Nerve compression syndrome or compression neuropathy , also known as trap neuropathy , is a medical condition caused by direct pressure on the nerve. It is known colloquially as a neural trap , although it can also refer to compression of nerve roots (by herniated disks, for example). Symptoms include pain, tingling, numbness and muscle weakness. The symptoms only affect one particular part of the body, depending on which nerve is affected. Neural conduction studies help to confirm the diagnosis. In some cases, surgery may help relieve pressure on the nerves but this does not always alleviate all the symptoms. A nerve injury by one episode of physical trauma is a compression neuropathy but is usually not included under this title.
Video Nerve compression syndrome
Syndrome
- Upper extremity
- Lower, abdominal and pelvic extremities
Maps Nerve compression syndrome
Signs/symptoms
Tingling, numbness, and/or burning sensation in areas of the body that are affected by the associated nerves. These experiences can occur directly after humiliation or may occur several hours or even days afterwards. Pain is less common than tingling or numbness as a symptom of neural tangling, although the burning sensation, if it occurs, may be (subjective) classified as pain.
Cause
The nerves can be compressed by a prolonged or repetitive external force, such as sitting with one's arm over the back of a chair (radial nerve), often putting a person's elbow on the table (an ulnar nerve), or improper fitting or a clamp on the foot (peroneal nerve). Part of the patient's body can cause compression and the term entrapment neuropathy is used primarily in this situation. The offending structure may be a well-defined lesion such as a tumor (eg lipoma, neurofibroma or metastasis), ganglion cyst or hematoma. Alternatively, there may be tissue expansion around the nerves in the space where there is little room for this to occur, as is often the case with carpal tunnel syndrome. This may be due to weight gain or peripheral edema (especially in pregnancy), or certain conditions such as acromegaly, hypothyroidism or scleroderma and psoriasis.
Some conditions cause nerves to be very susceptible to compression. These include diabetes, in which the blood supply to the nerves is already impaired, making the nerves more sensitive to mild compression levels. The genetic condition of HNPP is a much rarer cause.
Pathophysiology
External pressure reduces the flow in the vessels that supply the nerves with blood (vasa nervorum). This causes local ischemia, which has a direct effect on the ability of the axon nerve to transmit the action potential. As compression becomes more severe over time, focal demyelination occurs, followed by axonal damage and ultimately scarring.
Diagnosis
Symptoms and signs depend on which nerve is affected, where as long as the nerves are affected, and how severe the nerves are affected. Positive sensory symptoms are usually the earliest, particularly tingling and neuropathic pain, followed or accompanied by reduced sensation or total numbness. Muscle weakness is usually noticed later, and is often associated with muscle atrophy.
Compression neuropathy can usually be diagnosed with self-confidence based on symptoms and signs alone. However, neural conduction studies are helpful in confirming the diagnosis, measuring severity, and overriding other nerve involvement (indicating multiplex mononeuritis or polyneuropathy). Scanning is usually unnecessary, but may be useful if tumors or other localized press lesions are suspected. Nerve injury, as mononeuropathy, can cause symptoms similar to compression of neuropathy. This sometimes causes diagnostic confusion, especially if the patient does not remember the injury and there are no obvious physical signs to suggest it. The symptoms and signs of each particular syndrome are discussed on the relevant page, listed below.
Treatment
When underlying medical conditions cause neuropathy, treatment should first be directed to this condition. For example, if weight gain is the underlying cause, then a weight loss program is the most appropriate treatment. Compression neuropathy that occurs in pregnancy is often lost after delivery, so no special care is required. Some compression neuropathy may be operable: carpal tunnel syndrome and cubital tunnel syndrome are two common examples. Whether or not it is feasible to offer surgery in a particular case depends on the severity of the symptoms, the risks of the proposed surgery, and the prognosis if left untreated. After surgery, the symptoms may disappear completely, but if compression is severe or prolonged then the nerve may not fully recover and some symptoms may persist. Drug treatment may be useful for underlying conditions (including peripheral edema), or to improve neuropathic pain.
A textbook on massage states that massage can reduce at least some of the trap symptoms:
The main goal in treating nerve compression or tension pathology is to relieve the detrimental forces on the nerves. If the soft tissue binds or traps the nerves, reduce the tension in the tissue so that the nerves are no longer limited. Use caution during treatment to ensure that additional pressure is not applied to the affected nerve, resulting in irritating symptoms. Soft tissue treatment helps reduce harmful compression or tension, but does not speed the healing of neurological pathology, which is very slow to cure. However, creating an optimal environment for the body's healing process is essential for the most efficient recovery process. Massage is an effective additional treatment for nerve mobilization techniques, which are used to relieve nerves bound or confined to nervous tension disorders.
See also
References
External links
Source of the article : Wikipedia
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