Peripheral Nerve Compression

What is Peripheral Nerve Compression?

The human body has 2 nervous systems, the central nervous system that includes the brain and spinal cord, and the peripheral nervous system that includes a network of nerves that lie outside the brain and spinal cord.

The peripheral nervous system transmits signals from the brain and spinal cord to the rest of your body. As nerves leave the spine, they will course through the body and are susceptible to entrapment or compression anywhere along its course. Peripheral nerve compression occurs when a nerve is compacted or squeezed through repetitive activities or trapped by swelling due to acute injuries.

Peripheral nerves are fragile and easily damaged. A nerve injury can affect your brain's ability to communicate with your muscles and organs. Damage to the peripheral nerves is called peripheral neuropathy.

Classification of Peripheral Nervous System

The peripheral nervous system is classified into 3 types based on their functions, namely:

  • Sensory nerves – responsible for communicating sensations such as touch, temperature, pain, etc.
  • Motor nerves – responsible for controlling the movement of all muscles, such as those utilized for talking, walking, gripping things, etc.
  • Autonomic nerves – responsible for controlling automatic functions of the body, such as blood pressure, digestion, bladder function, breathing, heart rate, etc

Symptoms of Peripheral Nerve Compression

Some of the signs and symptoms of peripheral nerve compression include:

  • Muscle cramping or twitching
  • Difficulty moving arms or walking
  • Abnormal pulse or blood pressure
  • Muscle weakness
  • Sensitivity to touch
  • Loss of coordination and balance
  • Numbness, tingling, or prickling sensation in the fingers or toes
  • Burning, freezing, shooting, or throbbing-like pain
  • Unusual sweating

Causes of Peripheral Nerve Compression

Some of the common causes of peripheral nerve compression include:

  • Diabetes
  • Alcoholism
  • Exposure to toxins
  • Certain medications
  • Inherited disorders
  • Traumatic injuries
  • Infections
  • Vitamin deficiencies
  • Bone marrow disorders
  • Tumours
  • Autoimmune diseases
  • Metabolic problems
  • Vasculitis (inflammation of the blood vessels)

Diagnosis of Peripheral Nerve Compression

Diagnosis of peripheral nerve compression involves the exact detection of nerve damage and its cause, which can be difficult to diagnose. Your doctor will review your medical history and family history for neurological diseases and will conduct physical and neurological examinations for muscle strength, sensation, posture, and coordination.

Your doctor may order other tests including:

  • Blood tests for vitamin, sugar and thyroid levels, and liver and kidney function
  • Computed tomography (CT) scan or MRI to detect herniated discs or spinal tumours
  • Nerve function tests using electromyography to measure the electrical activity of the nerves
  • Nerve biopsy, in which a part of the damaged nerve is removed to test for abnormalities
  • Lumbar puncture to test cerebrospinal fluid in the lower back for signs of disease

Treatment for Peripheral Nerve Compression

Treatment for peripheral nerve compression includes both non-surgical as well as surgical options.

Non-Surgical Options

  • Over-the-counter pain medications for mild pain symptoms
  • Prescription pain medication for severe pain symptoms
  • Topical treatments such as capsaicin cream and lidocaine patches
  • Transcutaneous electrical nerve stimulation (TENS) therapy for pain management
  • Intravenous immune globulin and plasma exchange treatment to manage inflammatory conditions by suppressing the immune system
  • Physical therapy to treat muscle weakness and improve movements
  • Use of a brace or splint to help you avoid putting pressure on the nerve
  • Lifestyle changes to avoid movements that produce pain and adopting ergonomic strategies at workplace and home

What are the Surgical Options?

Surgical options are usually considered as a last resort in the treatment of nerve compression syndrome. Not everyone who has nerve compression syndrome qualifies for surgery.

The surgical procedure required depends on the degree of compression, the type of nerve compression syndrome, and the nerves and structures affected.

If you have neuropathy caused by pressure on nerves, such as pressure from tumours, herniated discs, etc, you might need surgery to decrease the pressure.

Prevention of Peripheral Nerve Compression

Some of the measures employed to prevent peripheral nerve conditions include:

  • Regular and moderate exercise to improve muscle strength and overall muscle function
  • Abstaining from alcohol and tobacco, which are known to aggravate pain and cause nerve damage
  • Consuming a healthy diet
  • Monitoring blood glucose levels to keep a check on diabetes
  • Taking care of your limbs with protective gear during sports