Entrapment Neuropathy: More Than Just Carpal Tunnel!

Entrapment Neuropathy:  More Than Just Carpal Tunnel!

Last week we talked about carpal tunnel syndrome (CTS), one of the most common forms of neuropathy affecting a single nerve (mononeuropathy).  What you might not know is that carpal tunnel syndrome is only one of a family of ailments in the upper limbs known as entrapment neuropathies.  The other entrapment neuropathies are not as well-known in the mainstream as CTS, and so people who suffer from nerve symptoms in their forearms and hands frequently jump to conclusions.  NeuropathyDR® is here to help set the record straight!

An entrapment neuropathy, also called nerve compression syndrome, occurs when a nerve is wedged or “pinched” against a bone, inflamed muscle, or other internal mechanism in your arm.  Aside from the median nerve (the one associated with CTS) there are two main nerves that help to control your arm and hand: the radial nerve and the ulnar nerve.  Both are susceptible to compression, and the results can be painful!

Entrapment occurs under a number of conditions, most commonly:

  • When there is an injury originating at your neck or a disease of the cervical spine
  • When your elbow has been injured due to fractures or improper use
  • When your wrist has been injured due to fractures or Guyon canal alignment problems
  • An aneurysm or thrombosis in your arteries
  • Factors commonly associated with peripheral neuropathy, such as diabetes, rheumatism, alcoholism, or infection

Your radial nerve runs the length of your arm, and is responsible for both movement and sensation.  Radial neuropathy usually occurs at the back of the elbow, and can present itself with many of the common symptoms of neuropathy such as tingling, loss of sensation, weakness and reduced muscle control (in this case, often difficulty in turning your palm upwards with your elbow extended).

A number of palsies affect the radial nerve, such as:

  • Saturday night palsy (also called Honeymooner’s palsy), where your radial nerve is compressed in your upper arm by falling asleep in a position where pressure is exerted on it by either furniture or a bed partner
  • Crutch palsy, where your nerve is pinched by poorly-fitted axillary crutches
  • Handcuff neuropathy, wherein tight handcuffs compress your radial nerve at your wrists

    Peripheral neuropathy is not a condition forgiving of delayed treatment. The longer you wait, the more severe and long-lasting (potentially permanent) your nerve damage can be.

Two main conditions affect the ulnar nerve: Guyon’s canal syndrome and cubital tunnel syndrome.  Guyon’s canal syndrome is almost exactly the same in symptoms as carpal tunnel syndrome (pain and tingling in the palm and first three fingers), but involves a completely different nerve.  Guyon’s canal syndrome is caused by pressure on your wrists, often by resting them at a desk or workstation, and is frequently experienced by cyclists due to pressure from the handlebars.

Nearly everyone has experienced cubital tunnel syndrome: it’s the “dead arm” sensation we’ve all felt when we wake up after sleeping on top of our arm!  Sleeping with your arm folded up compresses the ulnar nerve at your shoulder, causing it to effectively “cut off” feeling to your arm.  As you probably know from experience, this sensation is unsettling but temporary.

Diagnosis for all compression neuropathies is fairly consistent: your NeuropathyDR® clinician will examine your arms for signs of neuropathy, and will likely ask you to perform several demonstrations of dexterity.  If your clinician suspects you may have an underlying condition, nerve or blood tests may be recommended.  To pinpoint the specific location of a compression, your clinician may also suggest MRI or x-ray scans.

Similar to carpal tunnel syndrome, most cases of compression neuropathy are mild. Treatment for these mild cases involves ice, rest, and a change in habits of motion or stress that are causing the symptoms.  For more severe cases, your clinician may prescribe painkillers or anti-inflammatories, and in extreme cases, a surgical solution is sometimes justified.

If you suffer from a compression neuropathy or have questions about this or any other kind of neuropathy, NeuropathyDR® can help!  Contact us, and we can answer your questions and put you in touch with a NeuropathyDR® clinician in your area who has been specially trained to treat any symptoms you might have.  As with any neuropathy, don’t wait!  The sooner a condition is diagnosed, the more options for treatment your clinician will have.

 

http://www.mdguidelines.com/neuropathy-of-radial-nerve-entrapment

http://emedicine.medscape.com/article/1285531-overview

http://emedicine.medscape.com/article/1244885-overview

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2599973/?tool=pmcentrez

 

Entrapment Neuropathy…Pain By Any Other Name

 


Ever heard of carpal tunnel syndrome?

