02/18/2026
Pronator Teres Syndrome is a compression neuropathy involving the median nerve as it passes between the two heads of the pronator teres muscle in the proximal forearm. This condition leads to pain and sensory disturbances in the forearm and hand, often mistaken for carpal tunnel syndrome. Unlike wrist-level compression, symptoms originate higher in the forearm.
The median nerve travels from the arm into the forearm through the pronator teres muscle. Repetitive pronation movements, forceful gripping, overuse, or muscle hypertrophy can compress the nerve in this region. Activities involving repeated forearm rotation—such as using tools, racquet sports, typing, or manual labor—may contribute to irritation and inflammation.
Patients typically experience aching pain in the proximal forearm, tenderness over the pronator teres region, and activity-induced numbness or tingling in the thumb, index, middle, and part of the ring finger. Weakness in grip strength and difficulty with fine motor tasks may also occur. Unlike carpal tunnel syndrome, nighttime symptoms are less common, and forearm pain is more prominent.
A key clinical sign is symptom reproduction during resisted forearm pronation or sustained elbow flexion, which increases pressure on the median nerve. Sensory changes may extend into the palm because the palmar cutaneous branch of the median nerve is affected before it reaches the wrist.
Management focuses on reducing compression and inflammation. Rest from aggravating activities, ergonomic modification, stretching of the forearm flexors, nerve gliding exercises, and strengthening of surrounding musculature can help relieve symptoms. In persistent cases, medical intervention or surgical decompression may be required.
Early recognition and treatment are essential to prevent chronic nerve irritation and functional impairment. Understanding the biomechanical stresses placed on the forearm can help clinicians and rehabilitation professionals design effective prevention and recovery strategies.
