Stroke can be accompanied by a variety of symptoms in your hands and fingers. These can include numbness, tingling, pain, and stiffness. Many doctors and patients have noticed that while other impairments typically improve with rehabilitation, these complaints tend to become worse over time. But why?
Researchers from Turkey were determined to figure out the reason these symptoms weren’t as responsive as others to therapy. They employed ultrasound imaging to measure the size and elasticity of an essential nerve in the wrist, the median nerve. The median nerve has a multitude of responsibilities. It moves many muscles in your forearm and hand. It is also responsible for controlling the sensations you feel in your thumb, pointer, and middle finger, and can cause carpal tunnel syndrome.
How does the median nerve relate to my discomfort?
The researchers hypothesized that ongoing spasticity of lower arm muscles after stroke could be causing persistent pressure, stress, and damage to the median nerve. They conducted a study and included 24 patients who had experienced a stroke an average of 19 months ago. On average, patients were 56 years old. Using ultrasound, researchers found that the size of the median nerve was smaller on the stroke-affected wrist compared to the unaffected side. Even more noteworthy, they saw that the size of the nerve continued to shrink as time passed after the stroke.
In line with their hypothesis, the researchers believed this continual shrinkage meant that compression over time leads to more and more damage due to a lack of blood flow and inevitable scarring of the nerve. The development of scar tissue would also explain the loss of elasticity of the nerve observed on the affected side, although this did not get worse with time.
What can I do?
The authors concluded that the persistent flexed position of the wrist many experience after a stroke could lead to ongoing damage to the median nerve. It is therefore vital to take care of your wrist posture. Make sure you move your wrist regularly. If it’s difficult to move your wrist early on actively, you can still lower your risk of compression. Rolling and stretching your wrist with your unaffected hand can help. Any symptoms located in your thumb to your middle finger may indicate early signs of median nerve compression. If this is the case, be sure to talk to your therapist or physician. Together, you can determine if your hand, arm, and even shoulder complaints could be related to compression of the median nerve and further discuss what you can do about it.
The author of the original article is Dr. Hulya Aslan, Department of Radiology, Baskent University Faculty of Medicine, Adana, Turkey.