Peripheral Nerve Injuries – Diagnosis and Treatment
Diagnosis
Doctors start by asking about the patient’s medical history, past injuries, surgeries, and current symptoms. Symptoms can include numbness, tingling, weakness, or unusual sensitivity to touch.
Next, the doctor performs a physical and neurological exam. This helps evaluate sensory and motor nerves for signs of neuropathy, nerve entrapment, or injury.
Common diagnostic tools include:
- Electromyography (EMG): Measures electrical activity in muscles to detect reduced nerve signals.
- Nerve Conduction Studies: Check how fast and well nerves send signals, helping to find nerve compression or entrapment.
- Magnetic Resonance Imaging (MRI): Creates detailed images to locate nerve problems or muscle atrophy.
- Ultrasound: Provides real-time images to show nerve compression or trauma.
- Blood Tests: Can find causes such as vitamin deficiencies, inflammation, or metabolic issues.
- Nerve Biopsy: In rare cases, a small piece of nerve is checked under a microscope.
Doctors use these methods to find the cause and extent of nerve damage.
Treatment
Surgical Intervention
Doctors may recommend surgery if nerve damage does not improve with rest or causes loss of function. Surgeons use tests such as EMG during procedures to check nerve recovery.
They perform these tests directly on the nerve for more accurate results. In cases of nerve entrapment syndromes like carpal tunnel or cubital tunnel syndrome, surgeons may enlarge passages or remove tissue pressing on the nerve to relieve pressure.
When a nerve is completely cut or severely damaged, doctors remove the injured section and sew healthy ends together in a procedure called nerve repair. If a gap remains, they use a nerve graft from another part of the body to bridge it.
Sometimes, doctors perform tendon or nerve transfers if muscle function is at risk. These procedures can improve movement, especially in severe cases.
Some common surgical options include:
Type of Surgery | Purpose |
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Nerve Repair | Reconnects healthy nerve ends |
Nerve Graft | Closes nerve gaps with tissue from elsewhere |
Tendon Transfer | Restores movement by shifting tendons |
Nerve Decompression | Relieves pressure on trapped nerves |
Nerve Transfer | Redirects different nerves to restore function |
Doctors may also use surgery to manage neuropathic pain or autonomic nerve problems when other treatments do not work. The choice of procedure depends on the cause and location of the injury.
Ways to Improve Movement and Quality
Restoring function after nerve injury often requires a combination of treatments. Many people benefit from physical therapy and supportive methods.
Braces and Splints: Braces or splints keep the limb or joint in the best position and help prevent further injury and stiffness.
Electrical Stimulation: Devices like transcutaneous electrical nerve stimulation (TENS) can activate muscles during nerve healing. A healthcare provider will advise if this is suitable.
Physical Therapy and Exercise: Regular therapy sessions may include stretches, exercises, and massage. These help maintain muscle strength, prevent wasting, and improve range of motion.
Pain Management: Managing pain is important. Medicines for nerve pain include anticonvulsants/nerve pain medications, serotonin-norepinephrine reuptake inhibitors (SNRIs), and sometimes opioid analgesics for severe pain. Other options may include non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections to reduce inflammation and pain.
Doctors often combine these treatments for nerve injuries such as entrapment neuropathies and peripheral neuropathy. Using surgery, therapy, and medication together can help people recover movement and reduce pain.
Getting Ready for Your Visit
Good preparation helps you get the most out of a visit for peripheral nerve issues.
Before the appointment, write down all your symptoms. Include details like when the symptoms started, how long they have lasted, and if they have changed over time.
This information helps doctors understand conditions linked with diabetes mellitus, autoimmune diseases, metabolic problems such as hypothyroidism, and less common causes like amyloidosis or alcohol use.
Bring a list of all your medicines—including prescription drugs, over-the-counter remedies, vitamins, and supplements. Some medicines can affect test results or interact with treatments.
Family physicians may want to review your medicine list because some medicines can cause nerve problems. In some cases, your doctor might ask you to pause certain medicines or avoid lotions on the day of your test.
Ask ahead if this applies to you.
Bring a friend or family member with you, as remembering all information can be tricky. Write down your questions about the peripheral nervous system, possible causes, and treatment options.
Preparation Tips |
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List symptoms and changes |
Bring medication details |
Ask about medicines to stop |
Take someone with you |
Prepare questions |