1) CTS – pain and paresthesiae of the median nerve distribution (thumb, index, and middle fingers), paresthesiae particularly nocturnal, symptoms worsen with clenched fists, Tinel’s positive, Phalen’s positive, sensory loss in median nerve distribution, weakness of abductor policies brevis, weakness of opponents policies,
2) MFPS – See under Myofascial syndromes in the notes or details.
3) TTS
4) Radiculopathies
5) Cubital Tunnel Syndrome – due to entrapment of ulnar nerve at the elbow, point tenderness at the cubital tunnel, pain and paresthesiae in the distribution of the 4th and 5th fingers of the hand, sensory loss in the 4th and 5th fingers, interossei weakness, Froment’s sign positive (wasting of the 1st dorsal interosseous muscle and inability to maintain adduction of the thumb so that hyperflexion of the interphalangeal joint occurs while pinching between thumb and the 1st finger), positive Wartenberg’s sign (inability to abduct the little finger), Tinel’s sign positive (percussion over cubital tunnel causes a shower of paresthesiae in the ulnar distribution), Mx – usually RSI, look for the RSI factors
6) Pronator Teres Syndrome – activities that require the use of the elbow, forearm supination and grasping, forearm pain, medial aspect of the forearm, point tenderness at the edge of the pronator teres, pain, and paresthesia in the median nerve distribution of the hand, reproduction of symptoms on resisted pronation of the forearm – usually an RSI,
7) Anterior Interosseous Syndrome – entrapment neuropathy of anterior interosseous nerve branch of the median nerve, pain in the volar aspect of the forearm, weakness of pronator quadratus, flexor policies longus and/or flexor digitus profundus
8) Posterior Interosseous Syndrome – pain around the elbow joint, pain distal to the lateral epicondyle, tenderness distal to the elbow, weakness of extension of a middle finger, if the entrapment involves sensory branch (which is called radial tunnel syndrome) no weakness nor sensory loss but pain and tenderness at the site of entrapment (this is usually 5-7 cm distal to the lateral epicondyle), weakness of supination, decreased strength of ulnar deviation of the wrist,
9) Hypothenar hammer syndrome – blanching, paresthesiae, pain in the hand, Allen’s test positive
10) Hyperventilation syndrome – transient paresthesiae of hand and feet, perioral region, lightheadedness, carpopedal spasms, occasionally syncope,
11) Alcoholic neuropathy – numbness, tingling, burning feet, painful sensations, wekaness of legs, in early and mild cases, when severe and with autonomic involvement muscle cramps, muscle aches, heat intolerance after exercises, impotence, micturition difficulties (incontinence, sensation of incomplete emptying of bladder, hesitancy), constipation, diarrhea, nausea and vomiting, swallowing difficulty, speech impairment, muscle contractions, muscle atrophy, dyskinesias, symptoms develop gradually, worsen over time, usually bilateral symptoms, lower limb involvement more than upper limb involvement, hyporeflexia, decreased pupillary response to light, Mx - alcohol cessation and symptomatic management