Mechanics, office workers, musicians, farmers: What do all these professions have in common? They all involve repetitive motions of the wrist that can irritate this part of your body and potentially lead to nerve damage over time.
You may have seemingly innocuous muscle pain over several days or even weeks, but you choose to ignore it since it doesn’t interfere with your daily life. In the process, you may be ignoring signs of nerve damage. Here are some nerve damage symptoms you should look out for, as well as information on when to see a doctor and potential treatment options.
Understanding Types of Nerve Damage
Nerves are cells in your body that transmit messages to your brain and spine using electrical signals. They are responsible for the sensation you feel throughout your body, your motor movements and even how your brain functions.
Nerve injuries can take different forms. “The main kind are nerve impingement or irritations or compressions, and the principal difference between them is whether nerve roots are impinged or compressed at the spinal level or if they’re compressed somewhere in the periphery of the body, such as the hand, the foot or the wrist,” said Daniel Vardeh, MD, a neurologist and pain specialist at Lahey Hospital & Medical Center in Burlington and Lahey Medical Center, Peabody.
Two of the most common types of peripheral nerve damage include:
Carpal tunnel syndrome: This type of nerve damage occurs when the median nerve at the wrist is compressed.
Cubital tunnel syndrome: Also known as ulnar neuritis, this type of nerve damage occurs when the ulnar nerve at the elbow is compressed.
“What these conditions all have in common is that there’s a specific site where the anatomic structures are particularly crowded or the nerve is exposed, and at that anatomic location, the nerve gets somewhat irritated, compressed or even damaged,” Dr. Vardeh said.
Two common types of nerve root compression are sciatica, where pressure on the nerve creates pain in your lower back and legs, and cervical radiculopathy, where the nerve root is compressed in your neck and it radiates down your arm.
N. George Kasparyan, MD, PhD, who specializes in hand and orthopedic surgery at Lahey Hospital & Medical Center, says two things typically are responsible for nerve damage: physical injuries like the conditions mentioned above and damage caused by biologic diseases, such as multiple sclerosis and amyotrophic lateral sclerosis (ALS). Whether the cause is physical or biological, the most common signs of nerve damage include numbness, weakness and pain.
“The pain can be a dull, aching pain. Often it’s burning pain, which is associated with pressure on the nerve,” Dr. Kasparyan said. “The classic presentation of carpal tunnel is burning nighttime pain in the fingers, specifically the thumb, the index finger, the long finger and half the ring finger. It’s the sort of burning pain that wakes you up at night.”
With cubital tunnel syndrome, weakness is one of the main symptoms, including muscle and hand weakness, the inability to make a firm grip or to spread out your fingers. Patients should also look out for more vague symptoms such as clumsiness of the hands. Issues with fine motor movements, including difficulty holding a cup of coffee or buttoning a shirt, could be a sign you have nerve damage, especially if you’ve experienced any other symptoms, including pain, numbness or weakness.
What Are Your Treatment Options?
Every case of nerve damage is different, and treatment will depend on the cause. In addition to Orthopedics, Hand Surgery in the Plastic Surgery Division may also take care of nerve disorders as well as Neurosurgery to some degree.
“In hand surgery, we often see patients who have a biologic disease, but then we’ll often refer them to the neurologist if we deem that’s the origin,” Dr. Kasparyan said. “If there are physical injuries, then we’re the ones taking care of it.”
Before treatment, your doctor must first make a diagnosis, which is based on your medical history and a physical exam. If your doctor suspects your nerve damage is due to a biologic problem, he or she will refer you to neurology for electrodiagnostic studies, which will provide more information on the severity and location of the compression and whether it’s a sensory or motor problem, or both.
If your nerve damage is due to physical injury, orthopedics often will handle your treatment. Dr. Kasparyan says his team typically will start by using more conservative approaches, such as putting your hand, wrist or elbow in a splint or brace to reduce pressure on the nerve or by giving you vitamin B6, an important amino acid in the brain that has been shown to improve nerve function. If conservative treatments don’t work, however, then steroid injections may be the next step to reduce inflammation. Surgery to decompress the nerve also may be an option if symptoms get worse.
Dr. Vardeh says while treatment can be effective, if you experience ongoing nerve damage symptoms, it’s better to see a doctor sooner rather than later.
“With nerve damage in general, it’s better to see a doctor earlier because often preventative measures — such as splinting or changing positions at work, for example — can prevent further nerve damage,” he said. “Once nerve damage occurs, it can be harder to reverse it.”
So if something just doesn’t feel right, talk to your doctor and check out the various treatments and research happening at Lahey Hospital & Medical Center. Our team is available to help with whatever ails you.