Over 7 trillion nerves make up the human body. Nerves act as an electrical wiring system, transmitting signals between the brain, spinal cord, and the rest of the body. Perfect electrical wiring is required to blow a bulb, and with a cut or break in the wire, it will not pass electricity. Like electrical wires, when injuries occur in the nerves, they will not convey messages to the rest of the body. Let’s see some nerve injuries, causes, symptoms, diagnoses, and treatment strategies in this blog.
Ulnar Nerve Injuries
The ulnar nerve connects your shoulder to your little finger. It controls the muscles in your fingers that allow you to perform fine movements. It also helps to control the forearm muscles to grasp objects tightly.
The ulnar nerve carries the signals between the hand and the brain. When an injury occurs to the ulnar nerve, it cannot carry the signals from the brain to the hands leading to sensory and motor impairments in hand. Injuries to the ulnar nerve can also cause paresthesia, dysesthesia, and muscle weakness in the affected hand.
Causes of Ulnar Nerve Injury
Pressure applied to the elbow or the base of the palm for an extended period of time is the main cause of ulnar nerve injury. Direct damage or pressure on the ulnar nerve can also cause ulnar nerve injury.
An ulnar nerve injury can also occur in slip and fall, motorcycle accidents, or car accidents when the elbow gets in direct contact with the objects during the crash—for example, being thrown against the dashboard in a car collision.
Symptoms of Ulnar Nerve Injuries
- Tingling in the arms when you type or write
- Feeling difficulty to move the hands
- A sensation of pins and needles
- Claw-like malformation in the ring and pinky fingers.
To determine whether you have ulnar nerve damage after car accident, the physician may ask you to take an X-ray, ultrasound, Magnetic Resonance Imaging (MRI) scan, nerve conduction study, or electromyogram.
Treatment of Ulnar Nerve Injury
Ulnar nerve injuries are treated in 2 ways.
- Non-surgical treatment
- Surgical treatment
The following are the nonsurgical therapies for ulnar nerve damage.
- Occupational therapy
- Physical therapy
Surgical treatment may be needed when the severity of ulnar nerve injury is more. The physician may suggest surgery under the following conditions.
- To reposition the ulnar nerve
- To reduce the ulnar nerve’s pressure.
- Cyst removal
Peripheral Nerve Injuries
Peripheral nerves help do simple things like buttoning shirts, bending the elbows, and taking steps forward. Peripheral nerve damage can cause symptoms that range from minor to severe, restricting your everyday activities. These nerves control the functions of movement, sensation, and motor coordination.
Classification of Peripheral Nerve Injuries
For peripheral nerve injuries, two classifications are often used.
- Seddon classification
- Sunderland classification
In 1972, Seddon divided nerve damage into three categories. They are neurapraxia, axonotmesis, neurotmesis.
Sunderland Classification of Nerve Injury
In 1978, Sunderland divided peripheral nerve injury into five degrees. They are,
- First degree
- Second degree
- Fourth degree
- Fifth degree
Sunderland considered neurapraxia as first degree, axonotmesis as second, third, and fourth-degree according to the severity of the injury, and axonotmesis as the fifth degree.
Causes of Peripheral Nerve Injuries
Injury to the peripheral nerve can occur due to a variety of factors such as gunshot wounds, electrical injury, certain medications, autoimmune disorder, alcohol and toxin, cut or stretch, and injury from an accident. A car accident or a fall might cause peripheral nerve damage. Peripheral nerve injuries are caused by motor vehicle accidents in 46% of incidents.
Symptoms of Peripheral Nerve Injuries
- Numbness for a short time
- Weakness in muscle
- Feeling a burning sensation, particularly at night
- Dysfunction of an organ or a gland
- Muscular atrophy
Diagnosis of Peripheral Nerve Injuries
The physician may suggest a Computed Tomography scan (CT), Magnetic Resonance Neurography (MRN), and Magnetic Resonance Imaging to diagnose peripheral nerve injury.
