Pressure on nerves in the neck (Figures 2-3) Sometimes there is weakness when bending the index and middle finger and weakness when bending the tip of the thumb. There is additional numbness in the palm near the thumb that is not present in carpal tunnel. The numbness in this condition is similar to carpal tunnel syndrome in the fingers. They may also develop from the wrist being bent in a position for a long time. Finger bending strength is typically normal. Severe cases can result in weakness to the thumb lifting away from the hand. However, when specifically tested, the small finger should have normal feeling. Other fingers and even the whole hand can sometimes feel numb. This causes numbness and tingling in the thumb, index, and middle fingers. Median nerve compression at the wrist ( Carpal Tunnel Syndrome) This nerve can be injured from cuts, placement of an IV for medication or fluids, handcuffs, or during surgeries on the radial bone. When the radial nerve branch is compressed, it typically is a sensory only problem. It can be challenging to diagnose, as nerve conduction studies and imaging may be normal. It may be worsened when straightening the wrist or finger. This condition can cause achiness or vague pain in the backside of the forearm. Proximal compression of the motor branch, called the posterior interosseous nerve, is called radial tunnel syndrome. The radial nerve could be compressed in either side of the forearm. Radial nerve compression in the forearm or wrist The weakness occurs when attempting to separate the fingers, when trying to bend the ring and small fingertips, and when trying to bend the wrist. Severe cases can have hand and grip weakness. There can also be pain at the inside portion of the elbow. This condition typically has the same symptoms as Guyon Syndrome but also numbness on the back of the hand on the pinky side. Ulnar nerve compression at the elbow ( Cubital Tunnel Syndrome) The ability to bend the ring and small fingertips remains. The weakness is most noticeable when attempting to separate the fingers. The back side of the hand is usually normal. This causes numbness and tingling typically on the pinky finger side of the hand. Ulnar nerve compression at the wrist (Guyon Syndrome) Soft tissue masses or ganglion cysts can result in nerve compression. An abnormally located muscle can also cause pressure. Sometimes a thickened edge of fascia or tendon can compress a nerve. Fascia is a structure below the fat layer that covers muscles and tendons. Sometimes tendon lining thickens in an enclosed space, and nerve pressure rises. A displaced or angled fracture can stretch the nerve. It can occur after an injury due to bleeding or swelling. In addition to numbness, compression neuropathy can cause weak or twitchy muscles. Compression neuropathy is pressure on a nerve anywhere along its course (Figure 1).
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