By Laurence T. Glickman, MD, MSC, FRCS(C), FACS
Nerve compression syndrome (NCS) is also known as nerve entrapment syndrome, compression neuropathy, entrapment neuropathy, or simply a trapped nerve. There are many types of NCS. Each affects a different nerve that may arise in the upper extremity, the neck, torso, trunk, or in the lower extremity.
The most common type of NCS is carpal tunnel syndrome. This occurs when the median nerve is compressed at the level of the wrist. The symptoms include numbness and tingling, weakness, and pain in the wrist and fingers of the hand.
The second most common NCS is cubital tunnel syndrome which occurs when the ulnar nerve is compressed at the elbow. The ulnar nerve provides sensation to the pinky finger and half of the ring finger, as well as power to the muscles within the hand.
Other types of NCS can occur in any nerve in the body where nerves can be compressed as they pass through a tight tunnel. These include the occiput (back of the head), the neck, axilla, the buttock, the groin, the knee, and the ankle.
Causes
NCS can be caused by repetitive injuries in the workplace, overextension of the wrist while typing a keyboard, or even the use of cell phones to take selfies. Injuries such as sprains or fractures can also lead to nerve compression. Benign as well as malignant tumors can also result in NCS. Certain systemic conditions also make you more susceptible to NCS. These include diabetes, high blood pressure, rheumatoid arthritis, and obesity.
Symptoms
Symptoms of NCS are numerous but include swelling, redness, inflammation, numbness and tingling, muscle weakness, as well as pain.
Diagnosis
Patients will often see a neurologist who may require a specific nerve conduction test or electromyography to test the nerves. Nonsurgical management is the mainstay of treatment. This includes a change in lifestyle, a change in job description, losing weight, the use of splinting, the use of nonsteroidal anti-inflammatory medication such as Motrin, as well as cortisone injections. Most patients respond to nonsurgical treatment, but outcomes are dependent on many factors such as comorbidities, age, and how long you have had the compression.
Surgical treatment
Should you be referred to a plastic surgeon, he or she might suggest a nerve decompression. The surgery can be quite simple or complex depending on the severity of the compression and the location. Outcomes are generally excellent but of course, are dependent on many factors. Almost all the surgeries are outpatient and recovery takes about 10 days or so following the surgical procedure.
Previous Post Next Post