From the Guidelines
Nerve entrapment in the forearm typically causes pain, numbness, tingling, and weakness in the affected area, with symptoms varying based on the compressed nerve, as seen in carpal tunnel syndrome, cubital tunnel syndrome, and radial tunnel syndrome 1. The most common nerve entrapments in the forearm include:
- Carpal tunnel syndrome (median nerve): numbness and tingling in the thumb, index, middle, and half of the ring finger, with possible hand weakness
- Cubital tunnel syndrome (ulnar nerve): numbness in the little finger and half of the ring finger, along with decreased grip strength
- Radial tunnel syndrome (radial nerve): pain in the lateral forearm and weakness in wrist and finger extension These symptoms occur because compression disrupts nerve function, affecting both sensory and motor pathways, and early intervention is crucial to prevent permanent nerve damage, as highlighted in the diagnosis and treatment of plexopathy 1. Initial treatment includes rest, avoiding aggravating activities, using splints or braces, taking NSAIDs like ibuprofen (400-600mg three times daily for 1-2 weeks), and applying ice to reduce inflammation, with physical therapy exercises helping to strengthen surrounding muscles and improve nerve gliding 1. For persistent symptoms, corticosteroid injections may provide temporary relief, and severe cases unresponsive to conservative treatment for 6-12 weeks may require surgical decompression, emphasizing the importance of prompt and effective management to minimize morbidity and mortality, and improve quality of life 1.
From the Research
Symptoms of Nerve Entrapment in the Forearm
The symptoms of nerve entrapment in the forearm can vary depending on the specific nerve affected. Some common symptoms include:
- Pain in the forearm, median nerve innervated digits, and palm 2
- Paresthesia (numbness or tingling) in the distal forearm 3
- Weakness and clumsiness in the hand or forearm 4
- Muscle wasting in severe cases 4
- Positive clinical tests such as the forearm scratch collapse test, pain with compression over the flexor digitorum superficialis arch/pronator, and Tinel sign 2
Specific Nerve Entrapments
Different nerves in the forearm can be affected, resulting in distinct symptoms:
- Entrapment of the superficial branch of the radial nerve (Wartenberg's syndrome) can cause pain and paresthesia in the radial side of the forearm and hand 5
- Median nerve entrapment in the forearm can cause pain, paresthesia, and weakness in the median nerve innervated digits and forearm 2
- Entrapment of the lateral antebrachial cutaneous nerve can cause lateral elbow pain and paresthesia in the distal forearm 3
Diagnosis and Treatment
Diagnosis of nerve entrapment in the forearm is mainly based on history and examination, with further investigations available for atypical presentations 4. Treatment options include activity modification, steroid injection, and surgical decompression for ongoing persistent symptoms or severe initial presentation 4. Early decompression of the median nerve can help prevent neurological complications and improve extremity function 6