Neuropathy - distal median nerve
Treatment is aimed at correcting the underlying cause.
If the median nerve is affected by carpal tunnel syndrome, a wrist splint can reduce further injury to the nerve and help relieve symptoms. It is often enough to wear the splint only at night to give the area a rest and allow inflammation to decrease.
In some cases, no treatment is required and recovery happens on its own. Over-the-counter or prescription medication may be needed to control nerve pain (neuralgia).
If other nerves are also affected, it is necessary to look for an underlying medical problem that can affect nerves. Medical conditions such as diabetes and kidney disease can damage nerves. In these cases, treatment is directed at the underlying medical condition.
Physical therapy exercises may be appropriate for some people to maintain muscle strength. Orthopedic assistance may maximize the ability to use the hand. Such therapy may involve braces, splints, or other appliances. Vocational counseling, occupational therapy, occupational changes, job retraining, or other measures may be recommended.
Some patients with carpal tunnel syndrome may need surgery. See: Carpal tunnel release
If the cause of the nerve dysfunction can be identified and successfully treated, there is a good chance of full recovery. In some cases, there may be partial or complete loss of movement or sensation. Nerve pain may be severe and persist for a prolonged period of time.
Call your health care provider if you have symptoms of distal median nerve dysfunction. Early diagnosis and treatment increase the chance of curing or controlling symptoms.
Jarvik JG, Comstock BA, Kliot M, et al. Surgery versus non-surgical therapy for carpal tunnel syndrome: a randomized parallel-group trial. Lancet.2009 Sep 26;374(9695):1074-81.
Zhao M, Burke D. Median neuropathy (carpal tunnel syndrome). In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 32.
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