Distal median nerve dysfunction
Distal median nerve dysfunction is a form of peripheral neuropathy that affects the movement of or sensation in the hands.
Peripheral neuropathy
Peripheral nerves carry information to and from the brain. They also carry signals in both directions between the spinal cord and the rest of the bo...
Read Article Now Book Mark ArticleA common type of distal median nerve dysfunction is carpal tunnel syndrome.
Carpal tunnel syndrome
Carpal tunnel syndrome is a condition in which there is excessive pressure on the median nerve at the wrist. This is the nerve that allows feeling a...
Read Article Now Book Mark ArticleCauses
Dysfunction of one nerve group, such as the distal median nerve, is called a mononeuropathy. Mononeuropathy usually means there is a local cause of the nerve damage. Diseases affecting the entire body (systemic disorders) can also cause isolated nerve damage.
Mononeuropathy
Mononeuropathy is damage to a single nerve, which results in loss of movement, sensation, or other function of that nerve.
Read Article Now Book Mark ArticleThis condition occurs when the nerve is inflamed, trapped, or injured by trauma. The most common reason is trapping (entrapment) by a ligament in the wrist. This causes carpal tunnel syndrome. Trapping puts pressure on the nerve where it passes through a narrow area. Wrist fractures may injure the median nerve directly. Or, it may increase the risk for trapping the nerve later on.
Inflammation of the tendons (tendinitis) or joints (arthritis) can also put pressure on the nerve. Some repetitive movements increase the chance of developing carpal tunnel entrapment. Women are more affected than men.
Tendinitis
Tendons are the fibrous structures that join muscles to bones. When these tendons become swollen or inflamed, it is called tendinitis. In many case...
Read Article Now Book Mark ArticleArthritis
Arthritis is inflammation or degeneration of one or more joints. A joint is the area where 2 bones meet. There are more than 100 different types of...
Read Article Now Book Mark ArticleProblems that affect the tissue near the nerve or cause deposits to form in the tissue can block blood flow and lead to pressure on the nerve. Such conditions include:
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Too much growth hormone in the body (acromegaly)
Acromegaly
Acromegaly is a condition in which there is too much growth hormone (GH) in your body.
Read Article Now Book Mark Article - Diabetes
Diabetes
Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.
Read Article Now Book Mark Article -
Underactive thyroid (hypothyroidism)
Hypothyroidism
Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone. This condition is often called underactive thyroid....
Read Article Now Book Mark Article - Kidney disease
- A blood cancer called multiple myeloma
Multiple myeloma
Multiple myeloma is a blood cancer that starts in the plasma cells in the bone marrow. Bone marrow is the soft, spongy tissue found inside most bone...
Read Article Now Book Mark Article - Pregnancy
- Obesity
Obesity
Obesity means weighing more than what is healthy for a given height. Obesity is a serious, chronic disease. It can lead to other health problems, i...
Read Article Now Book Mark Article - Amyloidosis
In some cases, no cause can be found. Diabetes can make this condition worse.
Symptoms
Symptoms may include any of the following:
- Pain in the wrist or hand that may be severe and wake you up at night, and that may be felt in other areas, such as the upper arm (this is called referred pain)
- Sensation changes in the thumb, index, middle, and part of the ring fingers, such as a burning feeling, decreased sensation, numbness and tingling
Numbness and tingling
Numbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...
Read Article Now Book Mark Article - Weakness of the hand that causes you to drop things or have difficulty grasping objects or buttoning a shirt
Exams and Tests
Your health care provider will examine your wrist and ask about your medical history. Tests that may be done include:
- Electromyogram (EMG) to check the electrical activity of the muscles
Electromyogram (EMG)
Electromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles.
Read Article Now Book Mark Article - Nerve conduction tests to check how fast electrical signals move through a nerve
Nerve conduction tests
Nerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve. This test is done along with electromyography (EM...
Read Article Now Book Mark Article - Neuromuscular ultrasound to view problems with the muscles and nerves
- Nerve biopsy in which nerve tissue is removed for examination (rarely needed)
Nerve biopsy
A nerve biopsy is the removal of a small piece of a nerve for examination.
Read Article Now Book Mark Article - Blood tests to look for medical conditions associated with mononeuropathy
- Magnetic resonance neurography (very detailed imaging of the peripheral nerves)
Treatment
Treatment is aimed at the underlying cause.
If the median nerve is affected by carpal tunnel syndrome, a wrist splint can reduce further injury to the nerve and help relieve symptoms. Wearing the splint at night rests the area and decreases inflammation. An injection into the wrist may help with symptoms, but it won't fix the underlying problem. Surgery may be needed if a splint or medicines don't help. Using proper ergonomics at work is essential. For example, you should use proper wrist support if you use a keyboard and mouse for computer work.
Surgery
Carpal tunnel release is surgery to treat carpal tunnel syndrome. Carpal tunnel syndrome is pain and weakness in the hand that is caused by pressure...
Read Article Now Book Mark ArticleFor other causes, treatment may involve any of the following:
- Medicines to control nerve pain (such as gabapentin or pregabalin)
- Treating the medical problem causing nerve damage, such as diabetes or kidney disease
- Physical therapy to help maintain muscle strength
Outlook (Prognosis)
If the cause of the nerve dysfunction can be identified and treated, there is a good chance of full recovery. In some cases, there is some or complete loss of movement or sensation. Nerve pain may be severe and persist for a long time.
Loss of movement
Muscle function loss is when a muscle does not work or move normally. The medical term for complete loss of muscle function is paralysis.
Read Article Now Book Mark ArticleNerve pain
Neuralgia is a sharp, shocking pain that follows the path of a nerve and is due to irritation or damage to the nerve. Common neuralgias include:Posth...
Read Article Now Book Mark ArticlePossible Complications
Complications may include:
- Deformity of the hand (rare)
- Partial or complete loss of hand movement
- Partial or complete loss of sensation in the fingers
- Recurrent or unnoticed injury to the hand
When to Contact a Medical Professional
Contact your provider if you have symptoms of distal median nerve dysfunction. Early diagnosis and treatment increase the chance of curing or controlling symptoms.
Prevention
Prevention varies, depending on the cause. In people with diabetes, controlling blood sugar may reduce the risk of developing nerve disorders.
For people with jobs that involve repetitive wrist movements, a change in the way the job is performed may be needed. Frequent breaks in activity may also help.
Reviewed By
Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Smith G, Shy ME. Peripheral neuropathies. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 388.
Toussaint CP, Kvint S, Ali ZS, Zager EL. Distal entrapment syndromes: carpal tunnel, cubital tunnel, peroneal, and tarsal tunnel. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 276.
Waldman SD. Carpal tunnel syndrome. In: Waldman SD, ed. Atlas of Common Pain Syndromes. 5th ed. Philadelphia, PA: Elsevier; 2024:chap 50.