Carpal tunnel syndrome is compression of the median nerve. It is experienced as pain in your forearm, wrist, and hand accompanied by swelling, fatigue, and numbness in your fingers and thumb from overexertion, or constantly using your hands. Pronator Teres Syndrome, which is more difficult to diagnose, is compression of the median nerve in the deep arch between the radius and the humerus. Pronator syndrome makes treatment of carpal tunnel syndrome more difficult.
Your wrist is a complicated joint with rotational movement at the end of your arm. Turning your hands palm up or palm down moves your forearm in pronation or supination. When you move your arm, your brachioradialis muscle, antagonist to your biceps muscle, moves your pronator quadratus and pronator teres muscles in your forearm.
Carpal tunnel syndrome is a nerve compressed by a muscle in your wrist. While carpal tunnel is a common problem, another source of wrist pain and dysfunction is pronator syndrome. Pronator syndrome is compression of a nerve by the pronator teres muscle at the elbow.
In a 2017 study of 21 patients with both carpal tunnel and pronator teres syndrome, arthroscopic surgery was performed to free the median nerve in patients with no previous carpal tunnel surgery. Other patients required open surgery in the hospital.
Surgery relieved all the pain in 15 of the 21 patients (71%). They had no sensory deficits after surgery, and their hand strength improved to 85% of the grip strength of their unaffected hand. Six patients (29%) suffered only occasional pain and no sensory deficits. Their hand strength after surgery was 50% of the strength of their unaffected hand. These six patients had milder recurrent carpal tunnel syndrome. None of the 21 patients required repeat surgery on tendons or ligaments.