Hand Paralysis

Overview and Facts about Hand Paralysis

The three main nerves in the hand are the ulnar, radial, and median nerves, and each serves a different part of the hand. Damage to one or more of these nerves can result in hand paralysis. 

Although paralysis is typically characterized by lack of movement, some forms of paralysis, called palsies, cause uncontrollable movement and tremors.

Signs and Symptoms of Hand Paralysis

The signs and symptoms of hand paralysis differ depending on which nerve has been damaged.

• Ulnar nerve paralysis — The ulnar nerve travels along the inside of the arm, just below the skin’s surface at the inner elbow. It runs down the forearm to the wrist, then branches to the ring and pinky fingers. This nerve controls the fine movement of the hand and fingers as well as some forearm muscles used for grip. Ulnar paralysis results in tingling and weakness of the hand, muscle wasting, and claw hand, a condition in which the muscles in the fingers tighten, causing them to be permanently bent. 
   
• Radial nerve paralysis — The radial nerve runs from the shoulder down the back of the arm, then through the forearm to the hand. This nerve enables extension of the wrist and fingers. Damage to the radial nerve can cause weakness in the fingers and wrist and could prevent the hand from opening or grasping. 
   
• Median nerve paralysis — The median nerve runs down the upper arm and through the forearm to the hand. It provides feeling to the thumb, index finger and middle finger. Paralysis of this nerve can cause numbness or a tingling, burning sensation in the thumb and first two fingers. It can also hinder the use of the thumb and result in an inability to pinch.

Causes and Risk Factors of Hand Paralysis

Causes of hand paralysis include the following:

• Nerve compression
• Nerve damage
• Diabetes
• Stroke
• Multiple sclerosis
• Blood vessel inflammation

Tests and Diagnosis of Hand Paralysis

After learning your medical history and examining the affected hand by extending your arm and fingers, your doctor may refer you to a neurologist.

A neurologist can test for nerve damage by measuring the amount of electrical activity present. Your doctor might also refer you to an orthopaedic surgeon who specializes in hand care.

Treatment and Care for Hand Paralysis

There is no cure for this orthopaedic condition; however, in some cases, partial muscle control or feeling may return after treating the cause of the paralysis, which might involve:

• Physical therapy — This could include massage, heat therapy and stimulating exercise.
• Occupational therapy — This generally focuses on ways to perform routine daily activities.
• Mobility aids — These include gripping aids.
• Adaptive equipment — This includes driving controls and special eating utensils.