UE nerve impengement

Median Nerve

Carpal Tunnel Syndrome (CTS)

Location: Wrist

Symptoms: Numbness/tingling in thumb, index, middle, and half of the ring finger. Often worse at night. Thenar muscle weakness in advanced cases.

Common Tests: Phalen's Test, Tinel's Sign at the wrist, Carpal Compression Test.

Diagram of Median Nerve Compression in Forearm

Pronator Syndrome

Location: Proximal Forearm

Symptoms: Aching pain in the forearm. Sensory symptoms similar to CTS but often includes the palm. Worsened by repetitive forearm rotation.

Common Tests: Resisted forearm pronation, Resisted elbow flexion with supination.

AIN Syndrome

Location: Forearm (Motor Branch)

Symptoms: Purely motor. Inability to make the "OK" sign (loss of tip-to-tip pinch). Weakness in flexing the thumb and index finger tips. No sensory loss.

Common Tests: "OK" sign test, Pinch grip test.

Ulnar Nerve

Cubital Tunnel Syndrome

Location: Elbow (Medial Epicondyle)

Symptoms: Numbness/tingling in the small and ring fingers. Pain at the "funny bone". Weakness of grip and finger coordination. Clawing of 4th/5th digits in late stages.

Common Tests: Tinel's sign at the elbow, Elbow Flexion Test, Froment's Sign, Wartenberg's Sign.

Diagram of Ulnar Nerve Compression at Wrist

Guyon's Canal Syndrome

Location: Wrist (Ulnar side)

Symptoms: Numbness/tingling in the small and ring fingers, but sensation on the back of the hand is normal. May have weakness of hand muscles without sensory loss.

Common Tests: Tinel's sign at Guyon's canal, Allen's test (to check for vascular issues), Phalen's test (wrist extension variant).

Radial Nerve

Radial Tunnel Syndrome

Location: Proximal Forearm (near Elbow)

Symptoms: Deep, aching pain in the dorsal forearm, often mistaken for tennis elbow. Weakness is minimal or absent. No sensory loss.

Common Tests: Resisted middle finger extension, Resisted supination. Tenderness over the radial tunnel.

PIN Syndrome

Location: Forearm (Motor Branch)

Symptoms: Purely motor. Inability to extend fingers and thumb at the knuckles (MCP joints), leading to "finger drop". Wrist extension is often weak but present (sparing of ECRL). No sensory loss.

Common Tests: Inability to actively extend fingers/thumb against gravity.

Nerve Entrapment Syndromes at a Glance

Syndrome	Nerve	Location of Compression	Key Symptoms	Common Provocative Tests
Carpal Tunnel Syndrome	Median	Wrist	Numbness/tingling in thumb, index, middle fingers; night symptoms.	Phalen's Test, Tinel's Sign (at wrist)
Pronator Syndrome	Median	Proximal Forearm	Aching forearm pain, sensory loss including palm.	Resisted forearm pronation.
Anterior Interosseous Nerve (AIN) Syndrome	Median (Motor Branch)	Forearm	Pure motor weakness; inability to make "OK" sign. No sensory loss.	Pinch Grip Test ("OK" sign).
Cubital Tunnel Syndrome	Ulnar	Elbow	Numbness/tingling in small and ring fingers; medial elbow pain.	Tinel's Sign (at elbow), Elbow Flexion Test, Froment's Sign.
Guyon's Canal Syndrome	Ulnar	Wrist	Numbness/tingling in small and ring fingers; dorsal hand sensation is spared.	Tinel's Sign (at wrist).
Radial Tunnel Syndrome	Radial	Proximal Forearm	Deep, aching pain in dorsal forearm, mimics tennis elbow. No sensory loss.	Resisted middle finger extension, Resisted supination.
Posterior Interosseous Nerve (PIN) Syndrome	Radial (Motor Branch)	Forearm	Pure motor weakness; "finger drop" or inability to extend fingers/thumb. No sensory loss.	Inability to extend fingers/thumb at MCP joints.