Q&A Topic: Peripheral Nerve Injuries

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Deborah L. Benzil, MD, FACS, FAANS

Q. What is a peripheral nerve injury?

A. Once a nerve exits the spine, it becomes a peripheral nerve. These nerves travel outward, into the face, neck, trunk, legs, and arms, bringing signals from the brain to the muscles, also initiating signals from the skin to the brain that allow you to feel sensations. Injuries to peripheral nerves include sudden trauma, like a knife wound; a tumor on a nerve; or damage from certain chronic diseases. Most common are everyday instances of a leg or arm “falling asleep” caused by nerve compression from sustained pressure. The most common injuries I see are carpal tunnel and ulnar (elbow) nerve entrapment.

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Q. What causes carpal tunnel and ulnar nerve entrapment?

A. Both injuries involve compression and inflammation of a nerve as it passes through a narrow channel. Carpal tunnel affects the median nerve that goes through the wrist, while ulnar nerve entrapment involves the ulnar nerve that goes past the elbow. Any slight inflammation of the nerve or thickening of tunnel walls can put pressure on the nerve that can result in nerve dysfunction. Both are considered repetitive stress injuries and develop slowly; over time, the entrapped nerve becomes a little more inflamed, causing a little more scar tissue to build up, and the cycle continues until symptoms become significant. Symptoms vary from patient to patient, but typically involve pain, numbness, and weakness. Some people are predisposed to these injuries and people with diabetes are five to ten times more likely to develop symptomatic nerve entrapment. Other than medical risk factors, it is unclear why some develop these conditions, though certain movements—repetitive use of the hand or repeated vigorous flexing of the elbow—may contribute to their development or aggravation.

Q. What are my treatment options for a peripheral nerve injury?  

A. If a nerve has been cleanly cut, as a result, for example, of a limb going through a plate-glass window, it should be repaired immediately. For patients with mild symptoms of nerve entrapment, such as a little pain, tingling, and weakness due to using the arms and legs in a different way or overuse, we at Northern Westchester Hospital (NWH) advise rest, anti-inflammatory medication, and physical therapy.  If symptoms don’t improve, or if the patient has longer-standing symptoms, surgery is often the best intervention. Surgery involves opening up the area above and below the entrapped nerve—whether near the knee, elbow or wrist—to find the area of compression. The nerve is released, and whatever is compressing it is removed, so its pathway is expanded. The vast majority of these procedures are outpatient surgery. NWH has an extraordinary collaborative environment; I frequently participate in operations with other surgeons when a nerve is involved.

Q. Can I do anything to prevent peripheral nerve injuries?

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A. As with many conditions, the best form of prevention is to be healthy—to eat healthily, exercise regularly, and to be at your proper weight. If you don’t exercise, you are more susceptible. Also, be physically prepared for whatever activity you do, such as playing sports on weekends or going on a physically demanding vacation.

Dr. Benzil is a Board-Certified Neurosurgeon currently serving as Vice President of the American Association of Neurological Surgeons (AANS) with faculty appointment through Columbia School of Medicine.  She completed both her undergraduate and neurosurgical residency at Brown University in Rhode Island and an additional brain tumor fellowship through the National Institutes of Health.  Dr. Benzil has been recognized for her many scientific, clinical, and organizational accomplishments in neurosurgery nationally and internationally.  Her practice with MKMG specializes in treatment of brain tumors, the entire spectrum of spinal disorders, peripheral nerve problems, and treatment with stereotactic radiosurgery. 

Learn More About Dr. Benzil
Neuro-oncology, Spine Surgery, Stereotactic Radiosurgery
Northern Westchester Hospital

Read Past Topics from Dr. Benzil:
Concussions and the Young Athlete
Brain Tumor Breakthroughs

Northern Westchester Hospital is a proud member of Northwell Health.

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