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- The patient presents with pain, tingling, paresthesias over the dorsolateral aspect of the hand, wrist, and fingers. The symptoms may extend from the dorsal radial forearm into the thumb, index, and long fingers. Much of the time, they are unable to localize the pain to a specific area.
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How do you know if you have Wartenberg's syndrome?
How do you know if a patient has Wartenberg's sign?
What is Wartenberg's syndrome?
Consequently, symptoms and signs of Wartenberg’s syndrome relate to paresthesia and anesthesia in the distribution of the nerve, most commonly in between the index finger and the medial thumb. Patients with Wartenberg’s syndrome can present with pain, sensations of burning, numbness and tingling, and dysesthesia in the previously described ...
- Introduction
- Background
- Anatomy
- Pathophysiology
- Differential Diagnosis
- Management
Wartenberg's Syndrome is described as the entrapment of the superficial branch of the radial nerve with only sensory manifestations and no motor deficits. In this condition, the patient reports pain over the distal radial forearm associated with paresthesia over the dorsal radial hand.This should not be confused with Wartenberg's Sign which refers ...
In 1932, Wartenberg described five cases of isolated neuropathy of the Superficial Radial Nerve (SRN) . He was so impressed by the similarity to the isolated involvement of the lateral cutaneous nerve of the thigh, Meralgia Paraesthetica, that he suggested the name Cheiralgia Paraesthetica. The condition is sometimes referred to as Wartenberg's Dis...
The SRN is the superficial sensory branch of the radial nerve. After the radial nerve bifurcates into the SRN and Posterior Interosseous Nerve (PIN), the SRN courses distally into the forearm deep to the brachioradialis. Approximately 9 cm proximal to the radial styloid, the SRN becomes a subcutaneous structure by traveling between the brachioradia...
The SRN can be compressed at any point along its course in the forearm, but it is believed to be at greatest risk at the posterior border of the brachioradialis as the nerve transitions from a deep to a subcutaneous structure. Trauma is also a common etiology for SRN compression, which can occur from direct pressure on the nerve (i.e. by a wristban...
Patients with SRN compression typically report pain or dysesthesias on the dorsal radial forearm radiating to the thumb and index finger, although the distribution of symptoms may vary owing to differences in anatomy. When such sensory disturbances present concomitantly with weakness of the PIN-innervated muscles, the clinician should consider alte...
Conservative Management
Patience is the cornerstone of therapy in patients with SRN compression symptomatology because spontaneous resolution is common. As external compression is a common underlying etiology, removal of the inciting element such as a wristwatch or bracelet is an essential component of nonsurgical management. Additionally, rest, splinting, and nonsteroidal anti-inflammatory drugs are appropriate first-line treatments.
Physiotherapy Management
Owing to the subcutaneous location of the SRN, a number of noninvasive therapeutic modalities centered around peripheral nerve stimulation (PNS) have been studied for the treatment of nerve pain, including pulsed low-intensity infrared laser, as well as direct electrical stimulation. The use of PNS to treat neuropathic pain is based on the gate control theory of pain. Although this theory has found support in the medical literature and is certainly intriguing, there is mixed evidence supporti...
Injection
The role of corticosteroid injection is less clear. Lanzetta and Foucher (1993) reported a 71% success rate in 29 patients who underwent conservative management alone, which was defined as removal of a tight watch strap, splinting, and, in 3 cases, a corticosteroid injection.
Wartenberg syndrome is a compressive neuropathy associated with sensory manifestations such as painful paresthesias on the dorsum of the thumb and radial hand. Wartenberg syndrome is not associated with any motor deficits.
Wartenberg's sign is a neurological sign consisting of involuntary abduction of the fifth (little) finger, caused by unopposed action of the extensor digiti minimi. [1] [2] This commonly results from weakness of some of the ulnar nerve innervated intrinsic hand muscles -in particular the palmar interosseous muscle to the little finger- caused ...
Pathophysiology. Wartenberg’s sign can help to diagnose ulnar nerve palsy or chronic cubital tunnel syndrome. In addition to cases of neurogenic origin, a positive Wartenberg’s sign may also indicate the contracture of hypothenar muscles after a compression injury, or the beginning of multiple sclerosis with cerebellar lesions.
Aug 8, 2023 · Nerve compression syndromes of the hand present with various signs and symptoms that correspond to the nerve involved and its anatomic distribution. There are three nerves and their corresponding branches that provide sensory and motor innervation to the hand that include the median, ulnar, and radial.
Jun 5, 2023 · The condition presents with symptoms such as pain and burning located on the dorsal and radial side of the hand. Often it is aggravated by activities such as pronation, pinching, and gripping. The radial nerve derives from the posterior cord of the brachial plexus and consists of fibers from the nerve roots at C5, C6, C7, C8, and sometimes T1.
