Nerve compression syndrome





Nerve compression syndrome or compression neuropathy, is caused by direct pressure on a nerve.



It is known as a trapped nerve.



Its symptoms include pain, tingling, numbness and muscle weakness. 



Common in trapment neuropathies include: carpal tunnel syndrome, ulnar neuropathy, and moralgia paresthetica.



Cervical radiculopathy is also considered as a peripheral nerve compression with pain traveling down the upper extremity into the last two digits that can come from either C8 cervical radiculopathy or an older neuropathy, or both.



C6 a C7 radiculopathy can present similarly to carpal tunnel syndrome.



Electromyography can be helpful in determining peripheral causes of pain.



Symptoms of entrapment neuropathy affects just one particular part of the body, depending on which nerve is affected. 



Median carpal tunnel carpal tunnel syndrome



Median (anterior interosseous) proximal forearm anterior interosseous syndrome



Median pronator teres pronator teres syndrome



Median ligament of Struthers Ligament of Struthers syndrome



Ulnar cubital tunnel Cubital tunnel syndrome



Ulnar Guyon’s canal Guyon’s canal syndrome



Radial axilla Radial nerve compression



Radial spiral groove Radial nerve compression



Radial (Posterior interosseous) proximal forearm posterior interosseous nerve entrapment



Radial (Superficial radial) distal forearmWartenberg’s Syndrome



Suprascapular suprascapular notch suprascapular nerve entrapment



Common peroneal fibular neck peroneal nerve compression



Tibial tarsal tunnel tarsal tunnel syndrome



Saphenous Roof of Adductor canal


Saphenous nerve entrapment syndrome



Lateral cutaneous nerve of thigh inguinal ligament meralgia paraesthetica



Sciatic piriformis piriformis syndrome 



Iliohypogastric lower abdomen iliohypogastric nerve entrapment



Obturator obturator canal obturator nerve entrapment



Pudendal pelvis pudendal nerve entrapment



Abdominal cutaneous nerves abdominal wall anterior cutaneous nerve entrapment syndrome



Symptoms manifest as tingling, numbness, and/ or a burning sensation in the area of the body affected by the corresponding nerve. 






A nerve may be compressed by prolonged or repeated external force.



Part of the patient’s body can cause the compression-tumor, ganglion cyst or a haematoma. 



Expansion of the tissues around a nerve in a space where there is little room for this to occur-carpal tunnel syndrome, peripheral edema.



Diabetes is a clinical condition that increase susceptible to nerve compression.



Pathophysiologically, external pressure reduces flow in the vessels supplying the nerve with blood.



 Vasoconstriction of the vasa nervorum  local ischemia, which has an immediate effect on the ability of the nerve axons to transmit action potentials. 



Over time, focal demyelination occurs, followed by axonal damage and finally scarring.



Symptoms and signs vary by which nerve is affected, where along its length the nerve is affected, and how severely the nerve it is damaged.



Early manifestations include 


positive sensory symptoms particularly tingling and neuropathic pain, followed or accompanied by reduced sensation or complete numbness. 



Later phenomena include muscle weakness is usually noticed later, with muscle atrophy.



A compression neuropathy is usually diagnosed clinically on the basis of the symptoms and signs alone. 



Nerve conduction studies can confirm  the diagnosis, quantifying the severity, and ruling out involvement of other nerves.



A mononeuropathy, may cause similar symptoms to compression neuropathy.



Treatment is directed to the underlying  condition.  



A weight loss program is the most appropriate treatment for compression neuropathy caused by obesity.



Compression neuropathy occurring in pregnancy often resolves with delivery.



Some compression neuropathies are amenable to surgery: carpal tunnel syndrome, cubital tunnel syndrome.



Surgery depends on the severity of the symptoms, the risks of the proposed operation, and the prognosis if untreated. 




After surgery symptoms may resolve completely, but compression was severe or prolonged some symptoms may persist. 



The goal of treating nerve compression is to relieve forces on the nerve. 



Nerves are very slow to heal. 


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