Complaints of tingling and numbness in the hands are common. These paresthesias are most often indicative of a compressive neuropathy affecting the nerves of the hand. Compression of the median nerve in the carpal tunnel is the most common, followed by compression of the ulnar nerve in the cubital tunnel at the elbow. More rarely, the median nerve is compressed at the arcade of the pronator teres in the forearm and the ulnar nerve in the Guyon’s canal at the wrist. Other compression sites also affecting the radial nerve, mainly under fibromuscular tunnels (distributed from the thoracic outlet to the distal part of the limb), and cervical root compressions may also cause paresthesias. The diagnosis is mainly clinical, but can be complemented by electromyography and ultrasound. The treatment is usually conservative in early stages, consisting in avoiding stress on the nerve and in corticosteroid infiltrations. If symptoms persist, surgical decompression gives good results and prevents sequelae if performed sufficiently early.
Key Words
Compressive neuropathy, tunnel syndrome, paresthesia, hand, carpal tunnel syndrome, cubital tunnel syndrome