What is nerve entrapment?
Nerve entrapment or nerve compression is a symptomatic medical condition caused by pressure on a major nerve in an upper or lower limb. It usually presents with numbness, tingling or a burning sensation, and less commonly pain in the area of the distribution of the nerve. For example, in the case of carpal tunnel syndrome, patients may feel numbness or tingling in the distribution area of the median nerve distal to the wrist (thumb, second and third finger). Weakness and atrophy of the muscles innervated by the entrapped nerve are late manifestation of the disease. Thumb muscles weakness and atrophy are seen in advanced untreated carpal tunnel syndrome.
Carpal tunnel syndrome (median nerve compression in the wrist), cubital tunnel syndrome (ulnar nerve entrapment in the elbow area), peroneal nerve compression (common peroneal nerve compression at fibular neck area) are some of the common nerve entrapment syndromes.
What are the causes of nerve entrapments/compression?
Causes of nerve entrapments/compression are:
- Prolonged and repeated direct force on the nerve anatomic pathway,
- Pressure from a mass lesion (tumor, infection, bony overgrowth, etc.) around the nerve,
- Peripheral edema or weight gain (pregnancy, thyroid disease),
- Tissue expansion in a tight space (carpal tunnel syndrome).
How is nerve entrapment/compression diagnosed?
Diagnosis is based on the symptoms reported by the patients and physical examination as well as paraclinical tests. Nerve conduction study is the most available and trusted test to confirm the diagnosis. It can help to locate the exact place of the nerve compression on the nerve distribution road. This will help in overlap diagnosis situations called double crush syndromes in which patient’s symptoms are related to two or more pathologies in different locations of the nerve pathway. Sometimes, an MRI or CAT scan is needed to roll out the mass lesions around the nerves.
How is nerve entrapment/compression treated?
Treatment may differ based on the cause of the nerve compression or entrapment. For example, in patients diagnosed by hypothyroidism, the first step is to treat the patient by thyroid hormone to gain normal physiologic condition impaired by hormone deficiency. The symptoms started during pregnancy usually resolve after delivery. In some situations, physical therapy, temporary application of braces and corticosteroid injection can be the primary treatments suggested by your physician before any surgical procedures. However, surgery can be the first offered treatment option in more advanced and prolonged cases. Surgical intervention is the only treatment option in patients with muscle atrophy or significant weakness.
Surgical treatment includes the release of the compression on the entrapped nerve and sometimes transposition of the nerve to a better place with less chance of entrapment recurrence. After surgery, a brace or splint may be applied for a period of time. Most patients feel significant improvement in their symptoms shortly after surgery. However, in prolonged compression situations and delayed diagnosis conditions, recovery may not be full and some symptoms may persist after surgery.
Why come to the International Center for Limb Lengthening to treat nerve entrapment?
Your doctor at the International Center for Limb Lengthening will take the time to make sure you understand all of your options and then will customize your treatment to meet your specific needs. Our patients benefit from our team-centered approach with world-renowned surgeons and specialized physician assistants, nurses and physical therapists. We help patients with nerve entrapment achieve their best possible result.