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Nerve Compression Syndrome

What is nerve compression syndrome?

Nerve compression syndrome occurs when a nerve is squeezed or compacted. It typically occurs at a single location. Nerves in the torso, limbs, and extremities may be affected. Common symptoms include pain, numbness, and muscle weakness at the site of the nerve.

Nerve compression syndromes are often caused by repetitive injuries. Medical conditions such as rheumatoid arthritis, diabetes, or hypothyroidism can also play a role.

Nerve compression syndrome is also known as:

  • nerve entrapment syndrome
  • compression neuropathy
  • entrapment neuropathy
  • trapped nerve
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Types

Common types

There are several different types of nerve compression syndromes. Each one affects a different peripheral nerve. The following are some of the most common types of nerve compression syndromes:

Carpal tunnel syndrome

Carpal tunnel syndrome is the most common type of nerve compression syndrome. It occurs when the median nerve is compressed at the wrist. The median nerve extends from the upper arm to the thumb. At the wrist, it passes through a structure called the carpal tunnel. Excess pressure on the wrist may cause swelling, which can lead to carpal tunnel syndrome.

Cubital tunnel syndrome

Cubital tunnel syndrome is the second-most common type of nerve compression syndrome. Also known as ulnar neuropathy or ulnar nerve entrapment at elbow, it occurs when the ulnar nerve is compressed at the elbow. The ulnar nerve is responsible for the sensation that you get when you hit your funny bone. It passes close to the skin at the elbow. Putting too much pressure on the elbow may cause swelling, which can lead to ulnar tunnel syndrome.

Other types

Nerve compression syndrome is most likely to occur at sites where nerves pass through tunnel-like structures. The following are some rarer types of nerve compression syndrome:

  • Suprascapular nerve compression syndrome. This affects the suprascapular nerve and can cause symptoms in the shoulder.
  • Guyon’s canal syndrome. This syndrome affects the ulnar nerve and can impact function in the hand.
  • Meralgia paresthetica. This affects the lateral cutaneous nerve and can cause symptoms in the outer thigh.
  • Radial nerve compression syndrome. This syndrome affects the radial nerve, which extends the length of the arm. It can impact wrist, hand, and finger function.

Causes

Causes of nerve compression syndrome

Nerve compression syndrome is often caused by repetitive injuries. These injuries may occur in the workplace due to repeated movements related to your job duties. For example, repeated overextension of the wrist while typing on a keyboard, using a mouse, or playing the piano can lead to carpal tunnel syndrome.

Accidents such as sprains, fractures, and broken bones can also cause nerve compression syndrome.

In addition, certain medical conditions can trigger or make you more susceptible to nerve compression syndromes. These include:

Repetitive injuries, accidents, and medical conditions may lead to:

  • reduced blood flow to the nerve
  • swelling in the nerve and surrounding structures
  • damage to the nerve’s insulation (the myelin sheath)
  • structural changes in the nerve

All of these changes have a negative impact on the nerve’s ability to send and receive messages. This can cause symptoms such as pain, numbness, and reduced function.

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Risk factors

Who’s at risk?

The following are some of the most common risk factors for nerve compression syndrome:

  • Adults over the age of 30 are more susceptible.
  • Women are more likely to develop certain types of nerve compression syndrome, including carpal tunnel.
  • Having a job that involves repeating certain movements can make you more likely to sustain a repetitive injury. People who use computers for long periods of time, as well as those who do manual work, may be at an increased risk.
  • You may be more susceptible if you have a medical condition that impacts circulation or nerve function.

Symptoms

Symptoms of nerve compression syndrome

Symptoms vary based on the type of nerve compression syndrome and location. They tend to occur at the site of the compression, and sometimes in surrounding areas and structures.

Some common symptoms include:

  • redness, swelling, and inflammation
  • aches and pain
  • tingling or numbness
  • muscle weakness
  • reduced flexibility
  • difficulty with certain movements
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Diagnosis

How is it diagnosed?

A doctor will assess your symptoms. The doctor may then use a physical examination and diagnostic tests to identify nerve compression syndrome.

