Learn About Distal Median Nerve Dysfunction
Distal median nerve dysfunction is a form of peripheral neuropathy that affects the movement of or sensation in the hands.
A common type of distal median nerve dysfunction is carpal tunnel syndrome.
Neuropathy - distal median nerve
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.
This 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.
Problems 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:
- Too much growth hormone in the body (acromegaly)
- Diabetes
- Underactive thyroid (hypothyroidism)
- Kidney disease
- A blood cancer called multiple myeloma
- Pregnancy
- Obesity
- Amyloidosis
In some cases, no cause can be found. Diabetes can make this condition worse.
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
- Weakness of the hand that causes you to drop things or have difficulty grasping objects or buttoning a shirt
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.
For 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
Proliance Surgeons
William Clark, MD, is a board-certified orthopedic surgeon and subspecialty certified hand surgeon. He has a clinical interest in arthroscopic surgery, joint replacement, trauma/fractures, nerve and tendon disorders, minimally invasive surgery of the wrist, elbow, and shoulder, complex hand surgery, and treatment of Dupuytren’s contracture.As a physician, he involves patients by discussing the diagnostic and treatment options for each condition and by encouraging them to participate in making their healthcare decisions. As a surgeon, he believes his mission is to provide safe, effective surgical care while staying abreast of the latest advances and techniques. His ultimate goal is patient satisfaction because this is what makes orthopedic surgery an enjoyable and rewarding profession for him. Dr. Clark is rated as an Advanced provider by MediFind in the treatment of Distal Median Nerve Dysfunction. His top areas of expertise are Carpal Tunnel Syndrome, Ganglion Cyst, Rhizarthrosis, Trigger Thumb, and Hip Replacement.
Luigi Meccariello practices in Benevento, Italy. Mr. Meccariello is rated as an Elite expert by MediFind in the treatment of Distal Median Nerve Dysfunction. His top areas of expertise are Distal Median Nerve Dysfunction, Mononeuritis Multiplex, Carpal Tunnel Syndrome, Bone Graft, and Osteotomy.
Massachusetts General Physicians Organization Inc
Abhiram Bhashyam is an Orthopedics specialist and a Hand Surgeon in Boston, Massachusetts. Dr. Bhashyam is rated as an Elite provider by MediFind in the treatment of Distal Median Nerve Dysfunction. His top areas of expertise are Distal Median Nerve Dysfunction, Mononeuritis Multiplex, Rhizarthrosis, Osteotomy, and Nerve Decompression. Dr. Bhashyam is currently accepting new patients.
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.
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
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 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.
Published Date: June 13, 2024
Published 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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