Conditions Caused by Nerve Compression

The Nervous System

Comprised of a complex network of nerves and cells, the nervous system transmits information to and from the brain and spinal cord to the rest of the body –  essentially our body’s electrical wiring, it controls our movements and our ability to experience sensations. The central nervous system consists of our brain and spinal cord, which branches out into the peripheral nervous system to innervate the rest of the body.

The Spinal Column and Nerve Roots

The spine is formed of individual blocks of bone known as vertebrae, these are stacked upon one another and cushioned at each join by intervertebral discs; the structure as a whole, serves to protect the spinal cord, which runs through the middle of this protective casing. The discs are formed of a tough fibrous outer layer known as annulus fibrosus, with a softer gel centre composed of a substance referred to as the nucleus pulposus. The discs act as shock absorbers, protecting the structure from daily movement and any knocks or bumps.

At each point in the spinal column where two separate vertebrae meet, two nerve roots exit the spinal cord – one on either side of the vertebrae. These nerves extend into the body branching out to innervate other areas. Nerve compression can happen anywhere in the body – however, it frequently occurs at the nerve roots in the spinal column, leading to numerous back pain related conditions.

What Causes Nerve Pain?

Compression or irritation to the nerves is often caused by changes to the surrounding tissue, leading to neuralgia or neuropathic symptoms (nerve pain). Neuralgia is present when the nerve’s function is affected by damage or irritation – causing it to relay uncontrollable pain signals to the brain which provokes feelings of severe and intense pain, this ultimately results in a number of knock on side effects to the patient’s wellbeing and quality of life.

Symptoms of Nerve Compression

Depending on which nerve is compressed and at which point in the body, symptoms may vary. Sharp, shooting or lancinating pains, shock like pains, numbness, tingling sensations, skin sensitivity, skin colour changes and swelling of the skin amongst others are commonly reported phenomena.

Possible Causes of Nerve Compression

Spinal Spondylosis

A term used to encompass a wide range of conditions relating to the degeneration of the spine usually as a result of the breakdown of the body’s natural wear and repair cycle caused by ageing.

Spinal Stenosis

Stenosis refers to the abnormal narrowing of a passage in the body, spinal stenosis is generally an age-related condition occurring when the spinal canal narrows. It may be caused by a range of other pre-existing medical conditions such as osteoarthritis, ankylosing spondylitis or a tumour.  Spinal stenosis can lead to compression or entrapment of the nerve roots or in more severe cases of the actual spinal cord itself. Any resultant symptoms will depend on exactly where the compression has occurred. Stenosis in other parts of the body may also lead to nerve compression such as the narrowing of the carpal tunnel in the wrist causing the compression of the median nerve (carpal tunnel syndrome), or when the cubital tunnel becomes narrowed in the medial epicondyle resulting in the compression of the ulnar nerve – (cubital tunnel syndrome).

Arthritis

This is a common condition causing pain and inflammation of the joints, it is categorised into osteoarthritis and rheumatoid arthritis. Osteoarthritis is caused by the mechanical wear and tear on the joints, which can result in abnormal bone growth as the natural wear and repair cycle of the joints and bones becomes irregular; the bony spurs can cause a range of different symptoms. Rheumatoid arthritis is an autoimmune condition in which the immune system attacks the joints in the body. Both conditions have associations with nerve compression.

Degenerative Disc Disease

The gel like substance in the nucleus of the intervertebral discs gradually begins to dry out and shrink as the body ages, this dryness leaves the disc more prone to herniation (see beneath for information regarding herniated discs.)

Herniated Disc

Commonly referred to as a slipped, bulging or prolapsed disc –  herniation occurs when cracks or tears in the tough exterior fibrous casing of the intervertebral disc, allows the gel like substance of the nucleus to seep out and encroach on nearby tissue. Due to the close proximity of the nerve roots to the discs, nerve root compression frequently occurs.

There are a number of possible causes for this condition including the aforementioned degenerative disc disease and other age related conditions as well as injury, poor posture, repetitive strain movement and smoking may also be possible causes.

Repetitive Strain Injury

Repeated movements to one part of the body, can over time cause inflammation to the surrounding tissues. Nerve compression may transpire as a result, depending on where the strain occurs.

Diabetes

This illness causes the blood supply to the nerves to become compromised, in some cases nerves may become increasingly sensitive to minor degrees of compression.

Tumours or infection

Certain types of cancer or infection, depending where they occur, can cause compression of nerves anywhere in the body.

pin cushion

Health Problems Related to Nerve Compression

Radiculopathy

This is a collective term used to describe conditions caused by nerve compression in the back, radiculopathy may occur at any point along the spine, but is more common in the cervical and lumbar region, rarely occurring in the thoracic region of the torso.

Lumbar Radiculopathy - Sciatica

Perhaps one of the most well documented conditions caused by nerve compression, sciatica is a relatively common complaint. The largest single nerve in the whole body, the sciatic nerve exits from spinal nerves L4 to S3, extending from the lumbar (lumbrosacral plexus) all the way through to the buttock area and into the lower limb, through the leg where it branches off just above the knee joint to innervate the tibial nerve in the lower leg and the common peroneal nerve. Compression of the sciatic nerve in the lumbar region can cause pain to radiate to other parts of the body including the buttocks and leg.

