From the Research
Treatment for pronator teres syndrome should begin with conservative measures, including rest, NSAIDs, and physical therapy, with surgery reserved for severe cases that do not respond to conservative management after 3-6 months, as supported by the most recent study 1. The goal of treatment is to alleviate symptoms, such as pain, numbness, and weakness in the forearm and hand, by reducing compression of the median nerve as it passes between the two heads of the pronator teres muscle.
- Conservative measures include:
- Rest from aggravating activities
- NSAIDs like ibuprofen (400-600mg three times daily) or naproxen (500mg twice daily) for 1-2 weeks to reduce inflammation and pain
- Physical therapy focusing on stretching and strengthening exercises for the forearm, typically 2-3 sessions weekly for 4-6 weeks
- Specific exercises include pronator stretches, wrist flexor stretches, and gentle strengthening with resistance bands
- Ergonomic modifications to workstations and proper positioning during activities that involve repetitive forearm movements are essential for recovery and prevention
- Night splinting may help maintain a neutral wrist position during sleep
- If conservative treatment fails after 6-8 weeks, corticosteroid injections near the compressed median nerve may be considered, as suggested by 2.
- Surgery is reserved for severe cases that don't respond to conservative management after 3-6 months, involving decompression of the median nerve by releasing the pronator teres muscle, with significant improvement in symptoms and functional outcomes, as reported in 3. The importance of early diagnosis and treatment is highlighted by the potential for long-term complications, such as persistent numbness, weakness, or chronic pain, if left untreated or undertreated, as noted in 4 and 5.