Monday, 10 April 2017

How To Deal With Entrapment/Compression Neuropathies

Today's post from (see link below) looks at neuropathy from the point of view of a surgeon and in this case, a plastic surgeon. As you all know, there's no cure per se for neuropathy but certain forms may be relieved by surgery of one form or another. These are compression neuropathies (sometimes called entrapment neuropathies) which are caused by a nerve becoming trapped. This can be because a disease causes the nerve pathways to narrow, or it can be as a result of injury. Either way, releasing the trapped nerve may result in a huge improvement in symptoms, although there are no guarantees, depending on the damage to the nerve itself. Worth a read.

Compression Neuropathies in Extremities
03 Aug 2016 Compression Neuropathies in Extremities

The many types of neuropathies are a series of complex conditions that can take many forms and be caused by many different things depending on the type of neuropathy that is diagnosed. Understanding what your specific neuropathy is and what the symptoms are is the first step in taking control of your condition.

What are Neuropathies?

This term describes a problem with the nerves (typically the peripheral nerves) and it could involve one of three nerve types. These three different nerves include:

Sensory Nerves – an issue with these nerves causes tingling, pain, numbness, and weakness in the hands and feet
Motor Nerves – issues with these nerves causes weakness in the hands and feet
Autonomic Nerves – a problem with these nerves causes changes in the heart rate and blood pressure as well as swelling

There are two major types of neuropathies and knowing this information can help determine the severity of the issue you are currently suffering from. These two types include mononeuropathy and it affects a single nerve. The other is called polyneuropathy and affects several different nerves.

When studying the specific forms of neuropathies, a common form is called compression neuropathy. This is caused by damage to sensory nerve roots or even peripheral nerves and could potentially have many different causes.

What are Common Causes and Symptoms?

Compression neuropathy is caused by mechanical pressure or occasionally localized trauma from an injury to a specific area. This form of neuropathy is normally characterized by paresthesia, weakness or even paralysis. This will depend on what specific form of neuropathy you may have.

Diabetes and pre-diabetes are the most common causes of compression neuropathy although they are not the only causes. This being the most common cause is because with diabetes the nerves are swollen and when these nerves run through certain tight channels within the body, they become compressed. This causes the resulting pain and numbness.

Treatment Options

The most popular form of treatment is surgery although there may be other options for your form of compression neuropathy. The decompression surgery relieves the compression on the nerves and can reduce or completely eliminate pain, improve sensation, improve balance and also prevent ulcerations or amputations. This form of surgery has great results and it is estimated that about 80% of diabetic and pre-diabetic patients have some success from receiving this surgery.

Checking for other conditions is very important because some forms of compression neuropathy have causes that can be treated without the need for surgery. For example, if the issue is a thyroid based problem, other treatment options may be a possibility.

Common Forms of Compression Neuropathies

There are many forms of compression neuropathies that are common and well known. 

Carpal Tunnel Syndrome 

caused by compression of a nerve in the wrist
Involves numbness in the first three fingers. 

Cubital Tunnel Syndrome

caused by compression of ulnar nerve at elbow
Numbness in 4th and 5th fingers, hand weakness

Radial Nerve Neuropathy

compression of radial nerve in forearm or upper arm
Often follows humeral fractures and surgery
Forearm pain, weak wrist dorsiflexion or finger extension 

Tarsal Tunnel Syndrome

caused by compression of the tibial nerve in the ankle
also called posterior tibial neuralgia

Meralgia Paresthetica (LFCN Neuropathy) 

caused by compression of a nerve in the thigh area
may follow surgery in groin/hip area, professions caring belts around waist, like police officers, fire fighters, contractors 

Foot Drop 

most often caused by an injury to the peroneal nerve
there are options for treatment beyond surgery although surgery is an option that can be considered

Compression neuropathies include many different forms and have just as many causes. Understanding the proper form of treatment begins with first understanding what the cause was. While diabetes and pre-diabetes are often causes, there may have been trauma from a sports injury or another disease that is the root issue. Having all of this information may help you and your healthcare provider decide whether or not surgery is the best choice for your individual condition.

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