What Is Nerve Entrapment?
Your nervous system is intended to be quite sensitive so that it can pick up sensory cues from the surrounding environment. However, when the nerves become exposed to sustained stimuli, this can produce chronic pain and nerve damage. Nerve entrapment occurs when some tissue like bone or muscle presses upon the neural fiber and can produce intense pain, numbness or loss of motor control.
Although nerve entrapment may result from any traumatic injury, it is most commonly a product of repetitive stress injuries. Some of the most common examples of nerve entrapment conditions include carpal tunnel syndrome or cubital tunnel syndrome.
Most Common Causes of Nerve Entrapment
There are many ways that a nerve can become compressed, but the most common involves repeated motions that can produce swelling around a nerve. Conditions like carpal or cubital tunnel syndrome are common because the nerve passes through a small opening that may narrow if inflammation occurs.
In addition to repetitive stress, nerve entrapment may also occur if tissue is dislodged. Trauma like sprains, fractures or tissue scarring may apply pressure to a nerve that is sufficient to produce pain, weakness or loss of sensation.
There are also some health conditions that can make you more susceptible to nerve entrapment:
- High blood pressure
- Autoimmune diseases
- Thyroid dysfunction
- Tumors or cysts
- Congenital birth defects
- Nervous system disorders
If you fall into one of the following classes of people, you have an elevated risk of developing nerve compression:
- You are 30 years old or older
- You are female
- You have a job that requires repetitive motions for long periods of time
- You have a health condition related to the nervous or circulatory systems
Kinds of Nerve Entrapment Syndrome
There are hundreds of nerves composed of billions of nerve cells in the human body and almost any of these may become compressed. Some nerves are at greater risk of entrapment and produce more common nerve compression syndromes including the following:
- Carpal tunnel syndrome—this condition is caused by the compression of the median nerve as it travels through carpal tunnel of the wrist. Pain may occur up the arm as well as numbness and weakness in the hand.
- Cubital tunnel syndrome—compression of the ulnar nerve at the cubital tunnel in the elbow is often a result of repeated or ongoing strain. Symptoms like pain, numbness and weakness in the fingers can be remedied with medication, activity modification, exercise, or surgery.
- Radial tunnel syndrome-this condition involves entrapment of the radial nerve in the upper arm.
- Tarsal tunnel syndrome- this condition involves compression of the posterior tibial nerve at the ankle.
- Piriformis syndrome—if the piriformis muscle which stretches from the lower spine to the pelvis spasms uncontrollably then it may compress the sciatic nerve. This may produce pain, numbness, and weakness in the legs and buttocks that may worsen while seated.
- Meralgia paresthetica—this condition involves compression of the lateral cutaneous nerve which causes pain or numbness in the outer thigh. Commonly found among obese patients who wear tight-fitting leg garments.
- Herniated disc—if a spinal disc is damaged or misaligned, it can apply pressure to a spinal nerve, producing pain in the back or legs. Usually, this condition will resolve on its own in a few days or weeks.
How to Identify a Nerve Compression Syndrome
Nerve compression may occur almost anywhere on the human body, and the symptoms may vary depending on which nerve is affected. The most common symptoms of nerve entrapment include
- Swelling and redness
- Inhibited motion
- Muscle weakness
Your doctor may perform a series of tests to determine if a nerve is being compressed. Firstly, your doctor will assess your symptoms and investigate your medical history. If certain factors like a traumatic injury or repetitive motion are present, then your physician may perform some more sophisticated tests like a nerve conduction test, electromyography, ultrasound or MRI to confirm the diagnosis.
Treating a Nerve Compression Syndrome
If you are diagnosed with a nerve compression syndrome, then your doctor may recommend one or more of the following therapies:
- Rest—because so many nerve compression syndromes are related to repeated movements, one of the first treatment options is inactivity. This may require a splint or brace to immobilize an affected area.
- Posture adjustment—if the nerve compression condition is the result of poor positioning, you may need to retrain your posture or other body positioning to put less strain on the problematic nerve.
- Physical therapy—this is a very common treatment option because it strengthens and stretches muscles in the problem area which can reduce pressure. Treatments like manual manipulation may also erode scar tissue which may be causing the nerve compression.
- Exercise—many kinds of exercise, including yoga that emphasize gentle stretching can help relieve pressure on nerves. If the condition is related to body weight, physical activity can also help maintain a healthy weight.
- Bracing—many people with nerve compression issues find that a brace or splint can help ease pain by preventing a stressful position. These may be worn during the day, but, in some cases, it may be necessary to wear them while sleeping.
- Elevated limbs—swelling is a common issue with nerve compression, so one simple solution is to raise the problematic area above the trunk of your body. If possible, place your limb at a 45-degree incline using pillows.
- Heat and ice—icing a nerve compression may bring down swelling and numb the pain. Alternating with heat is quite effective as it will promote blood circulation and healing. Do not apply heat or ice for more than 20-minute periods.
- Medications—non-steroidal anti-inflammatory drugs like ibuprofen or naproxen can reduce swelling and pain. Some cases may warrant more powerful corticosteroids to bring down inflammation and pain.
- Peripheral nerve stimulation- this procedure places an electrical stimulator near the peripheral nerve. The device produces a weak current that stimulates the peripheral nerve and blocks pain impulses to the brain.
- Surgery—if your condition does not respond to more conservative therapies then you may be a candidate for a surgical procedure. The exact nature of the procedure will depend on the type of nerve compression you are suffering from. In some cases, it may involve removal of the impinging tissue, while in others, it may require damaging the nerve in order to provide symptom relief.
Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care
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