What is a nerve compression?

By | 23 April 2021

Nerve compression is used to describe the state of compression of a nerve fiber under pressure. The trunk, arms, or legs may be affected by this condition, which usually affects only one area. Symptoms such as pain, numbness, and muscle weakness may occur after nerve compression.

The underlying cause of nerve compression is usually repetitive trauma. Apart from this situation, nerve compression may also occur in diseases such as rheumatoid arthritis, diabetes, and hypothyroidism related to the thyroid gland.

What is Nerve Entrapment?

Nerve compression is the condition that occurs due to pressure created by tissues around a nerve, such as bone, cartilage, muscle, or tendon. As a result of this pressure effect, nerve functions are negatively affected and symptoms such as pain, tingling, numbness, or weakness may occur.

There are many types of nerve impingement syndromes. This typing is done according to the affected nerve and area. The most common nerve impingement syndromes are as follows:

CARPAL TUNNEL SYNDROME

Carpal tunnel syndrome is the most common nerve compression. It occurs as a result of the compression of the structure called the median nerve around the wrist. This nerve starts from the upper part of the arm and extends to the thumb. The transition point from the wrist is through a structure called the carpal tunnel. Causes such as edema in the wrist create extra pressure on the nerve passing through the tunnel, and this may result in the development of carpal tunnel syndrome over time.

MERALGIA PARESTHETICA

If the “lateral femoral cutaneous nerve”, which is the sensory nerve in the thigh area, is subjected to compression in the regions where it passes in the lower extremity, nerve compression called meralgia paresthetica may occur. In this condition, pain and loss of sensation occur especially in the lateral outer region of the thigh (where the trouser pocket is). These symptoms generally tend to occur unilaterally.

What are the Symptoms of Nerve Stress?

Symptoms caused by nerve compression may vary depending on the affected area. Nerve compression occurring in the neck area usually occurs as pain reflected towards the shoulder. In this condition, which is called cervical radiculopathy, many other symptoms may occur in addition to pain:

  • Burning pain in the neck, shoulders, and arms
  • Changes in the intensity of pain with head movements
  • Tingling in the wrist and fingers
  • Weakness in the muscles in the arm and shoulder area
  • Loss of sensation in the hand, arm, or shoulder area

In cervical radiculopathy patients, it can be determined that the symptoms are relieved when the person puts their hands on their head. This is caused by the decrease in the pressure on the nerve after the movement.

Symptoms of cubital tunnel syndrome that occur in the elbow area can be aggravated by a person bending their elbow. Numbness or tingling in the hands and fingers, weakness and coordination problems are among the symptoms that may occur due to this syndrome.

Carpal tunnel syndrome, which is the most common nerve compression disorder, is a condition that occurs more frequently in women. With the development of this syndrome, a symptom of hand and arm pain may occur, which worsens especially at night. In addition to pain, various complaints about movements such as electrification, weakness, or grasping objects can be added to the disease table. Carpal tunnel syndrome symptoms come and go. As a result of the aggravation of the nerve compression over time, an increase in the emergence and continuation of the complaints may occur.

Nerve compression conditions in the legs are known as sciatica. The sciatic nerve, the largest nerve in the body, starts from the pelvis and continues down the legs. Back pain that radiates down the back of the thigh or hip is a complaint that indicates sciatica. In advanced cases, symptoms such as weakness and numbness in the legs may occur.

What Causes Nerve Stress?

Nerve compression usually occurs due to repetitive injuries. These injuries are especially detected in the person’s profession and working conditions. For example, there is an increase in the possibility of developing carpal tunnel syndrome involving the wrist in professions that require constant use of keyboards and mice or artists who play musical instruments such as the piano. Apart from these repetitive traumas, situations such as sudden strain or bone fracture may result in nerve compression by creating pressure on the nerves. This reflection of repetitive traumas and accidents on the nerves may occur due to the interruption of the blood supply to the nerve, swelling of the surrounding tissues, damage to the myelin sheath surrounding the nerve, or structural changes in the nerve cell. All these changes negatively affect the functions of the nerve, such as receiving and transmitting electrical information, and as a result, complaints such as pain, numbness, and loss of function may occur.

Care should be taken, as nerve compression may occur during the course of various ailments and health-related conditions in addition to repetitive trauma and accidents:

  • Diabetes
  • Autoimmune diseases such as rheumatoid arthritis
  • Thyroid dysfunction
  • Tumors or cysts pressing directly
  • Pregnancy or menopause
  • Obesity
  • Congenital (congenital) defects
  • Nervous diseases

How is Nerve Entrapment Diagnosed?

In the diagnostic approach to nerve compression, first of all, physicians refer to physical examination and medical history. During the physical examination, various movement tests can be used according to the affected area. After the physical examination, various examinations are applied to fully enlighten the nerve compression:

NERVE TRANSMISSION STUDIES

This examination, which enables the measurement of electrical nerve impulses and evaluates their function, is performed using electrodes placed on the skin. Nerve conduction studies record the electrical response that occurs when a small amount of current flows over the nerve. By evaluating this response, physicians can detect the presence of possible damage to the relevant nerve.

ELECTROMIOGRAPHY (EMG)

EMG is an examination performed by placing needle-shaped electrodes on the muscles. The EMG test allows measuring the electrical activity of muscles both at rest and during activation. As a result of the test, it is aimed to reveal whether there is any abnormality in the nerves that reach these muscles.

MAGNETIC RESONANCE IMAGING (MRI)

MRI, which enables detailed imaging of body structures in the strong magnetic field created by generating radio waves, is an imaging examination that can be applied especially in cases such as nerve root compression. Ganglion cysts, growths in joint surface or muscle structures, edema, vascular diseases, and changes in nerve structure can be detected by MRI.

How is Nerve Stress Treatment?

Nerve compression treatment is basically divided into 2 main groups as surgical and non-surgical treatment. Non-surgical treatment methods are medication, lifestyle changes, and physical therapy applications. Avoiding the movement that triggers pain, providing ergonomic working conditions at home and workplace, or choosing jobs with different job descriptions instead of jobs that worsen complaints are among the lifestyle changes that can be made to control nerve compression. Decreasing body weight in nerve compression caused by obesity may contribute to the improvement of complaints.

Physical therapy applications aim to increase flexibility, strength, and range of motion in the affected area of ​​the patients. With these applications, symptoms such as pain and numbness can also be improved. In some cases of nerve compression in the limbs, splint applications may be beneficial to prevent unconscious compulsive movements during sleep. Non-steroidal anti-inflammatories or corticosteroid-derived drugs are among the drugs prescribed by physicians for people with nerve compression. These drugs help to reduce edema and suppress inflammation in the area where the nerve is compressed.

Various regional relieving surgeries can be used in advanced cases where no results can be obtained from non-surgical treatments. In these surgeries, the affected nerve and the affected point are determined, and a portion of the connective tissue or soft tissue in this area can be removed and the pressure on the nerve can be reduced.

 

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