Disease States: Compression Neuropathy

Compression neuropathies occur when nerves are chronically compressed or mechanically injured at specific locations. Compression may occur as a result of trauma, inflammation or entrapment.

Examples of Compression Neuropathies:

Carpal Tunnel Syndrome (CTS): Carpal tunnel syndrome is the most common and widely known compression neuropathy. It occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (although not the little finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move. The carpal tunnel - a narrow, rigid passageway of ligament and bones at the base of the hand - houses the median nerve and tendons. Sometimes, thickening from irritated tendons or other swelling narrows the tunnel and causes the median nerve to be compressed.

Symptoms can start gradually, with frequent burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers. Some carpal tunnel sufferers say their fingers feel useless and swollen, even though little or no swelling is apparent. The symptoms often first appear in one or both hands during the night, since many people sleep with flexed wrists. As symptoms worsen, people might feel tingling during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people are unable to tell between hot and cold by touch.

Cubital Tunnel Syndrome: It occurs when the ulnar nerve behind the elbow that runs through the cubital tunnel is compressed. The ulnar nerve controls muscles used for gripping, primarily of the little, ring, and sometimes middle fingers. It also controls muscles in the hand used for strong pinch, and other muscles that coordinate fine movements.

Symptoms may primarily involve numbness and tingling in the little and ring fingers, the side and back of the hand. These complaints occur or worsen when the elbow is bent. Your hand may also become cold or numb when it is on top of a steering wheel. You may be aware that the hand has become weaker, resulting in trouble opening jars. You may drop things, or your hand may not perform quite as easily as it did before. The problems usually worsen with extended activities.

Tarsal Tunnel Syndrome: It is similar to carpal tunnel syndrome however it occurs at the level of the ankle. Tarsal tunnel syndrome is a compression, or squeezing, on the posterior tibial nerve that produces symptoms anywhere along the path of the nerve. The posterior tibial nerve runs along the inside of the ankle into the foot.

Symptoms may include one or more of the following: tingling, burning, or a sensation similar to an electrical shock, numbness , pain, including shooting pain The symptoms are typically felt on the inside of the ankle and/or on the bottom of the foot. In some people, a symptom may be isolated and occur in just one spot. In others, it may extend to the heel, arch, toes, and even the calf.

Foot Drop: It occurs when there is compression of the peroneal nerve at the fibular head causing a significant weakness of ankle and toe dorsiflexion. The most common cause is habitual leg crossing, or prolonged positioning like sitting on an airplane or being in surgery.

Symptoms may include frequent tripping due to foot drop, night cramps in the anterior lower leg if the compression is chronic), pain at the site of compression, tingling, numbness in the lateral lower leg and foot. There are other neurologic causes as well that can manifest as foot drop. These can be differentiated through clinical and electrodiagnostic examinations.

Disc Syndrome: Is a condition resulting from a compression of a spinal nerve in the back and/or neck that involves radiculer pain in limbs. Lumbar disc syndrome affects the lower back and legs. Cervical Disc Syndrome affects the neck region and arms.

Symptoms may include pain in back or neck, pain in arm or legs, muscular weakness, and parasthesia.

Spinal Stenosis: Is a narrowing of the spinal canal in the back and/or neck. This narrowing occurs when the growth of bone or tissue or both reduces the size of the openings in the spinal bones. This narrowing can squeeze and irritate the nerves that branch out from the spinal cord. It can also squeeze and irritate the spinal cord itself. Spinal stenosis is most often caused by changes in the shape and size of the spinal canal as people age.

Lumbar Stenosis Symptoms: Numbness, weakness, cramping, or pain in the legs, feet, or buttocks, stiffness in the legs and thighs, low back pain. These symptoms get worse when you walk, stand straight, or lean backward. The pain gets better when you sit down or lean forward.
Cervical Stenosis Symptoms: Cervical spinal stenosis does not cause symptoms unless the spinal cord or nerves becomes squeezed. Symptoms usually develop gradually over a long period of time and may include stiffness, pain, or numbness in the neck, shoulders, arms, hands, or legs. Balance and coordination problems, such as shuffling or tripping while walking, incontinence. Cervical spinal stenosis can be crippling if the spinal cord is damaged.

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