The hand is innervated by three nerves: the median, ulnar, and radial nerves. Each of these nerves has sensory and motor branches. Sometimes the nerves in the hand can become impinged or compressed, causing pain, burning sensations, weakness, numbness, and tingling in the hand.
It is important to see a hand surgeon if you experience symptoms of hand nerve compression. Early diagnosis and treatment can help prevent further damage and improve long-term outcomes. Our board-certified hand surgeons at the Hand Center of Northern Arizona will provide a proper diagnosis and recommend appropriate treatment options based on the severity and cause of your symptoms.
AIN Compression Neuropathy
Anterior interosseous nerve (AIN) compression, also known as Kiloh-Nevin’s syndrome, is a type of nerve entrapment syndrome that occurs when the AIN nerve, which provides motor function to the forearm muscles, becomes compressed or trapped. The condition can cause weakness and pain in the forearm and hand. Patients may also have difficulty with fine motor skills in the fingers. AIN compression can be caused by a variety of factors, including trauma or injury to the forearm or wrist, overuse or repetitive motions, and anatomical abnormalities.
Treatment for AIN compression typically involves conservative measures such as rest, ice, and physical therapy to reduce inflammation and improve the range of motion. Anti-inflammatory medication may also help relieve pain and swelling. If these treatments don’t help after 12 months, then surgical decompression of the AIN is the best course of action. During AIN surgical decompression, we make an incision in the proximal volar forearm, examine the nerve, release fascia and tissue structures that may be impinging the nerve, and remove any space-occupying lesions in the nerve fibers.
Cheiralgia parasthetica, or Wartenberg’s syndrome, occurs when the superficial sensory radial nerve in the wrist is compressed. The condition more commonly affects women than men. Symptoms include pain, numbness, and tinging in the dorsoradial hand without affecting hand strength or coordination. Up to half of patients with Wartenberg’s syndrome also have de Quervain’s disease.
If we suspect you have Wartenberg’s syndrome, we’ll conduct a physical exam. We’ll tap the superficial sensory radial nerve to see if you have tingling in the thumb, index finger, and middle finger. This is considered a positive Tinel’s sign. We’ll also bend your thumb into your palm, wrap your fingers around your thumb, and then arch your hand down toward your little finger. If this exacerbates symptoms, that is considered a positive Finkielstein test for Wartenberg’s syndrome.
Wartenberg’s syndrome can be treated non-surgically and operatively. Rest, activity modification, anti-inflammatory medications, and wrist splints are the first line of treatment. Patients with Wartenberg’s are encouraged to avoid activities that aggravate their symptoms and further impinge the nerve. If non-surgical approaches don’t work, we can decompress the nerve by releasing the fascia between the brachioradialis and the extensor carpi radialis longus.
PIN Compression Syndrome
The posterior interosseous nerve (PIN) is a branch of the radial nerve that provides motor innervation to the thumb and wrist extensor muscles. When this nerve is compressed, patients report weakness in the thumb and wrist and pain in the forearm and wrist. This nerve injury is more common in manual laborers and bodybuilders. It is typically caused by repetitive movements, fractures or dislocations, space-filling lesions such as cysts or tumors, inflammation, or prior surgeries. If PIN compression syndrome is suspected, your hand surgeon will recommend non-surgical treatments first. These include rest, activity modifications, stretching, splinting, anti-inflammatory medications, and corticosteroid injections if a mass has been ruled out. If symptoms persist, then surgical decompression of the PIN has been shown to help 75-97% of non-trauma patients recover motor function.
Medical Review: This procedural information has been medically reviewed by plastic and reconstructive surgeon, Brian A. Cripe, M.D.