Is it really a carpal tunnel syndrome? Proximal compression of the median nerve

Purpose: This study aims to review the different clinical and theoretical aspects of median nerve compression syndromes, in order to differentiate carpal tunnel syndromes from other more proximal median nerve compressions.

Data Source: All relevant studies and data in the article were obtained from MEDLINE searches between 1966 and 1998 and from reference volumes dealing with the subject of the article.

Results: Carpal tunnel syndrome is the most common compression of the median nerve. However, compression at the elbow below Struthers' ligament, at the forearm below the pronator ring and biceps, and compression of the anterior branch of the median nerve can lead to signs and symptoms similar to carpal tunnel syndrome. Orthopedic testing and neurological evaluation (electromyography and nerve conduction velocity) are used to determine the diagnosis and the exact site of nerve compression.

Conclusion: In order to avoid ineffective treatments, it is important to ensure that the diagnosis of signs and symptoms of median nerve damage is accurate and that the site and mechanism of median nerve compression have been identified. The chiropractor has all the knowledge necessary to make a proper diagnosis and to direct the patient to the most appropriate interventions.