Longitudinal sliding of the median nerve in patients with non-specific arm pain

Andrew Dilley, Samuel Odeyinde, Jane Greening and Bruce Lynn

This study uses ultrasound imaging to examine median nerve sliding through the proximal and distal nerve segments in 18 non-specific arm pain (NSAP; also known as repetitive strain injury) patients. Longitudinal nerve sliding was measured during metacarpophalangeal, wrist and elbow movements. During elbow movements, the angle of elbow extension at which the nerve begins to move was determined, since this was expected to decrease with a restriction through the shoulder. The results from this study were compared with previously reported data. Nerve movements ranged from 1.26 to 4.73 mm in patients compared with 1.43–5.57 mm in controls. There was no significant difference in nerve sliding or in the angle of elbow extension at which the nerve began to move.

In summary, restriction of median nerve sliding is unlikely to play a major role in NSAP. Therefore, painful responses during limb movements which tension the nerve are unlikely to result from abnormal increases in nerve strain.

Manual Therapy, 2008, 13(6), 536-543.

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