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Peripheral nerve injuries

Overview

Your peripheral nerves are the links between your brain and spinal cord and the rest of your body. Peripheral nerves are fragile and easily damaged.

A nerve injury can affect your brain's ability to communicate with your muscles and organs. Damage to the peripheral nerves is called peripheral neuropathy.

Stretching or pressing on a nerve can cause injury. The nerves also may be damaged as a result of other health conditions that affect the nerves, such as diabetes or Guillain-Barre syndrome.

In carpal tunnel syndrome, pressure on the median nerve in the wrist causes damage. Or the nerves may be crushed, cut or damaged in an accident such as a sports injury or a car crash.

Peripheral nerve injuries may be mild or severe. Nerves are made of fibers called axons, which are surrounded by tissues that act like insulation.

Sometimes in a peripheral nerve injury, either the fibers or the insulation are damaged. These injuries are more likely to heal.

In more-severe peripheral nerve injuries both the fibers and the insulation are damaged, and the nerve may be completely cut. These types of injuries are very difficult to treat and recovery may not be possible.

For example, if you feel tingling or numbness or develop weakness in your leg, arm, shoulder or hand, you may have injured one or more nerves in an accident. You may also experience similar symptoms if a nerve is being compressed due to factors such as a narrow passageway, tumor or other diseases.

Severe peripheral nerve injuries may cause total loss of feeling to the area where the nerve is damaged.

It's important to get medical care for a peripheral nerve injury as soon as possible because nerve tissue sometimes can be repaired. Early diagnosis and treatment in some cases can prevent complications and permanent injury.

Diagnosis

Your doctor will review your medical history, ask about any accidents or previous surgeries, and discuss your symptoms with you. Your doctor will also conduct a physical and neurological examination. If your neurological examination shows signs of a nerve injury, your doctor may recommend diagnostic tests, which may include:

  • Electromyography (EMG). In an EMG, a thin-needle electrode inserted into your muscle records your muscle's electrical activity at rest and in motion. Reduced muscle activity can indicate nerve injury.
  • Nerve conduction study. Electrodes placed at two different points in your body measure how well electrical signals pass through the nerves.
  • Magnetic resonance imaging (MRI). An MRI uses powerful magnets and radio waves to produce detailed images of the nerves that may be damaged and the affected area.

Treatment

If your nerve is injured but not cut in half, your treatment team will assess whether the nerve is healing.

  • If your nerve is healing properly, you may not need surgical repair. You may need to rest the affected area until it's healed. Nerves recover slowly and maximal recovery may take many months or several years.
  • You'll need regular checkups to make sure your recovery continues to its maximum potential.
  • If your condition is due to another medical condition, your doctor will treat the underlying condition.
  • Depending on the type and severity of your nerve injury, you may need medications such as aspirin or ibuprofen (Advil, Motrin IB, others) to relieve your pain. In some cases, you may need corticosteroid injections to relieve your pain.
  • Your doctor may recommend physical therapy to prevent stiffness and restore function.

Surgery

If one of your peripheral nerves fails to heal properly, your surgeon can use electromyography (EMG) testing in the operating room to assess whether scarred nerves are recovering. Doing an EMG test directly on the nerve is more accurate and reliable than doing the test over the skin.

Sometimes a section of a nerve is cut completely or damaged beyond repair. Your surgeon can remove the damaged section and reconnect healthy nerve ends (nerve repair) or implant a piece of nerve from another part of your body (nerve graft). These procedures can help your nerves to regrow.

Sometimes your surgeon can borrow another working nerve to make an injured nerve work (nerve transfer).

If you have a particularly severe nerve injury or one that has been untreated for a long time, your doctor may suggest surgery to restore function to critical muscles by transferring tendons from one muscle to another.

Peripheral nerve graft

To repair a damaged nerve, your surgeon removes a small part of the sural nerve in your leg and implants this nerve at the site of the repair.

Nerve transfer

Your surgeon can bypass a damaged section of nerve by reconnecting a healthy nerve to restore function.

Last updated: November 18th, 2017

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