Thursday, April 9, 2009

Pronator Teres Syndrome and Minnesota Workers' Compensation

Repetitive motion injuries, or cumulative trauma injuries, are commonly known as Gillette injuries under Minnesota workers’ compensation law.

Because the symptoms of carpal tunnel syndrome and pronator teres syndrome are similar, it is often difficult to determine which nerve has been injured when a person experiences symptoms in his or her fingers, hands, wrists, forearms, and elbows.

Pronator teres syndrome (also referred to as Pronator syndrome) is an upper extremity nerve entrapment syndrome involving the median nerve.

PTS develops from compression of the median nerve by the pronator teres muscle, and is sometimes referred to as pronator syndrome. The term pronator syndrome also can include median nerve compression by other structures in the elbow, such as the ligament of Struthers or the bicipital aponeurosis (lacertus fibrosus). Compression can be due to muscle hypertonicity or fibrous bands within the muscle pressing on the nerve. In some cases, pressure is placed on the nerve by anatomical anomalies, such as the nerve traveling deep to both heads of the pronator teres. In this situation, the nerve might be compressed against the ulna by the pronator teres muscle itself.

Symptoms of pronator syndrome include a diffuse forearm ache, usually resulting from prolonged muscular effort. Paresthesia may also be noted in the median field of the hand. There may also be tenderness over the area of entrapment, which can lead to pain in the forearm. Pressure on the area of nerve entrapment may cause abnormal sensations down the path of the median nerve. This is known as Tinel’s sign. People suffering from pronator syndrome may also experience decreased strength to muscles in the forearm. Specifically, victims of pronator teres syndrome may result in a decreased ability to pronate the wrist, a loss of wrist flexion, partial loss of finger flexion, and a loss of thumb opposition. In contrast, people with carpal tunnel syndrome will not demonstrate weakness in wrist flexion, wrist pronation, or finger flexion.

People with carpal tunnel syndrome and pronator teres syndrome both experience sensory loss, however the patterns of sensory loss differ. Pronator syndrome causes sensory loss in the entire median nerve field of the hand. In contrast, carpal tunnel syndrome causes sensory loss primarily in the thumb and fingers. Additionally, pronator teres syndrome pain is exacerbated by repetitive elbow flexion, and symptoms arise in the forearm as well as the hand. Carpal tunnel syndrome, on the other hand, is aggravated by wrist movements, and forearm pain is not as common or as severe.

People with carpal tunnel syndrome frequently report night pain, while individuals with pronator syndrome generally do not. This is because prolonged wrist flexion during sleep aggravates carpal tunnel syndrome, whereas wrist flexion does not affect the pronator teres muscle.

Treatment for pronator teres syndrome may include conservative therapies such as massage and physical therapy, ultrasound, anti-inflammatory medications, pain medications, or corticosteroid injections. If conservative therapies fail, decompressive surgery may be necessary.

People suffering from pronator teres syndrome as the result of repetitive motions at work are entitled to workers’ compensation benefits under Minnesota law, including medical benefits, wage loss benefits, permanency benefits, and/or rehabilitation benefits. Unfortunately, workers who suffer from pronator teres syndrome may ultimately be medically required to avoid the types of repetitive motions required by their jobs.

If you’ve been diagnosed with pronator teres syndrome as the result of your work related activities, you should report the injury to your employer, and consider retaining an experienced workers’ compensation lawyer to make sure you get the benefits you are entitled to. To schedule a free, no-obligation consultation with one of our attorneys, contact Meuser & Associates at 877-746-5680, or click here to send us an email.

Visit Minnesota Workers' Compensation and Personal Injury Law Firm, Meuser & Associates, P.A., at
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