Jonathan Aarons M.D.

Tired of Chronic Pain?

Cheiralgia Paresthetica

Cheiralgia Paresthetica
Cheiralgia Paresthetica

Cheiralgia Paresthetica is a painful entrapment of the superficial branch of the radial nerve at the wrist.  It is also known as “Handcuff Neuropathy” or “Wartenberg’s Syndrome since his article in 1932.  Patients have pain, numbness and tingling over the wrist and thumb.  It can radiate proximally up the foream or distally into the thumb and first finger.  Patients find it difficult to wear jewelry around their wrists and work with their hands.  The causes of cheiralgia paresthetica can be trauma, post-surgical, or from tight fitting bands such as jewelry or a cast.  It can also be associated with other forms of neuropathy, such as diabetes mellitus.  Testing involves X-rays and MRIs of the wrist to exclude trauma and tumors.  Electromyography (EMG) and Nerve Conduction Studies (NCV) are used to determine the exact point of nerve injury and to exlcude other causes such as a herniated cervical disc.  Treatment begins with conservative modalities such as rest, heat, ice, non-steroidal anti-inflammatory medications and physical therapy.  Injection at the radial nerve with a local anesthetic and a steroid may serve both to diagnose the issue and to provide treatment.  In refractory cases, surgery may be needed to release any nerve compression.

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