Pronator syndrome is compression of the median nerve about the elbow / upper forearm. It has symptoms similar to those of carpal tunnel syndrome, but is much less common. The two syndromes are therefore often confused. In addition, the two syndromes can occur simultaneously, meaning that the median nerve is compressed in two places at the same time, ie. the “double crush” syndrome.
As opposed to causing numbness of the fingers at night, pronator syndrome often causes numbness with heavy use. It is also associated with pain over the upper forearm.
A nerve study can diagnose pronator syndrome. However, the results of the nerve study should be confirmed on physical examination. If there’s any question, a diagnostic injection into the carpal tunnel to see if that temporarily resolves the symptoms (implying that the problem is solely due to carpal tunnel syndrome), or if another source of symptoms, such as pronator syndrome, exists. If surgery is elected, it can be performed through a small cosmetic incision. The surgical results are very good.