I have aching pain down the inside of my forearm with numbness in the thumb and index finger. I saw an orthopedic surgeon who diagnosed it as pronator syndrome. She recommended hand therapy. I'm thinking about seeking a second opinion. What do you think?
Pronator syndrome is a nerve entrapment (pressure on the median nerve in the forearm). The nerve can get pinched between two other soft tissue structures such as muscles, tendons, ligaments, or fascia (connective tissue).
The syndrome produces more than just forearm aching pain. Like you, many patients also report numbness and tingling in the thumb and index finger. The symptoms are usually mild-to-moderate in intensity. Hand function may be impaired but disability from this problem is rare.
Recommended treatment is usually conservative (nonoperative) care. As far as seeking out a second opinion, there's nothing wrong with that for any condition. Information gathering is an important step in determining the best way to treat a problem like pronator syndrome.
Some surgeons don't believe pronator syndrome even exists. There are no clear cut diagnostic tests that prove a patient has this problem. The clinical and electrodiagnostic tests usually used with nerve compression just don't yield consistent results from patient to patient.
Depending on how the surgeon who sees you next feels about the condition called pronator syndrome, you may get the same advice, you may not. Nonspecific forearm aching that isn't easily reproduced with testing is a puzzling problem. Research is really needed to figure out what's going on and find ways to address the underlying problem.
Steven Presciutti, MD, and Craig M. Rodner, MD. Pronator Syndrome. In The Journal of Hand Surgery. May 2011. Vol. 36A. No. 5. Pp. 907-909.
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