Distal median nerve dysfunction : Symptoms & Signs, Diagnosis & Tests

Symptoms & Signs

  • Pain in the wrist or hand that wakes you up at night
    • May be severe
    • Pain may be felt in other areas (this is called referred pain)
  • Sensation changes in the thumb and first two fingers, such as:
    • Burning feeling
    • Decreased sensation
    • Numbness
    • Tingling
  • Weakness of the hand that causes you to:
    • Drop things
    • Have difficulty grasping objects

Diagnosis & Tests

Examination may show decreased sensation in the thumb side of the hand. This is called the “radial” side. There may be weakness of the thumb and difficulty using it to pinch.

Tests that reveal distal median nerve dysfunction may include:

  • Electromyogram (EMG)
  • Nerve conduction tests
  • Nerve biopsy (rarely needed)

Tests are guided by the suspected cause of the dysfunction as suggested by the patient’s history, symptoms, and pattern of symptom development. They may include various blood tests, x-rays, imaging scans, or other tests and procedures.


Review Date : 9/11/2008
Reviewed By : Sean O. Stitham, MD, private practice in Internal Medicine, Seattle, Washington; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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