Some tests used to diagnose rarer forms of nerve compression syndrome include:

For carpal tunnel and cubital tunnel syndrome, diagnostic tests aren’t always necessary. Still, they may provide helpful information about the location and severity of the compression.

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Treatment

Treatment options

Treatment for nerve compression syndrome often begins with lifestyle changes and noninvasive therapies. Treating an underlying condition causing nerve compression syndrome may also ease symptoms. In severe cases, nerve compression syndrome may require surgery.

Lifestyle changes

Avoiding movements that cause pain, adopting ergonomic strategies at work and at home, or changing job duties may improve symptoms. When obesity is the cause of nerve compression syndrome, losing weight can improve symptoms.

Physical therapy

Working with a physical therapist can help improve your flexibility, strength, and range of motion in the affected area. Physical therapy can also help relieve symptoms such as pain and numbness.

A 2017 study suggested that physical therapy and surgery had similar effectiveness in treating carpal tunnel syndrome in women. However, further research is needed as this study hasn’t been repeated and involved only 100 women.

Medication

Medication can help relieve symptoms of nerve compression syndrome such as pain and inflammation. The type of medication prescribed depends on the severity of symptoms. Some drugs commonly prescribed to manage symptoms caused by nerve compression syndrome include:

  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and aspirin
  • corticosteroids such as dexamethasone, which are injected directly around the nerve

Prosthetic devices

In some cases of nerve compression syndrome, a doctor or physical therapist may recommend a splint or a brace to help you avoid putting pressure on the nerve.

Surgery

Surgical procedures are generally considered a last resort in the treatment of nerve compression syndrome. Not everyone who has nerve compression syndrome qualifies for surgery.

The surgical procedure required depends on the type of nerve compression syndrome, the degree of compression, and the nerves and structures affected. Each procedure has its risks and benefits. The outlook for surgery depends on many factors, including how long you’ve had symptoms, how severe your symptoms are, and any other underlying health conditions you might have. In general, the outlook is good.

A surgeon can help you understand whether surgery for nerve compression syndrome is a good option for you.

Home remedies

The following home remedies may prevent or relieve symptoms of nerve compression syndrome:

  • icing the affected area for 10 to 15 minutes
  • applying topical creams, such as menthol
  • stopping activities that cause pain
  • taking regular breaks when doing repetitive tasks
  • wearing a splint or brace
  • using relaxation exercises
  • keeping the affected area warm
  • elevating the affected area
  • doing stretches and exercises to improve strength and flexibility
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Outlook

Outlook

The outlook for nerve compression syndrome varies. In very severe cases, it can lead to permanent nerve damage or loss of function in the affected area. However, this is rare.

You should make an appointment with your doctor if you experience symptoms of nerve compression syndrome. When nerve compression syndrome is identified and treated early, significant improvements can be made. Many people make a full recovery.

Prevention

Prevention tips

You may be able to prevent nerve compression syndrome by doing the following:

  • using ergonomic strategies at work and at home
  • avoiding repetitive movements
  • avoiding movements that cause pain
  • stretching affected areas
  • treating underlying health conditions, such as diabetes or rheumatoid arthritis
Article resources
  • Ali ZS, et al. (2015). Chapter 47 – Nerve compression/entrapment sites of the upper limb. DOI: 10.1016/B978-0-12-802653-3.00096-8
  • Choi S-J, et al. (2015). Ultrasonography for nerve compression syndromes of the upper extremity. DOI: 10.14366/usg.14060
  • Dong Q, et al. (2012). Entrapment neuropathies in the upper and lower limbs: Anatomy and MRI features. DOI: 10.1155/2012/230679
  • Fernández-de-las-Peñas C, et al. (2017). The effectiveness of manual therapy versus surgery on self-reported function, cervical range of motion, and pinch-grip force in carpal tunnel syndrome: A randomized clinical trial. DOI: 10.2519/jospt.2017.7090
  • Neal SL, et al. (2010). Peripheral nerve entrapment and injury in the upper extremity. DOI: http://www.aafp.org/afp/2010/0115/p147.html
  • Thatte MR, et al. (2011). Compressive neuropathy in the upper limb. DOI: 10.4103/0970-0358.85350
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