Pronator Teres Syndrome: Symptoms, Test & Treatment

Instructor: Kirstyn Wade

Kirstyn is a registered nurse and has a master's degree in Nursing Education. She has taught college Nursing courses.

Pronator teres syndrome is a condition affecting the arm. In this lesson, you will learn more about the symptoms, how to test for pronator teres syndrome, and treatment options.

Arm Pain

Christina, an avid tennis player, has been experiencing increased pain in her right arm just below her right elbow. She is also experiencing some numbness and tingling into her right palm. It's getting more and more difficult for her to play tennis, so she decides to see a sports medicine doctor to figure out why she is in pain.

What Is Pronator Teres Syndrome?

After a thorough examination, Christina's doctor diagnoses her with pronator teres syndrome, also known as pronator syndrome. Pronator teres syndrome occurs when the median nerve near the elbow becomes compressed between the two sections of the pronator teres muscle in the forearm.


Pronator teres muscle of the forearm is highlighted in purple.
Arm Muscles


Pronator teres syndrome is typically caused by certain repetitive movements of the forearm. These movements involve forearm pronation, or turning the forearm from a palms up position to a palms down position. Pronation, along with forcefully gripping or grasping something in the hand, can cause strain in the pronator teres muscle in the arm. As the pronator muscle becomes more irritated and inflamed, it causes the median nerve to become compressed and entrapped in that area as it goes through the elbow. This then causes sensory symptoms in the arm.

Pronator teres syndrome is commonly seen in tennis players, carpenters, mechanics, and weight lifters.


Repetitive pronation motions, like those involved in tennis, can cause pronator teres syndrome.
Tennis


What Are the Symptoms of Pronator Teres Syndrome?

Symptoms of pronator teres syndrome include:

  • Aching pain in the forearm
  • Tenderness over the actual pronator teres muscle
  • Weakness in the arm or hand
  • Numbness and tingling in the palm, thumb or index finger
  • Typically not having pain or discomfort at night (pain at night is more common with carpal tunnel syndrome)

How Is Pronator Teres Syndrome Diagnosed?

Pronator teres syndrome is often confused with carpal tunnel syndrome. Both conditions are affected by the median nerve in the arm. However, with pronator teres syndrome, the median nerve is compressed at the pronator muscle near the elbow, causing more forearm pain. With carpal tunnel syndrome, the median nerve is compressed near the wrist, causing more wrist and finger pain.

A simple test can help physicians determine if this pain is pronator teres syndrome, carpal tunnel syndrome, or something else. This test involves resisted pronation.

To perform this test, a physician will hold a patient's hand in a handshake position, with the elbow relaxed in a neutral position. The physician will place their other hand on the patient's elbow for support. The physician will then attempt to supinate, or turn the patient's arm palm up, while the patient resists the motion, causing the pronator teres muscle to contract. As the patient is resisting this movement, the physician will extend (straighten) the patient's elbow. If the patient has pronator teres syndrome, this movement will typically elicit the same type of pain or discomfort the patient has been experiencing.

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