Repetitive motion disorder?

Nerve compression syndrome?

How about a “trapped nerve”?

Chances are, you’ve probably heard of at least one of these conditions.

These medical conditions are entrapment neuropathies.

Entrapment neuropathies or compression neuropathies are a type of peripheral neuropathy caused by direct pressure on one nerve.  The pressure can be caused by trauma or injury to the specific nerve, repetitive use of a specific part of the body, a cast or brace that doesn’t fit properly or just frequently sitting with your arm over the back of a chair.

If you’re experiencing[1]

–           A burning or stinging pain in one part of your body

–           Tingling

–           Numbness

–           Muscle weakness

You could be suffering from entrapment neuropathy.  To avoid permanent nerve damage, you need to see a doctor immediately, like your local NeuropathyDR® clinician, for proper diagnosis and treatment.

What Exactly Causes Entrapment Neuropathy?

You might be wondering why something as simple as sitting with your elbows on the table all the time can cause entrapment neuropathy for you but your Uncle Harry worked in a coal mine for 40 years swinging a pick axe and never had a problem with his arms, back or anything else.

Entrapment neuropathy occurs when some kind of external pressure disrupts the flow of blood through vessels that supply specific nerves.[2] This oxygen starvation can sometimes occur because of internal problems as well such as lesions, cysts or tumors or even substantial weight gain. When this happens over and over again, the nerve is starved of its oxygen supply and becomes damaged and eventually scarred.  Once this happens, it no longer functions properly.

If you have a chronic condition like diabetes[3] that already compromises your blood flow, the fact that Uncle Harry never had these issues and you do is probably more indicative of your overall physical condition than genetics.  Your body is just more susceptible to this type of injury.  You need to be more mindful of how you move and use whichever part of your body is affected.

How Will My NeuropathyDR® Diagnose Entrapment Neuropathy?

The symptoms you report will vary depending upon which part of your body is affected by entrapment neuropathy.  Your condition will probably start with tingling or pain in the nerves followed by loss of sensation or numbness.  Muscle weakness will be the last to develop and usually occurs because the muscles have atrophied due to lack of use (i.e., your hand hurts so you stop using it as much).

Entrapment or compression neuropathy can usually be diagnosed based on symptoms.  Be sure you keep a good record of when and how your symptoms started.

Your NeuropathyDR® clinician will probably use nerve conduction studies to confirm the diagnosis and rule out the involvement of other nerves.  If entrapment neuropathy is suspected, your health care provider will then order an MRI to determine which nerve is damaged, how badly and to see if an internal issue such as a tumor or cyst is putting pressure on the nerve.

It is vitally important that you choose a health care provider with the clinical skills and experience to recognize your symptoms for what they are and distinguish them from other diseases.  Entrapment neuropathies can mimic other conditions and vice versa. The longer it takes to get the appropriate diagnosis and treatment, like the treatment protocol used exclusively by NeuropathyDR® clinicians, the more likely you are to have permanent nerve damage.

Treating Entrapment Neuropathy

If your NeuropathyDR® clinician determines that an underlying medical issue is causing your entrapment neuropathy, such as a tumor, cyst, inflammation or even weight gain, steps will be taken to first treat that condition.

If a tumor or cyst is the underlying problem, surgery may be ordered to remove the growth.  If you have issues with inflammation or weight gain, your NeuropathyDR® clinician will work with you to design a weight loss program and nutrition plan to resolve either of these issues.

The nutrition counseling provided by your NeuropathyDR® clinician is part of an overall lifestyle modification plan that will help you control your weight and increase your physical activity, within your abilities, to reduce the likelihood of your entrapment neuropathy causing permanent nerve damage or recurring once your immediate problem is taken care of.

In concert with these two steps to treat your entrapment neuropathy, your NeuropathyDR® clinician will also prescribe manual manipulation to readjust your skeletal structure and nerve pathways and nerve stimulation therapy to assist your damaged nerve in healing and open up the flow of blood to help the nerves repair themselves.

All of these steps are integral parts of the exclusive NeuropathyDR® designed specifically for the treatment of peripheral neuropathies, including entrapment neuropathies in all its forms.

For more information on coping with entrapment neuropathy, get your Free E-Book and subscription to the Weekly Ezine “Beating Neuropathy” at http://neuropathydr.com.