Nerve Compression Syndromes

A nerve compression syndrome occurs when there’s pressure on a peripheral nerve. These nerves connect to parts of your body (like your hands and feet) that are farther away from your brain and spinal cord. Carpal tunnel syndrome is the most common form of nerve compression.

Nerve compression syndromes are a common cause of nerve (neuropathic) pain in your limbs. They can lead to a pinched nerve and nerve damage (neuropathy).

Types of this condition

Nerve compression syndromes can affect different peripheral nerves in your body.

Syndromes that affect your upper limbs include:

• Carpal tunnel syndrome (median nerve in your wrist)
• Pronator teres syndrome (median nerve in your elbow)
• Radial tunnel syndrome (radial nerve in your elbow)
• Suprascapular nerve entrapment (suprascapular nerve in your shoulder)
• Thoracic outlet syndrome (nerves in your lower neck and upper chest)
• Cubital tunnel syndrome (ulnar nerve in your elbow)
• Guyon’s canal syndrome (ulnar nerve in your wrist)

Nerve compression syndromes that affect your lower limbs include:

• Meralgia paresthetica (lateral femoral cutaneous nerve in your thigh)
• Peroneal nerve compression (peroneal nerve in your lower leg)
• Pudendal nerve entrapment syndrome (pudendal nerve in your pelvic area)
• Sciatica (sciatic nerve in your lower back, hips, butt or leg)
• Tarsal tunnel syndrome (tibial nerve in your heel or the sole of your foot)

Nerve compression syndromes can also affect your head. These conditions often happen when an artery or vein presses against a nerve at your brainstem. Some include:

• Trigeminal neuralgia (fifth cranial nerve)
• Hemifacial spasm (seventh cranial nerve)
• Glossopharyngeal neuralgia (ninth cranial nerve)

A syndrome that affects your chest or abdomen is intercostal nerve compression (intercostal neuralgia). It involves the nerves near your ribs.

Symptoms of nerve compression syndromes

Symptoms of nerve compression syndromes tend to come on gradually. They may come and go and can range from mild to severe. The symptoms may get worse when you do activities that pull or press on the affected nerve.

Nerve compression syndromes cause a variety of symptoms depending on which nerve they affect. You may experience:

• Pain, numbness or tingling around the compression (usually a joint like your wrist, elbow or ankle)
• Inability to move a limb, lift your hand or foot, or grasp or hold onto items
• Limb weakness that makes it hard to do daily tasks or makes you feel clumsy
• Muscle loss in the affected area

Nerve compression syndrome causes

Nerve compression often affects nerves that travel through small openings (called tunnels or canals) in your joints. Tissue swelling or damage puts pressure on the nerve, causing symptoms.

Possible causes of these syndromes include:

• Accidents and trauma
• Ankle, knee or wrist sprains
• Arthritis
• Broken bones and bone spurs
• Casts, splints and the use of crutches
• Dislocated joints, such as a dislocated elbow or dislocated shoulder
• Herniated disk
• Increased weight from obesity or pregnancy
• Scar tissue
• Surgical complications
• Tumors or cysts

Risk factors

Anyone can develop a nerve compression syndrome. But you’re at increased risk if you do certain jobs or activities with repetitive joint movements, like:

• Assembly line work
• Baseball
• Construction work
• Cycling
• Golfing
• Playing tennis
• Typing
• Weightlifting

Complications of this condition

Severe nerve compression that’s untreated and lasts more than six weeks can cause permanent muscle loss and nerve damage. This is why it’s important to see a healthcare provider soon after symptoms start.

How doctors diagnose this condition

A healthcare provider will do different tests during a physical exam to assess your symptoms. For example, they may ask you to hold onto items or lift your foot or hand.

If the exam shows a potential nerve problem, you may get one or more of these diagnostic tests:

• Electromyography (EMG) and nerve conduction study to measure how nerve signals reach your muscles
• MRI, neuromuscular ultrasound or X-rays to check for compressed nerves and look for problems like arthritis, ligament injuries and fractures

How is it treated?

Treatment for nerve compression syndromes depends on the severity and underlying cause.

Many cases improve with nonsurgical treatments, such as:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) and steroid injections for pain and inflammation
• Physical and occupational therapy to improve strength and flexibility, and learn new ways to do tasks that won’t irritate the compressed nerve
• Splints, braces or orthotics to support the injured area

If nonsurgical treatments don’t provide enough symptom relief, surgery can help. Depending on the underlying cause, surgery can:

• Open up the nerve tunnel
• Remove tumors or cysts
• Repair, relocate or transfer nerves

What can I expect if I have this condition?

Each case is different. But many people get symptom relief through nonsurgical methods. Your healthcare provider will give you a better idea of what to expect.

Can this be prevented?

If you’re at risk for nerve compression syndromes, these steps may help prevent them:

• Adjust your keyboard to help your wrists stay flat when you type.
• Don’t rest your elbows on an office chair or a desk for an extended period.
• Stretch your limbs throughout the day.
• Take periodic breaks from typing.
• Use a wrist rest with your keyboard and mouse pad.