Houston Methodist. Leading Medicine

Hand FAQ

Question:

Have you ever heard of bartenders getting thumb drop from mixing drinks? I can't think of any other reason why my thumb and fingers are dropped down. Sometimes I can lift them up fine. Other times they just droop.

Answer:

There have been reports from bartenders and others who repeatedly turn the hand palm up and palm down. This problem is not common but has been described by violin players, swimmers, military personnel, and bartenders. The condition is thought to be a nerve palsy called posterior interosseous nerve (PIN) syndrome. A branch of the radial nerve in the forearm that supplies motor (movement) function to the extensor muscles of the thumb and fingers is affected. The repetitive motion of the forearm causes muscle contraction of the supinator muscle. The nerve gets pinched by this muscle as it contracts and especially if it gets built up in bulk from constant use. It would be a good idea to see an orthopedic surgeon or hand specialist for an examination and proper diagnosis. You may be able to benefit from a special splint to rest the muscle and nerve while still allowing you to do your job. Antiinflammatory medications can help reduce any swelling. Rarely, more invasive treatment such as surgery is needed when there is a tumor, cyst, or scar tissue pressing on the nerve causing the same symptoms. Alan C. Dang, MD, and Craig M. Rodner, MD. Unusual Compression Neuropathies of the Forearm, Part I: Radial Nerve. In Journal of Hand Surgery. December 2009. Vol. 34A. No. 10. Pp. 1906-1914.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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