identified on the MRI, surgical release is then recommended.
    Postoperatively the arm, forearm and elbow are wrapped in a bulky dressing for one week.  After this point, flexion and extension exercises are started and slowly progressed. Return to full function and full duty work are fairly consistent but vary based on several factors but particularly the amount of deconditioning at the time of surgery.
    The prognosis for full recovery is generally very good, however one must consider the amount of deconditioning that was present at the time of surgery.  Full recovery may take as long as 6 months even after surgical decompression.  If there is severe nerve damage, recovery may take longer and may be incomplete. Risks of the surgery are very rare but include: the persistent symptoms or pain, motor weakness, nerve injury, loss of function, and other generalized surgical risks such as hematoma, seroma or neuroma.

    For more information on how to treat Poximal Median Nerve Compression, visit www.neuropaxclinic.com and call us at 314-434-7784 to set up an appointment!

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