Median neuritis is a leading cause of carpal tunnel syndrome, or CTS. The median nerve runs the length of the arm, but when it becomes inflamed (neuritis) or entrapped, it can cause a wide range of symptoms generally associated with CTS, including lack of grip strength, pain, swelling, and more. Within this post, we will address several important questions, including:
- What is median neuritis?
- What causes median neuritis?
- What are the symptoms of median neuritis?
- What leads to developing median neuritis?
- What can be done to prevent median neuritis?
- What treatment options are available for patients?
- Is surgery beneficial for sufferers?
- How can Michigan Surgery Specialists help?
What Is Median Neuritis?
Median neuritis is nothing more than the inflammation of the median nerve, usually at the point that it crosses the wrist, through the carpal tunnel. When the median nerve becomes inflamed or is compressed by callous tissue or other inflamed tissues, it causes the symptoms we have come to associate with carpal tunnel syndrome.
What Causes Median Neuritis?
There are several potential causes of median neuritis. The most common issues are ergonomic and environmental factors – repetitive movements over time cause inflammation. For instance, prolonged typing without proper wrist support, or the prolonged use of hand tools can both cause carpal tunnel syndrome. Inflammation of the median nerve can cause problems moving through the carpal tunnel, creating pain and discomfort. In addition, inflammation in any of the nine tendons found within the carpal tunnel can also cause pressure. Other causes include callous material buildup, lesions, increased compression due to higher cross-sectional areas of a bifid median nerve, and more.
What Are the Symptoms of Median Neuritis?
Median neuritis sufferers can experience a broad range of symptoms. Note that not all symptoms listed below may be present at the same time, and some patients only experience some of these symptoms:
- Tingling in fingers
- Numbness in fingers and hand
- Swelling in hand/fingers
- Pain (sometimes worse at night)
- Decreased grip strength
- Decreased sensation in fingers and hand
- An increased tendency to drop things
- Difficulty working with small items (jewelry clasps, etc.)
What Leads to Developing Median Neuritis?
Median neuritis is most often associated with overuse or improper posture situations related to your environment. Any sort of posture or position that increases pressure on the median nerve as it moves through the carpal tunnel can cause these symptoms. The pressure on the nerve can be caused by a wide range of factors, including:
- Arthritis
- Injury to the wrist
- Trauma to the wrist
In addition, there are other conditions that may affect your chances of developing median neuritis, even if environmental factors that increase pressure within the carpal tunnel are not present, including:
- Diabetes
- Obesity
- Hypothyroidism
- Tumors/pseudo-tumors
- Flexor tenosynovitis
- Wrist synovitis
- Accessory palmaris longus or profundus
- Accessory flexor digitorum muscle
- Accessory lumbricals
- Pregnancy
- Gout
- Calcium pyrophosphate deposition disease
Note that these factors are relatively rare. Most cases of median neuritis are due to dynamic factors found in the workplace, such as prolonged postures of wrist flexion.
What Can You Do to Prevent Median Neuritis?
In many instances, median neuritis can be prevented by adopting proper ergonomics and avoiding prolonged wrist flexion during job-related activities. However, this is not always possible. Some professions require you to adopt improper wrist positions or engage in repetitive motions that cause inflammation in the median nerve and other tendons. For instance, construction workers, auto mechanics, individuals who use keyboards, and many others are unable to avoid these situations. In these cases, physical therapy exercises can help to reduce your risk of developing median neuritis and the symptoms associated with carpal tunnel syndrome.
What Treatments Are Available for Median Neuritis?
Median neuritis sufferers have a wide range of treatment options depending on the severity of their condition.
- Nonsurgical – In many cases, nonsurgical treatment methods can help alleviate symptoms and reduce inflammation. These include:
- Limiting or ending positions that overextend the wrist
- Using wrist splints at night to keep your wrists in a neutral position
- Steroid injections into the carpal tunnel to reduce inflammation
- Over the counter pain medication to reduce inflammation
- Treating underlying conditions such as diabetes, arthritis, or hypothyroidism
- Surgical – In some cases, surgery is necessary if the damage to the median nerve or other tissues is significant. Usually, this procedure involves cutting a band of tissue that crosses the median nerve, which will reduce pressure and alleviate symptoms.
Is Surgery Beneficial for Median Neuritis Sufferers?
While surgery can treat median neuritis, conservative treatments are usually the first options tried. However, there are factors that will affect whether surgical or nonsurgical methods are used, such as progress/severity of the condition, the patient’s age, and whether there are underlying conditions that are affecting the body, such as diabetes. Arriving at the right treatment solution will require a personalized approach based on your specific risk factors, environmental factors, and other considerations.
How Can Motus Help?
Motus employs physical and occupational therapy specialists who can help limit the impact of median neuritis on your life now, as well as in speeding recovery if surgery is best route for you.
Source:
https://jamanetwork.com/journals/jama/article-abstract/324078
https://www.drlox.com/elbow/median-neuropathy/
http://peripheralneuropathycenter.uchicago.edu/learnaboutpn/typesofpn/compression/carpaltunnel.shtml
https://emedicine.medscape.com/article/1141168-clinical
https://www.jbsr.be/articles/10.5334/jbsr.1354/
https://clinicalgate.com/24-median-neuropathy/
https://www.healthline.com/health/carpal-tunnel-syndrome#treatment