Possible causes of Sciatica may include, a herniated disc, degenerative disc disease, spinal stenosis, Spondylolisthesis, pregnancy; other less common causes include, cauda equina, tumour, infection, internal bleeding.

Cervical Radiculopathy

Compression or irritation to one or more of the nerves in the cervical (neck) region of the spine may result in painful symptoms felt at the source or radiating away to other areas – principally the arms. Brachialgia, a condition associated with cervical radiculopathy is characterised by shooting pains travelling down one of the arms. Other symptoms may include, pins and needles in the hand and fingers, numbness, weak muscles in the shoulder, arm and hand.

Lateral Recess Stenosis

The lateral recess is a bony tubular passageway from which nerve roots exit the spinal column, lateral recess stenosis refers to the narrowing of this cylindrical opening, which may result in the compression or irritation of exiting nerve roots. Possible causes include, a herniated disc, the growth of bony spurs or Spondylolisthesis where a vertebra slips out of place, putting pressure on the exiting nerves.

Carpal Tunnel Syndrome

This is a result of the compression or irritation of the median nerve at the wrist. The median nerve is a long nerve, extending all the way down the arm, where it passes through the carpal tunnel – a narrow passageway on the palm side of the wrist made up of bone and ligaments; if the tissue in the carpal tunnel becomes inflamed or swollen, the space in the tunnel will narrow resulting in pressure upon the nerve as it passes through it. The median nerve’s function is to control sensations and movement in the hand – it innervates many of the muscles in the anterior forearm carrying messages to and from the brain. Carpal Tunnel Syndrome causes pain and tingling sensations in the hand, typically affecting the thumb, index and middle finger; there are a range of possible causes including, arthritis, injury to the wrist, pregnancy, repetitive strain injury, diabetes, an underactive thyroid or growths.

Cubital Tunnel Syndrome

The ulnar nerve passes through the cubital tunnel in the medial epicondyle, more commonly referred to as the funny bone in the elbow. Compression of the ulnar can occur as result of the narrowing of the cubital tunnel causing symptoms of tingling sensations, pain or numbness in the hand, little and ring finger, a weaker hand grip and clumsiness in the hand. Symptoms may worsen in the morning due to poor sleeping positions. The condition may be caused by localised inflammation and swelling, osteoarthritis, fractures, joint dislocation or fluid retention.

occipital neuralgia headache

Occipital Neuralgia

Compression of the lesser and or greater occipital nerve; this nerve extends from the cervical spine to the back of the head; its function is to innervate areas of the scalp. Compression of the occipital nerve can cause shooting pains, or sensations of burning or aching with a resultant headache. It may be caused by cervical spine related problems such as degenerative conditions, or herniated cervical discs, other possible causes include injury, severe muscle tightening, and tumour or infection.

Trigeminal Neuralgia

A disorder of the trigeminal nerve; one of the largest in the head, it is responsible for innervating a large area of the head and face and controlling important motor functions such as biting or chewing. Trigeminal neuralgia, compression of the trigeminal nerve can cause extremely painful symptoms, it is typically characterised by bouts of sharp stabbing pain on one side of the face, sometimes followed by a dull ache. The exact cause of the compression is not always established, however in many cases physicians believe it to be the result of a blood vessel compressing the nerve. This may damage the myelin sheath covering the nerve, causing the nerve to fire uncontrollable pain signals.

Cauda Equina

A rare condition caused by the compression of a bunch of nerves at the tail end of the spine – these nerves are known as the cauda equina. The term literally translates from Latin as horse’s tail, this is due to the physical appearance of the nerves, which branch out from the spinal cord into a bunch of individual nerves. Cauda Equina Syndrome is considered a medical emergency which if left untreated may result in permanent paralysis, symptoms may include lower back pain, pain in the legs, bladder, bowel or sexual dysfunction, numbness and sensory loss across the buttocks and the perineal region. The condition may be a result of a prolapsed lumbar disc, spinal stenosis, spondylolisthesis or inflammatory conditions, infection, cancer or trauma.

What is Chronic Pain?

Acute pain, such as the pain felt from a tissue cut or fractured bone, essentially serves as an alert for injury; chronic pain is different –  pain signals are fired repeatedly and uncontrollably within the central nervous system causing constant pain, this makes simple, everyday tasks a challenge to carry out. Severe pain disrupts everything and may seriously affect the patient’s quality of life, causing further associated negative side effects such as, low mood, isolation and depression.

How We Can Help

The Pain Management Clinic offers tailored treatment for those suffering from a range of pain related conditions; treatment plans may enlist a multidisciplinary team of health professionals such as physicians, surgeons, physiotherapists, psychologists and other health professionals.

Pain clinicians often understand chronic pain in terms of the biopsychosocial model, this takes into consideration the patient’s biological (physical condition), psychological (emotions, thoughts and behaviour) and social (socio economic and socio-environmental) when determining their individual state of health and any subsequent treatment needed – this ultimately provides a fully comprehensive treatment plan.

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