Somatic dysfunctions in patients with the median nerve tunnel syndromes

Objective. To determine where along the course of the median nerve somatic dysfunctions (SD) arise in tunnel syndromes and to compare the frequency of their detection in patients and in healthy individuals. Material and methods. Analysis of initial (pre-treatment) data from a prospective controlled randomized trial performed from September 2023 to May 2026 at “Harmony Clinic” LLC (Irkutsk) and “Angara” Clinical Resort” JSC. Fifty patients with stage I–II median nerve tunnel neuropathy and 48 healthy volunteers were examined; in addition to the standard osteopathic assessment, local SD were recorded along the course of the median nerve followed by distribution into seven topographic regions. Results. Local SD were more frequent in patients than in controls in all seven topographic regions (all p < 0.002 after Holm correction). The largest gap was found at the wrist (96 % vs 15 %, 81 percentage points) and the distal forearm (76 % vs 21 %, 55 points); gaps in the remaining regions ranged from 32 to 37 points. The mean number of involved regions was 5.2 in patients versus 2.1 in controls; three or more regions were involved in 41 patients (82 %), while isolated single-region involvement did not occur. Conclusion. The clinical picture of the median nerve tunnel syndromes is formed not only by local compression but also by the nerve impaired gliding distributed along the nerve bed.