Treatment of Trapped Peripheral Nerves

Peripheral nerve entrapment is a medical condition that is not particularly rare (it is more common in certain areas of the body such as the elbow, wrist, knee and foot) but it does require treatment. A trapped nerve initially causes numbness in the area that it innervates, and in later stages can even cause muscle weakness and degeneration, eventually leading to irreversible damage. When the damage is severe and chronic, surgical intervention by a surgeon who specializes in damaged peripheral nerves is required – a specialist such as Prof. Shimon Rochkind, a senior neurosurgeon at the Neurosurgical Center for Excellence at the Herzliya Medical Center and one of the world leaders in everything related to the treatment of the peripheral nervous system.

How does peripheral nerve entrapment occur?

Nearly every region of our body contains peripheral nerves that originate in the spinal cord, which serves as part of the central nervous system, and that split off of it to innervate all parts of our body in order to provide the ability of sensation and movement.

These nerves look like long, thin cords that can often be very tiny. They find their way to various organs through the rest of the body’s tissues: bones, muscles, tendons and more.

Under certain circumstances, particularly at points where the tissue is especially dense, there can be pressure on the nerve tissue. This pressure can be caused by a number of factors, including:

  • Growth of a tumor, cyst or hematoma
  • Formation of a bone spur that causes narrowing of the nerve sheath
  • Spending an extended amount of time in a particular position that exerts external pressure on the nerve
  • External trauma that affects adjacent tissues
  • Sclerosis (collection of fatty precipitates in the area of the nerve)

The pressure on the nerve essentially disrupts the nerve’s blood supply, resulting in impairment of its function and severe damage to the tissues in the area where the pressure is exerted. The longer the pressure is applied to that region, the more severe the tissue damage will be: when the pressure is minimal and does not last excessively long, the treatment is mostly conservative and the nerve can heal; however when the pressure is intensive and very prolonged, the nerve could be severely damaged, even to the extent that it cannot recover by itself.

Symptoms of Peripheral Nerve Entrapment

For the most part, trapped peripheral nerves will result in the appearance of quite clear symptoms:

  • Numbness and “pins and needles” sensations
  • Momentary or prolonged loss of sensation in the area for which the nerve is ‘responsible’
  • Severe neuropathic pain – stabbing/shocking/burning in nature
  • Advanced to severe weakness and even paralysis of the muscles innervated by the trapped nerve
  • Muscle wasting

The longer the damage continues, the more clear the symptoms become. Loss of sensation, numbness and “pins and needles” typically appear during the earliest stages, whereas the symptoms related to advanced to severe weakness and even muscle wasting typically appear in the later and most severe stages.

As mentioned previously, there are areas that are particularly vulnerable to this type of damage, including the elbow (through which the ulnar nerve passes), the wrist region (through which the median nerve passes), the knee (through which the peroneal nerve passes) and the foot (through which the posterior tibial nerve passes). The symptoms that characterize these kinds of injuries are most often a sense of numbness and “pins and needles” in the fingers/toes, ‘disappearance’ of sensation at certain points along the length of the hand/leg, disturbances of sensation and muscle weakness in the hand/foot, and more.

Treatment for Trapped Peripheral Nerves

When the damage to the nerve is discovered relatively early, treatment will generally be conservative: avoidance of particular positions that increase pressure on the nerve, use of external devices (special braces), taking anti-inflammatory medications that can improve the condition in many cases while ensuring protection of the normal nerve tissue. If these treatments do not help, or if the cause of the pressure turns out to require immediate intervention, then an operation to release the trapped nerve is the appropriate treatment.

The operation is a microsurgical procedure performed using special instruments to release the nerve, including a special surgical microscope that ensures that the nerve tissue is not damaged during the procedure. The operation also includes release of the nerve from adhesions and post-traumatic scarring that forms on its tissues, if present, as well as removal of tumors, bone spurs and the like if necessary.

At the Center for Excellence at the Herzliya Medical Center, operations to release trapped nerves are performed by Prof. Rochkind who has so far performed numerous surgeries of this type. He has access to the most advanced medical instrumentation in the world of neurosurgery and a work environment that allows for the optimal implementation of his surgical skills.

Are you dealing with localized pain or numbness, with lack of sensation, with “pins and needles” or numbness in a particular area of your body?

It’s possible that you are suffering from the results of a trapped nerve.

Contact us to get a precise diagnosis and professional care at the Neurosurgical Center for Excellence at the private Herzliya Medical Center.

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