Nerve Compression Syndromes

What are nerve compression syndromes?

A nerve compression syndrome can occur when there’s pressure on nerves in the peripheral nervous system. These nerves connect to parts of your body (like your hands and feet) that are farther away from the central nervous system (like your brain and spine).

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

What are the types of nerve compression syndromes?

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

Syndromes that affect your upper limbs include:

• Carpal tunnel syndrome: Compressed median nerve in your wrist.
• Pronator teres syndrome: Compressed median nerve in your elbow.
• Radial tunnel syndrome: Pressure on the radial nerve in your elbow.
• Suprascapular nerve entrapment: Damage to the suprascapular nerve in your shoulder.
• Thoracic outlet syndrome: Compressed nerves in your lower neck and upper chest (thoracic outlet).
• Ulnar nerve entrapment: Compressed ulnar nerve in your elbow (cubital tunnel syndrome) or wrist (Guyon’s canal syndrome).

Nerve compression syndromes that affect the lower limbs include:

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

What causes nerve compression syndromes?

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 nerve compression syndromes include:

• Accidents and trauma.
• Ankle, knee or wrist sprains.
• Arthritis.
• Broken bones and bone spurs.
• Diabetes.
• Dislocated joints, such as a dislocated elbow or dislocated shoulder.
• Herniated disk.
• Hypothyroidism (underactive thyroid gland).
• Surgical complications.
• Tumors or cysts.

Who's at risk for nerve compression syndromes?

Anyone can develop a nerve compression syndrome. Sometimes, the weight from obesity or pregnancy squeezes a nerve. Casts, splints and the use of crutches can also cause nerve problems.

People who do certain jobs or activities that require repetitive joint movements also are more at risk. This includes:

• Assembly line workers.
• Baseball players.
• Bicyclists.
• Construction workers and carpenters.
• Golfers.
• Tennis players.
• Typists.
• Weightlifters.

What are the symptoms of nerve compression syndromes?

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

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

• Pain, numbness or tingling in the area of 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 affects your ability to do daily tasks or makes you feel clumsy.
• Muscle loss in the affected area.

How are nerve compression syndromes diagnosed?

Your healthcare provider will perform different tests during a physical exam to evaluate your symptoms. Your healthcare provider may ask you to hold onto items, pick up something or lift your foot or hand.

If an exam indicates a potential nerve problem, you may receive one or more of these diagnostic tests:

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

What are nonsurgical treatments for nerve compression syndromes?

Some nerve compression syndromes 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. You can also learn new ways to move and perform tasks that won’t irritate the compressed nerve.
• Splints, braces or orthotics to support the injured area.

What are surgical treatments for nerve compression syndromes?

If nonsurgical treatments don’t provide adequate symptom relief, surgery can help. Depending on the cause of the nerve compression, surgery can:

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

How can I prevent nerve compression syndromes at home?

If you’re at risk for nerve compression syndromes, these steps can help:

• 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.
• Wear a brace or splint.

What are the complications of nerve compression syndromes?

Severe nerve compression that lasts more than six weeks can cause permanent muscle loss and nerve damage. You should see your healthcare provider early about symptoms so you can start the appropriate treatment.

What’s the prognosis for people with nerve compression syndromes?

Many people get symptom relief through nonsurgical methods. When needed, decompression surgery to take pressure off of the nerve often helps. Physical and occupational therapy exercises can prevent nerve problems from recurring.

When should I call my doctor?

You should call your healthcare provider if you experience:

• Difficulties with daily tasks like buttoning a shirt, typing or holding a pen.
• Joint pain.
• Limb numbness, tingling or weakness.
• Problems walking.

A note from Cleveland Clinic
Nerve compression syndrome is the result of nerve irritation or pressure. Carpal tunnel syndrome in the wrist is the most common type. Nerve compression syndromes can also affect your lower limbs. You should see your healthcare provider if you experience unexplained limb numbness, pain, tingling or weakness. Your healthcare provider may recommend surgery if nonsurgical treatments don’t provide symptom relief or you have a severely compressed nerve.