The nerves in your body send signals from your brain and spinal cord through your arms and legs and into your hands and feet. Sometimes, when these nerves get damaged, they don’t work properly. If that happens, you can have trouble feeling or using your arms, hands, legs or feet.
We talked to Joshua Hustedt, MD, an orthopedic surgeon with Banner - University Medicine, who explained more about what causes these injuries and how to best treat them.
What causes peripheral nerve injuries?
Lots of different things can injure these nerves—they are relatively easy to damage. Trauma is one possibility—you can damage your nerves if you’re in a car accident, if you fall or if you cut yourself. Medical conditions such as diabetes, carpal tunnel syndrome and Guillain-Barre syndrome can also cause these injuries. Sometimes, autoimmune diseases cause them.
What symptoms of peripheral nerve injuries might you notice?
It’s most common for people to notice numbness or an inability to move an arm or leg, according to Dr. Hustedt. However, the symptoms you experience are often dependent on the nerves damaged.
- Motor nerves: Muscle weakness, muscle twitching that is uncontrollable and painful muscle cramps are common symptoms.
- Sensory nerves: Symptoms can range from trouble walking or numbness and tingling in your extremities to problems feeling pain or changes in temperature or trouble balancing with your eyes closed.
- Autonomic nerves: Common symptoms may include excessive sweating, blood pressure fluctuation or changes, gastrointestinal symptoms and heat intolerance.
If you think you may have damaged a peripheral nerve, contact your doctor right away. Some treatments, including surgeries, work best in the months after an injury. So, with a faster diagnosis, you may have more treatment options to consider.
How are peripheral nerve injuries diagnosed?
In a clinical exam, your doctor can check your arms, hands, legs or feet to see how strong they are and whether you have sensations in them. They will ask about your symptoms, medical history, and any accidents or surgeries. If your doctor needs more detailed information, they might recommend diagnostic tests like nerve conduction studies or ultrasounds.
- Nerve conduction studies. In these tests, you’ll have electrodes placed at two different locations on your body to measure how well electrical signals are transmitted through your nerves.
- Ultrasound. This test uses sound waves to create images inside your body so your doctor can see if there’s nerve damage.
How can you treat peripheral nerve injuries?
In some cases, nerves are damaged but not cut completely. Those injuries are easier to heal. These treatments might be options:
- Sometimes, you can rest, and the nerve slowly heals. You’ll want to see your doctor routinely to make sure you’re improving.
- If you have a medical condition that’s causing the injury, treating that condition may help heal the nerve injury as well.
- If your injury is painful, your doctor may recommend ibuprofen or aspirin. If those aren’t effective, steroid injections might help.
- You can see a physical therapist, who can help improve your function and reduce stiffness.
If those options don’t help, there are surgical procedures that can treat these injuries.
- Nerve decompression surgery. Sometimes, the nerve injury is caused by compression of the nerve. In those cases, it might be possible to surgically remove the tissues causing the problem.
- Tendon transfer surgery. In this type of surgery, a surgeon can move a tendon that controls one part of the body to another nearby part. For example, if the nerve that controls your thumb is damaged, you can have one of the two nerves that control your index finger transferred to it.
- Nerve transfer surgery. “Nerve transfer surgery is a new treatment that has revolutionized nerve damage,” Dr. Hustedt said. “This new and exciting field can help change the lives of those suffering from nerve injuries.” With nerve transfers, surgeons can borrow from a functioning nerve to restore function to a damaged nerve. “Like splicing in a live wire, this allows for sensation and function that was not available with tendon transfers,” he said.
- Nerve graft. Although similar to nerve transfer surgery, a nerve graft is used when the nerve is damaged so badly it cannot be repaired or cut completely. With a nerve graft, the damaged section is removed and replaced with a section of nerve from another part of your body.
“Even if you have nerve damage, a nerve transfer or tendon transfer can restore a significant amount of function,” Dr. Hustedt said.
How do you know which treatment is best?
Your doctor can talk to you about the pros and cons of various options, based on your specific injury and symptoms. Timing matters, too. Dr. Hustedt said that nerve transfer surgery is highly effective but needs to be performed six to 18 months (about 1 and a half years) after the injury. Tendon transfer surgery can be performed later. Your doctor might recommend nerve decompression surgery after you’ve tried less-invasive options.
The bottom line
Accidents and medical conditions can injure your delicate peripheral nerves, causing muscle weakness, pain and a lack of sensation. Depending on the level of damage to your nerve, medication, physical therapy and surgery could help. Nerve transfer surgery, a relatively new procedure, can restore sensation and function where other treatments might not be effective. To learn more about treating peripheral nerve injuries, reach out to an expert at Banner Health.
