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Median Nerve

Rohini Mohan
Many people experience numbness and pain in their arms while they sleep or after they exert themselves. This pain in the arm could be due to the median nerve getting compressed and must be treated before the pain become unbearable.
The median nerve originates from the brachial plexus situated with the cervical spine or the C5-T1 nerve root. The brachial plexus are nerve fibers that run from the spine and cross through the neck, armpits, and into the forearms.
The median nerve passes the Carpal Tunnel of the wrist and then it connects to the fingers, the only exception being the small finger and the ring finger's radial half. It also connects with the thumb, the nail beds and plays a key role in controlling the sensation in the fingers, hands, and the upper arms.

Functions of the Median Nerve

Sensory and Motor Roles

This nerve performs both motor as well as sensory roles as it carries both the fibers within it. When entrapment of the nerve occurs, the compression that is caused, leads to the malfunction of both motor and sensory performing abilities.
Individuals also experience a combination of both numbness and pain. They usually describe it to be akin to pinpricks or electrical cramping, much similar to the feeling experienced when we hit our elbows suddenly and a feeling of electricity surges through that area. This nerve acts as the flexor to the muscles in the thumb, the wrist, and the fingers.

Anterior Interosseous Nerve (AIN)

AIN exists inside the forearm. This nerve helps move the thumb up and down. Its basic function is to assist in maneuvering both thumb and wrists. Therefore, when the median nerve or the AIN gets jammed, moving the wrist become excruciatingly painful. While others complain of constant thumb twitching that irritates them and causes numbness as well as pain.

Palmar Cutaneous Sensory nerve

On the other hand the compression could be affecting the palmar cutaneous sensory nerve or even the recurrent branch of median nerve. The palmer nerve splits from the median nerve and gives feeling to the palm side of the thumb and two fingers besides it.
The lack of motor control or gradual degeneration of this median nerve through compression, leads to difficulty in carrying out simple tasks such as grasping items and hand coordination, which makes it tough to even write on a notepad sometimes. Holding even small items aloft such as coffee mugs become very strenuous and painful.

Disorders of the Median Nerve

Nerve Injury

Carpal tunnel syndrome leads to symptoms such as experiencing numbness in hands, tingling in the fingers and extreme pain in the wrists and forearm. It usually occurs while sleeping when we tend to sleep in one position for long.
Inter vertebral slip of the disks, tumors, or bone spurs that apply pressure on the median nerve fibers at the root level may lead to compression. This nerve may get damaged in many other ways as well, especially if the carpal tunnel gets diseased or inflamed, it will naturally disperse its pressure on the median nerve and thereby make it numb.
The other causes could be nerve damage due to accidents, post surgery side effects that may have affected this nerve, though these do not last long and eventually diminish.

Carpal Tunnel Syndrome

The carpal tunnel syndrome occurs due to the excessive compression of thus nerve, within the carpal tunnel, thereby directly affecting the signals reaching the arms and hands as well as making the affected area numb. It is believed that this phenomenon is genetically related and may also occur due to trauma inflicted above the elbow.
Carpal tunnel syndrome is not always the only cause of median nerve numbness, as the entrapment could easily have occurred at the forearm and may be at more than one location. Therefore, it is best to flex your arms and feel where the pain is most dense, as those may be the likely areas that are causing the distress.

Pronator Teres Syndrome

Comparatively rarer than carpal tunnel syndrome, this neuropathy affects the elbow and not the wrist. This condition may arise when the median nerve gets trapped between pronator teres muscles, thereby causing severe pain in the forearm and the elbow.

Median Nerve Palsy

This disorder makes it impossible to move the thumb, because the thenar muscles become paralyzed, and affects the sensory aspects of other fingers of the hands. It also causes a claw like hand formation which is also known as ape-hand deformity. The condition may arise from neuropathy or as a result of injury to this nerve.

Get Decompressed

Ideally, get yourself checked by an orthopedist who checks for the areas of nerve entrapment through nerve conduction studies or simply through an Magnetic Resonance Imaging (MRI). They may even check via Electromyography (EMG). Depending on the diagnosis, surgery may be required if the patient feels that the duration of possible self-healing is too long.
The surgical procedure of nerve decompression would require the removal of small tissues, tendons, or muscles from around the entrapped nerve so as to give it room to circulate blood properly. After this, certain minor exercises would be needed to be practiced as a part of your physiotherapy.
Median nerve compression reduces to a large extent through regular warm oil massage that applies gentle pressure around affected areas. This improves overall blood circulation in the entire arm upto fingertips which eases the pain and numbness. Therefore, trying out this natural healing method would be better before deciding to get it surgically rectified.