NERVE COMPRESSION

Nerve compression, sometimes referred to as a pinched nerve syndrome, occurs when a nerve in the peripheral nervous system experiences excess pressure from surrounding tissues such as bone, cartilage, muscles, or tendons. Nerve compression usually occurs at a single location but compression at the root of a nerve may cause pain to extend to nearby areas of the body.

Nerve compression may occur as a result of repetitive injuries or simply holding the body in certain positions for a long period. This condition can affect any part of the body and the symptoms generally depend on the affected area.

What are the Types of Nerve Compression Syndrome? 

Nerve compression syndrome commonly affects areas in the body where nerves pass through tunnel-like structures. This may occur due to the absence of adequate soft tissue in these areas to protect the nerves. The most common types of nerve compression syndrome may include:

Carpal tunnel syndrome

The most common type of nerve compression syndrome, carpal tunnel syndrome, occurs when the median nerve undergoes compression at the wrist. The median nerve, which extends from the upper arm to the thumb, passes through an opening at the wrist called the carpal tunnel.

Cubital tunnel syndrome

Cubital tunnel syndrome, also known as ulnar neuropathy, occurs when the ulnar nerve undergoes compression at the elbow. The ulnar nerve extends from the shoulder to the hand and helps move the arms, wrists, and hands.

Other types of nerve compression syndrome may include:

  • Meralgia paresthetica, which affects the lateral cutaneous nerve in the thigh
  • Radial tunnel syndrome, which affects the radial nerve in the elbow
  • Suprascapular nerve entrapment, which affects the suprascapular nerve in the shoulder
  • Thoracic outlet syndrome, which affects the nerves in the lower neck and upper chest
  • Sciatica, which affects the sciatic nerve in the lower back, hips, butt, or leg

What are the Causes of Nerve Compression

Nerve compression occurs when surrounding tissue inflammation or damage applies excess pressure on a nerve. In some cases, certain medical conditions or accidents such as sprains and fractures may lead to tissue damage thereby causing nerve compression. Conditions that may lead to nerve compression include:

What are the Symptoms of Nerve Compression?

Symptoms of nerve compression occur in specific areas of nerve entrapment and may get worse when the individual performs activities that pull or press on the nerve. The more common symptoms of nerve compression may include:

What are the Risk Factors for Nerve Compression?

Individuals who regularly partake in activities that require repetitive joint movements may experience nerve compression the most. Medical conditions that impact circulation or nerve function of the body may also increase the risks of nerve compression. Other risk factors of nerve compression may include pregnancy, prolonged bed rest, and the use of crutches, casts, or splints.

How do Specialists Diagnose Nerve Compression?

A specialist may carry out a physical examination to evaluate the patient’s symptoms and get an initial diagnosis. The specialist may order some diagnostic tests to confirm the location and extent of the compression. These diagnostic tests may include:

  • Blood tests to measure the thyroid levels of the patient
  • Nerve conduction tests to measure the functioning of electrical nerve impulses in the muscles
  • Electromyography to evaluate the electrical activity of muscles
  • MRI scans to check for nerve root compression

What are the Treatment Options for Nerve Compression?

Treatment for nerve compression mostly involves non-surgical procedures but may require surgery in severe cases. Non-surgical treatment options for nerve compression may include:

  • Use of Non-steroidal anti-inflammatory drugs (NSAIDS) and steroid injections to relieve pain and inflammation
  • Physical therapy and exercises to improve the strength and flexibility of muscles in the affected area
  • Use of prosthetic devices including splints or braces to avoid putting pressure on the affected nerve

Specialists may recommend surgical procedures to treat nerve compression as a last resort. This procedure depends on the type of nerve compression syndrome and the severity of the compression. Specialists may only consider this procedure in the case where all non-surgical treatment options fail to relieve symptoms.

References

Pinched nerve information page. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Pinched-Nerve-Information-Page.

Neal SL, et al. (2010). Peripheral nerve entrapment and injury in the upper extremity.

Rutkove SB. Overview of lower extremity peripheral nerve syndromes. https://www.uptodate.com/contents/search.

Rutkove SB. Overview of upper extremity peripheral nerve syndromes. https://www.uptodate.com/contents/search.

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