Treatment of Pronator Teres Syndrome

Black spa stone with set of acupuncture needles on tray

Pronator Teres Syndrome is a compression neuropathy or nerve entrapment of the median nerve at the elbow. It is more common in females and both sexes in their 40’s. It is also more common in people that lift weights or have highly developed forearms. The patient with Pronator Teres Syndrome will often present with symptomatology in the Median Nerve distribution of the first three digits and the radial half of the index finger like Carpal Tunnel Syndrome, the only difference is the site of the nerve compression. In CTS the site of nerve compression is at the wrist usually beneath the Transverse Carpal Ligament. In Pronator Teres Syndrome the nerve compression is typically under or within the Pronator Teres Muscle.

The Pronator Teres Muscle originates on the supracondylar ridge of the humerus and inserts or ends on the lateral or outside surface of the radius or outside forearm bone. The muscle has two heads like the biceps of the upper arm. The muscle functions as a pronator or internal rotator of the forearm and flexes the elbow to some degree. The telltale sign of Pronator Teres Syndrome is the numbness in the Median Nerve distribution of the hand is increased by repetitive stressful motion the forearm especially pronation, not flexion and extension of the elbow. Clinically Tinel’s sign is + at the wrist with CTS and + in the forearm with Pronator Teres Syndrome. Phalen’s Sign or Reverse Phalen’s Sign is an Orthopedic Test which is performed at the wrist which is typically + with CTS and negative with Pronator Teres Syndrome.

A Chiropractor would treat Pronator Teres Syndrome by analyzing the Cervical Spine for misaligned vertebrae or Subluxations. It would also be prudent to analyze the wrist and elbow as well for misalignments or abnormal joint mechanics. The elbow and wrist would be manipulated if dysfunctional.  It would also be appropriate to perform some type of Myofascial Release of the Pronator Teres Muscle or Therapeutic Muscle Stretching which would help lengthen shortened or spastic muscle fibers and break down scar tissue or adhesions.

The Acupuncturist on the other hand might treat this condition by stimulating or needling the Pericardium Meridian or pathway. The Pericardium Meridian originates at Pericardium 1 which is located on the chest lateral to the nipple and ends at Pericardium 9 which is located on the tip of the middle finger. The significance of this meridian is the Median Nerve which is compressed in Pronator Teres Syndrome also runs through the forearm adjacent to the Pericardium Meridian. The Acupuncturist may also perform a technique called Trigger Point Acupuncture where a specific muscle or muscles are targeted. The goal of this technique is to attempt to get the muscle to release or lengthen which is often accompanied by a visible or palpable twitch response, which signifies the desired result was reached. Other benefits of Acupuncture are increased blood flow in the area to decrease healing time and release of endorphins and enkephalins which help reduce pain and anxiety.

Posted in: Elbow/ Wrist/ Hand

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