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What is Nerve Entrapment?
Nerve entrapment refers to a clinical condition where the nerve fibers are being compressed or pressure is being applied to it by an external structure.
What causes Nerve Entrapment?
Nerve entrapment can be due to a variety of causes, depending on where the nerve is trapped. In the upper limb, the nerve fibers may be compressed at the level of the wrist, elbow and even the shoulder. Some common syndromes that are characterized by nerve entrapment in the upper limb include carpal tunnel syndrome, cubital tunnel syndrome and anterior interosseus syndrome.
In the lower limb, the nerve fibers may be compressed at the level of the spine, hip joint and ankle joint. Common syndromes include tarsal tunnel syndrome and iliohypogastric nerve entrapment.
Trauma is a common cause for nerve entrapment. It may also be seen in disc prolapse, certain cancers and even blood clots. All these compress upon nerve fibers causing nerve entrapment.
Symptoms and Diagnosis
The common symptoms include tingling, numbness and pain in the area that is supplied by the nerve fibers. Some patients complain of pins and needles in the hands and feet. Patients may have difficulty moving the joints affected and, depending upon the nerve that is trapped, may have difficulty performing certain day-to-day tasks.
Clinical examination is extremely useful in making a diagnosis of nerve entrapment. However, certain additional tests may be required to help make a diagnosis. These can include x-rays, nerve conduction studies and electromyography. Specialist tests such as an MRI scan or CT scan may also be warranted.
How is Nerve Entrapment treated?
Treatment options are directed towards managing the cause for nerve entrapment. General measures can include exercises prescribed by physical therapists and weight loss. Painkillers such as paracetamol and non-steroidal anti-inflammatory drugs are helpful. In more severe cases, steroid injections may need to be offered to reduce the inflammation and pain surrounding the trapped nerve. Opioid analgesics may be considered if the pain is debilitating.
In cases such as cubital tunnel syndrome, carpal tunnel syndrome and many others, surgery may need to be considered in order to relieve the symptoms and restore function. Splints and braces may be required as well. Treatment can take a while to show any benefit, but recovery is usually very good.