Peripheral nerve disorders of the upper extremity involve injury or compression of the nerves that supply the arm, forearm, and hand. Common symptoms include pain, numbness, tingling, weakness, and muscle atrophy in the affected areas.

Common Symptoms

• Pain, numbness, or tingling in the arm, forearm, or hand
• Weakness or inability to move the affected muscles
• Muscle wasting or atrophy in severe cases

Cause & Anatomy

Causes of Peripheral Nerve Disorder of the Upper Extremity:

• Compression or entrapment (e.g. carpal tunnel syndrome, cubital tunnel syndrome)
• Trauma or injury (e.g. fractures, dislocations)
• Repetitive stress or overuse
• Metabolic disorders (e.g. diabetes)
• Autoimmune disorders

The major nerves involved are the median, ulnar, and radial nerves originating from the brachial plexus. Their specific courses and innervations are crucial in identifying the affected nerve.

Diagnosis

• History of the problem, the timing of the problem, and any injuries provide great information.
• Physical examination (muscle strength, sensation, provocative tests to look at specific nerves and problems)
• Electromyography and nerve conduction studies check the electrical status of nerves
• Imaging (MRI, ultrasound) to visualize nerve compression

Prevention

• Ergonomic workstations and proper posture
• Avoiding repetitive or prolonged positions that compress nerves
• Controlling underlying medical conditions

Treatment

• Conservative: Splinting, activity modification, oral anti-inflammatory medication
• Steroid injections around compressed nerves
• Physical therapy and exercises

Surgery

Surgery may be indicated for severe or refractory cases, such as:

• Carpal tunnel release for median nerve compression
• Cubital tunnel release for ulnar nerve compression
• Nerve decompression or repair for traumatic injuries

Rehabilitation

After surgical decompression or repair, rehabilitation focuses on:

• Restoring range of motion and strength
• Improving dexterity and fine motor skills
• Desensitization for neuropathic pain
• Ergonomic training and activity modification

FAQ’s

What are the most common peripheral nerve disorders of the upper extremity?
Carpal tunnel syndrome (median nerve) and cubital tunnel syndrome (ulnar nerve).

Can peripheral nerve disorders resolve on their own?
Mild cases may resolve with conservative treatment, but severe or chronic cases often require surgical intervention.

How long does it take to recover after nerve decompression surgery?
Recovery can take several months, depending on the severity and duration of compression.