Cheiralgia paresthetica

Cheiralgia paresthetica, also known as hand neuropathy or Wartenberg's syndrome, is a condition characterized by sensory disturbances in the hand, specifically in the area innervated by the radial nerve. It often presents as a burning or tingling sensation, numbness, or a combination of these symptoms in the back of the hand and the thumb, index, and middle fingers. This condition is considered a type of peripheral neuropathy and is caused by compression or damage to the superficial branch of the radial nerve.

Etiology

The primary cause of Cheiralgia paresthetica is the entrapment or compression of the radial nerve as it traverses the forearm and enters the hand. This can occur due to several factors, including:

• Repetitive motions that strain the wrist and hand, common in certain occupations or sports.
• Direct trauma to the radial nerve, such as fractures of the radius bone or dislocations.
• Prolonged pressure on the nerve from activities like wearing tight wristbands or handcuffs.
• Systemic diseases that cause nerve damage, such as diabetes mellitus or rheumatoid arthritis.

Symptoms

Patients with Cheiralgia paresthetica typically report:

• Numbness or tingling in the dorsal aspect of the hand and the radial three and a half fingers.
• A burning sensation or pain in the affected area.
• Sensitivity to cold temperatures.
• Weakness in the hand may occur in severe cases.

Diagnosis

Diagnosis of Cheiralgia paresthetica involves a thorough clinical examination and patient history. Physicians may also employ several diagnostic tests, including:

• Nerve conduction studies to assess the function of the radial nerve.
• Electromyography (EMG) to evaluate the electrical activity of muscles.
• Imaging studies, such as MRI or ultrasound, to visualize the nerve and surrounding structures for any signs of compression or damage.

Treatment

Treatment for Cheiralgia paresthetica focuses on relieving the pressure on the radial nerve and managing symptoms. Options include:

• Rest and avoidance of activities that exacerbate symptoms.
• Application of cold packs to reduce swelling and pain.
• Non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief.
• Corticosteroid injections around the nerve to reduce inflammation.
• Physical therapy to strengthen the hand and wrist, and to improve range of motion.
• Surgical intervention may be necessary in severe cases to decompress the nerve.

Prevention

Preventive measures for Cheiralgia paresthetica include:

• Ergonomic adjustments to work and living spaces to reduce strain on the hands and wrists.
• Regular breaks during activities that involve repetitive hand or wrist motions.
• Wearing protective gear during sports or occupations that pose a risk of hand and wrist injury.

Prognosis

With appropriate treatment, most individuals with Cheiralgia paresthetica experience significant improvement in symptoms. Early diagnosis and intervention are crucial to prevent permanent damage to the radial nerve.