Median Nerve Injury: Symptoms- Numbness, Weak Grip, Treatment- R.I.C.E, Surgery

The median nerve originates from the medial and lateral cords of the brachial plexus. It runs down the arm and enters the forearm with the brachial artery. Any sort of damage or injury to the median nerve in the elbow results in symptoms in the forearm, wrist, and hand. The injuries to median nerve comprise of conditions where there is partial or complete tear of the nerve or compression of the nerve due to a displacement fracture or due to additional fluid after an injury.

At the elbow joint, the nerve runs through the inside part of the joint. Any trauma to this area results in high risk for causing an injury to the median nerve. The median nerve also passes through brachial artery and hence any injury to median nerve may also lead to an injury to this artery. In case of fractures, such as supracondylar fracture or elbow dislocation, assessment for any injury to median nerve should be done. Medial nerve symptoms can also occur in small injuries to medial ligament such as increased pressure on nerve due to bleeding and development of swelling in the area. Carpal Tunnel Syndrome is the most common injury involving median nerve.

• Difficulty or inability to rotate the hand over.
• Difficulty or inability to flex the wrist down.
• Tingling or numbness in the forearm, thumb, and the three adjacent fingers.
• Weak grip.
• The patient is not able to move the thumb across the palm.
• Muscle wasting at the base of the thumb.
• Pain in the wrist at night.

• Mostly median nerve injuries occur as a result of some other injury. So, the cause i.e. the initial acute injury should be treated first, as it can be some type of fracture/dislocation or injury to the soft tissue. Treating the cause of the injury relieves the symptoms in the median nerve.
• R.I.C.E. technique should be applied for soft tissue injury. This helps in reducing swelling, which in turn reduces the compression on the median nerve.
• Surgery should be done to realign a fracture at the elbow that becomes displaced. Displaced fracture compresses the nerve and by realigning it, any sort of pressure on the nerve is eliminated.
• Symptoms of median nerve abate quite rapidly if treatment is done promptly and thus reducing the chances of any chronic damage. However, if the treatment is delayed and the nerve gets damaged, then the symptoms persist for a longer time.