The median nerve passes through the carpal tunnel along with the flexor tendons of the forearm. During repetitive finger movements, the flexor tendons become taut like a chord, hitting the median nerve by hundreds of impacts. The resulting nerve damage causes nerve block of the median nerve, impairing nerve conduction. The syndrome consists of pain, numbness and weakness of the hand and atrophy of the hand muscles.

Early diagnosis and treatment are of critical importance, since chronic symptoms of nerve compression can result in irreversible nerve damage and permanent hand dysfunction due to necrosis of the nerve. In early phase treatment is conservative and consists of patient education, forearm/hand brace, physical therapy and exercises. Neglected cases may need surgical intervention.



Stressful conditions, strenuous, repetitive motions, overuse, may result in nerve dysfunction and impaired movement coordination. Normally, the flexor and extensor muscles of the forearm work synchronously, and synergistically. When the flexors contract, the extensors relax and vice versa. As a result of repetitive stress the flexor and extensor mechanism fails. The antagonistic muscles contract simultaneously but asynchronously, working against each other in a chaotic movement pattern. The increased muscle tone and resistance result in prolonged muscle contraction, muscle spasm and strain, causing severe pain and inflammation of the lateral epicondyle at the elbow, hence the diagnosis: lateral epicondylitis.

Treatment consists of physical therapy, bracing and proper exercises. Persistent and methodical approach is necessary to succeed in the treatment of this stubborn condition.

For more information or for an evaluation please call New York Midtown Orthopedics at 212-758-4688.

Remember: timely diagnosis and treatment may prevent chronic pain, surgery and permanent disability.