Table of Contents
Overview
Nerves serve as the body’s communication system, carrying messages from the brain to the rest of the body. This helps the body in carrying out different movements. When nerve injuries occur, they will not transmit the messages. This inhibits muscles from working and creates numbness in the area served by that nerve. Motor nerves connect the brain to the muscles and are responsible for controlling the intentional movements of the body.
Early detection and treatment of nerve injuries may help to avoid complications and long-term damage. The timing of the surgery, if needed, is also crucial to the outcome. In this blog, we will analyze the types of nerve injuries and their management strategies.
Causes of Nerve Injuries
Because of their delicate nature, nerves are injured when pressure is applied or stretched. A single cut in the nerve can cause it to stop transmitting signals since the signal cannot pass through a gap in the nerve.
Accidents are a common cause of nerve injuries. Nerve damage can occur when your nerves are pinched, crushed, or otherwise damaged over an extended period during a vehicle accident. Also, internal injuries, inflammation, and compression can all put pressure on your nerves, causing severe nerve injuries.
Risk factors of Nerve Injuries
Nerve injury can be caused by different risk factors such as drug side effects due to chemotherapy, toxic substances, diseases like Lyme and HIV. Vitamin B6 and B12 deficiency are also linked to a higher risk of nerve damage.
Nerve Damage Symptoms
Some of the most common symptoms of nerve injuries are,
- Muscle aches and pain
- A tingling sensation similar to a slight electric shock
- The sensation of wearing a tight glove or sock on your hand
- Sensation of burning
- Numbness
- Muscles become smaller than before
- Unable to extend the wrist
- Slowed movements
- Loss of feelings in cold and hot
- Sweating excessively or little
- You’re stumbling about a lot more than normal.
Diagnosis of Nerve Injury
Different diagnosis tests are performed to know the status of nerve injury. They are as follows.
Electromyography (EMG)
The test can be used to validate proper function or to determine the extent of nerve damage. It uses an electromyograph to evaluate and record the electrical activity produced by skeletal muscles. It assesses how spinal nerves convey information to and from the hands, legs, and paraspinal muscles. If you feel pain, tingling, numbness, or unexplained weakness in your arms or legs, an EMG may be recommended.
Computed Tomography (CT) Scan
Computed tomography allows doctors to examine the seriousness of nerve injury. A CT scan is a non-invasive, painless process that may be used to visualize practically every area of the body and determine the condition of the nerves.
Magnetic Resonance Neurography (MRN)
Although MR neurography can assess nerves across the body, it is most typically used to diagnose brachial plexus disorders. Unlike electro diagnostic investigations, which usually need a two- to three-week waiting period after abnormalities are found, MRN can be conducted at any time after nerve injury.
Nerve Injury Treatment
Treatment of nerve injuries is based on the severity of the injury. The nerve might heal itself in a week or month, depending on the severity of the damage. Mild injury is treated with physical therapy to maintain joint flexibility.
In case of damaged nerves or severe injuries, nerves can grow back to their original muscle or skin locations after being injured, but this can take several months. The signals between the brain and body will be stopped until the nerves grow. It may be cured by non-surgical or surgical treatment.
When the nerve is cut into two pieces, surgical treatment is needed for complete healing. The purpose of surgery is to help the damaged area perform better.
Types of Nerve Injuries
Nerve injuries were categorized by Seddon into three. They are discussed below in detail.
Neuropraxia
Neuropraxia affects many newborns who have had birth brachial plexus damage, but it usually goes away on its own within four to six weeks. The transmission of nerve impulses in the damaged area is stopped in neurapraxia. It’s usually caused by physical trauma, such as a strong hit to the neck, shoulders, or back. Nerve traction or compression is the most common cause of neurapraxia.
The injury occurs not only in the nerve itself but also in the surrounding myelin sheath. Particularly, football players are at high risk. Neuropraxia injuries, often known as stingers, occur as a result of forceful accidents, sports, improper positioning during anesthesia, and shoulder joint replacement.
Neuropraxia Symptoms
- Burning sensation
- Weaknesses
- Vasomotor and sudomotor paralysis
- Numbness
- Neck pain
Neurapraxia Treatments
Neurapraxia can be cured by non-surgical treatments. Your doctor will inquire about your symptoms and how the injury happened. If you have the symptoms listed above, you may need an X-ray or an MRI scan.
Minor nerve injuries can often be treated with rest, icing, elevating the affected area, orthotic treatments, pain medications for neuropathic pain, massage, acupuncture, as well as by range-of-motion exercises.
Physical therapy may be required to regain strength and range of motion. Depending on the severity of the damage, complete healing can take anywhere from a few days to a few months. During your rehabilitation, you may feel weaker and have a limited range of motion. The major goals of treatment are to keep the paralyzed muscles properly nourished and to keep the antagonists of the paralyzed muscles from contracting.
Axonotmesis
An injury to one of the body’s extremities’ nerves is known as axonotmesis. This type of injury affects the axons and their myelin sheath. It is severe compared to neurapraxia. Direct, blunt trauma, fractures, dislocations, contusions, and strain or crush injuries are all possible causes of this injury.
Axonotmesis Symptoms
- Abnormal sensation
- Weakness
- Pain
Treatment for Axonotmesis
The doctor may order a nerve conduction velocity (NCV) test to fully diagnose the problem. EMG may be done after 3 to 4 weeks if the diagnosis indicates a nerve injury. It is sometimes combined with a nerve conduction study, which assesses nerve conductivity. The rate of spontaneous recovery is 1 mm each day. Full recovery is predicted, but it may take weeks, months, or even years.
Neurotmesis
Full anatomical destruction of the axon and all surrounding connective tissue is known as neurotmesis. It can be challenging to predict whether a nerve injury is a neurotmesis or axonotmesis. The entire nerve, including the endoneurium, perineurium, and epineurium, is severed in neurotmesis.
This is the most severe type compared to the other two nerve injuries. This form of nerve damage, most common in crush injuries, can result in motor, sensory, and autonomic paralysis. The person who is affected by neurotmesis cannot get spontaneous recovery.
Neurotmesis Symptoms
- Pain
- Dysesthesias
- Loss of sensory function
- Loss of motor function
- Tingling or prickling sensations in the hands or feet
- Loss of cognitive function
Treatment for Neurotmesis
Clinical evaluation of symptoms, physical examination, and other diagnostic procedures are used to diagnose neurotmesis. EMG and nerve conduction investigations may also be used. Without surgical intervention, spontaneous recovery of function is feeble. During surgery, healthy nerves are connected to damaged nerves to restore the function of the affected nerve.
Conclusion
Nerve injury is serious yet avoidable. Maintaining a balanced and healthful diet will help you to prevent nerve damage. Keep the blood sugar in control. You may have a doubt about how long damaged nerves may take to heal. It may take 6 to 12 weeks to recover from a minor nerve injury. When the nerve is cut, it will grow at 1mm every day for the rest of 4 weeks.
Nerve damage is likely to be permanent, and you won’t always be able to regain function or strength. If you encounter any of the symptoms of nerve injury, you should consult a physician as soon as possible.
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