What is a Nerve Impingement?
Nerves are long and cylindrical wire-shaped structures that help connect your brain and spinal cord (the central nervous system) to your muscles and skin in the periphery. This connection enables conduction of information from the central nervous system to the muscles to produce desired movements and actions virtually everywhere in the body, whilst also enabling transfer of information such as pain signals to the central nervous system.
Nerve impingement results when excessive external pressure is applied continuously or repetitively on a nerve, either from surrounding tissues or from outside of the body, which cause injury and malfunctioning of the nerve. The commonest nerve entrapment is the carpal tunnel syndrome, where the median nerve is compressed/pinged by surrounding tendons and soft tissues in the wrist.
What are the symptoms and signs of Nerve Impingement?
Most people who suffer from nerve impingement experience the following:
- Burning pain in the affected area which may radiate beyond that area.
- Numbness or lack of sensation in the area of skin supplied by the impinged nerve
- Constant or intermittent tingling sensation, especially at night.
- Weakness of muscles supplied by the impinged nerve
What are the common causes of nerve impingement?
Some conditions which increases your chances of developing a nerve impingement include:
- Women seem to have a higher risk of developing nerve impingement
- Presence of Rheumatoid arthritis
- Works requiring repetitive joint movements e.g. secretaries have increased the risk of carpal tunnel syndrome
- Injuries after some fracture or trauma
- Chronic Kidney disease.
Nerve Impingement Diagnosis
Your doctor suspects nerve impingement after eliciting history of suggestive symptoms listed above and conducting physical examination. Your doctor may thereafter confirm your diagnosis by ordering one or more of the following tests:
- Nerve conduction study. Which allows the study of the electrical integrity of your nerves and provide insight to localize the sight of impingement and to assess the degree of nerve injury or damage.
- Electromyography (EMG). In which your doctor will insert a needle electrode through your skin into selected muscles to evaluates the electrical activity of your muscles when they contract and when they’re at rest. This provides additional information to the nerve conduction studied and provide further localizing and prognostic information about your condition. It also helps exclude alternative diagnosis such as nerve root disease that may otherwise be confused with nerve impingements.
- Ultrasound or Magnetic resonance imaging (MRI). In order to visually study the bones, tendons and other tissues surrounding and impinging on your nerves.
What are the treatment options for Nerve Impingement?
Fortunately, most people recover completely from nerve impingement after few to several weeks of observing some rest of the muscles, tendons and joints of the affected area and other conservative treatments. However, there are other people that might require some other more aggressive and prolonged treatments.
Pain killers such as nonsteroidal anti-inflammatory drugs (NSAIDs), can help relieve pain, but these need to be taken cautiously due to the risk of complications. Additionally, for some more severe cases, corticosteroid injections may provide minimal pain relief and suppression of local inflammation.
A physical therapist will teach you some conservative techniques such as splinting, exercises to stretch your muscles and nerves which help deal with pain. Also, you will receive some instructions to improve your posture and to avoid some physical activities that might otherwise make your condition worse.
In case you nerve impingement is severe and doesn’t improve after the aforementioned treatment options, your doctor might recommend surgery to relieve the pressure of the nerve by making specific cuts in the surrounding tissue. This is commonly referred to as decompression surgeries.