Pronator teres syndrome
What is it?
Some people are more likely to develop PTS due to certain activities or conditions. These include:
• Repetitive arm movements (e.g., using a screwdriver, playing sports like tennis or baseball)
• Excessive gripping or twisting motions
• Direct injury to the forearm
• Swelling due to medical conditions like diabetes or arthritis
What causes it?
The median nerve helps control feeling and movement in parts of your hand. This nerve travels from the upper arm down to the hand. It passes through a muscle in the forearm called the pronator teres muscle. If this muscle gets too tight or inflamed, it can put pressure on (compress) the nerve, leading to symptoms of PTS.
What puts a person at risk for it?
Pronator Teres Syndrome (PTS) is a condition where a nerve in the forearm, called the median nerve, gets squeezed or compressed near the elbow.
How does it present in a person?
The most common signs of PTS include pain in the forearm, that worsens when turning the forearm, associated with numbness, or tingling in the thumb, index, and middle fingers, weakness when trying to grip objects or do fine movements with the fingers.
How is it diagnosed?
Doctors usually diagnose PTS by getting your history and carrying out a physical exam alone. The physical exam usually includes checking for pain, weakness, and numbness in the arm and hand, and by asking the patient to move their arm in certain ways to see if symptoms appear.
Sometimes, they may need to conduct nerve tests (like electromyography and nerve conduction studies) to measure how well the nerve is working, or imaging studies (like MRI) if needed to rule out other conditions.
How is it treated?
Treatment for PTS usually starts with non-surgical methods, most of which you can do at home:
• Rest: Avoiding repetitive movements that worsen symptoms
• Physical Therapy: Stretching and strengthening exercises
• Braces or Splints: To keep the arm in a neutral position and reduce pressure
• Medications: Pain relievers like non-steroidal anti-inflammatory drugs.
• Steroid Injections: In some cases, to reduce swelling and nerve compression, doctors have to inject drugs like triamcinolone.
If symptoms don’t improve with these treatments after an adequate amount of time, surgery may be needed to relieve pressure on the nerve.
What is the usual outlook for people with it?
With treatment, most people recover well, especially with early intervention. Physical therapy and lifestyle adjustments can help relieve symptoms and prevent recurrence. Without treatment, the condition can worsen, leading to long-term nerve damage, weakness, and difficulty using the affected hand.