Also known as entrapment neuropathy or nerve compression syndrome is a disorder caused by direct pressure on one nerve. Colloquially it is called a trapped nerve although it might refer to the compression of the root of a nerve.
Depending on the part of the body that is affected the symptoms will affect one certain part of the body. The symptoms might include muscle weakness, numbness, pain and tingling. Surgery might help relieve the pressure but that might not alleviate all the symptoms.
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How does this happen? Flow in the vessels that supply blood to the nerve is reduced by external pressure. That leads to local ischemia which affects the ability of the axons to transmit action potentials. Over time, the compression gets more severe and focal demyelination occurs. Then axonal damage follows and in the end the scarring.
The compression of a nerve may be caused by repeated or prolonged external force like frequent or prolonged resting one elbow on a table, sitting with one arm over the back of a chair or an ill-fitting brace or cast on a leg. Also the compression might be caused by a ganglion cyst, tumor, hematoma or the carpal tunnel syndrome. The last one might be because of pregnancy (peripheral edema) or weight gain.
The disorder can be diagnosed on the basis of the symptoms and signs alone. Nerve conduction studies can help gauge the severity, confirm the diagnosis and rule out the implication of other nerves.
It is very important to distinguish other disorders that might come with similar signs and symptoms. Multifocal motor neuropathy and neuralgic amyotrophy are two diseases that might be misdiagnosed as entrapment neuropathy.
People with compression neuropathy should have the specialist assistance of a neurologist in aventura florida for a better understanding of the condition.
When the neuropathy is caused by an underlying medical condition treatment is first conducted at that condition. In cases of neuropathy occurring in pregnancy no special treatment is required as it resolves after delivery. Some cases of neuropathy might require surgery. Determinating the location, presence and type of nerve injury is still based on electrophysiological studies and neurological exams.
The most common entrapment neuropathy is the carpal tunnel syndrome (CTS) that might occur due to the entrapment of the median nerve in the carpal tunnel. The CTs diagnosis is usually simple and straight forward the diagnosis is more accurate if it is confirmed with electrodiagnostic studies. Nerve conduction studies add a specificity and sensitivity to the diagnosis. For the severe cases the treatment might require surgery while for moderate or mild cases steroid injections are useful.
Entrapment neuropathy of the ulnar nerve is pretty common and they are more prevalent at the elbow than at the wrist. The diagnosis in the case of the ulnar neuropathy at elbow is usually easily confirmed by nerve conduction studies. In the case of the ulnar neuropathy at wrist the protocol is a bit more complicated.
Distinguishing the entrapment neuropathies from other diseases of the peripheral nerve and recognizing the nerve entrapment syndrome are crucial for an effective treatment. In the future magnetic resonance imaging will play a significant role in the evaluating the diseases of the nervous system. Increasing the resolution and sensitivity of the MRI could help evaluation of the peripheral nerves injuries.