Peripheral Nerve Injury Treatment
Peripheral nerve injuries are widespread, yet there is no easy way to treat them effectively. According to the severity of the injury, the doctor suggests the treatment. If the injury is mild, the physician prescribes non-surgical treatment, and for severe injury, they may recommend surgical treatment.
In the case of minor nerve injury, the non-surgical treatment will be medication, acupuncture, massage therapy, and more. Severe injuries need treatments like DREZ procedure, nerve graft, muscle transfer, nerve repair, open decompression surgery, etc. It’s vital to get medical attention as soon as possible if you’ve suffered a peripheral nerve injury.
Median Nerve Injuries
The median nerve is a mixed nerve that plays a crucial part in the hand’s functionality. Most of the fingers in your hand, and a portion of your palm, are controlled by the median nerve. The little finger and a part of the ring finger that is not controlled by the median nerve is controlled by the ulnar nerve.
The elbow and the wrist are the two most typical areas for the median nerve to be injured or crushed. Carpal tunnel syndrome is a disorder that occurs when the median nerve in the hand is under excessive pressure.
Causes of Median Nerve Injuries
- Trapping is the most prevalent cause of median nerve damage. The nerve is trapped as it travels through a restricted space, putting pressure on it.
- Injuries to the elbow might result in damage to the median nerve.
- Kidney diseases
- Direct injury to the wrist or hands during a car accident
Symptoms of Median Nerve Injuries
- Unable to turn over the hand
- Difficulty in crossing the palm with the thumb
- Tingling sensation
Treatment of Median Nerve Injuries
Mild injury can be treated by applying ice on the affected area, compression, and keeping the hand in the upper position. The injury that cannot be treated this way may require surgery to get complete healing. The majority of treatment focuses on preventing further damage.
Radial Nerve Injury
The radial nerve travels from the top of the arm to the tips of the fingers. This nerve governs arm and hand movement and sensation and elbow, wrist, and finger extension. The injury in the radial nerve causes loss of function in the fingers, wrists, and hand and weakness and pain.
Causes of Radial Nerve Injuries
A broken humerus is the most prevalent cause of this type of nerve injury. Physical trauma, illness, or even exposure to poisons can also cause radial nerve injury. Other causes of radial nerve injuries include the following:
- Sustained pressure
- Sleeping on the arm
Symptoms of Radial Nerve Injury
The following are some of the signs and symptoms of radial nerve injuries:
- A sharp pain
- Inability to control muscles
- Problems with pinching and grabbing
Diagnosis of Radial Nerve Injuries
A physician may order physical examinations such as imaging studies and electrodiagnostic studies to identify a radial nerve injury. The electrodiagnostic test includes electromyography and nerve conduction studies. Imaging studies include X-ray, MRI, and ultrasound.
Treatment of Radial Nerve Injuries
When a nerve in your body is injured or cut, it will attempt to heal itself. Symptoms may fade away gradually without treatment in some circumstances. To help you manage your symptoms, your doctor may recommend medication or other therapy.
To get rid of radial nerve injury, the professionals may suggest first-line treatment such as braces or splints, steroid injections, acupuncture, massage, and more—up to 95 percent of individuals who receive non-operative treatment recover entirely within a few months.
If the patient’s condition does not improve with rest and non-surgical care, surgery may be required to get complete recovery. The doctor may recommend functional muscle transfer, tendon transfer, or nerve repair to reconstruct the damaged nerves in the surgical treatment method.
- Tendon Transfer
A tendon transfer procedure is used to restore the lost movement and function of the injured nerve.
- Nerve repair
Nerve repair surgery aims to re-establish the feeling and muscular function in a damaged location. It’s a complicated procedure.
- Functional Muscle Transfer
The functional muscle transfer procedure is an alternative way to reconstruct the injured nerves when the tendon transfer and nerve reconstruction is not possible to rebuild the damaged nerves. If a clinician cannot regenerate the nerve because of the extent of the injury, a functional muscle transfer may be recommended.
Axillary Nerve Injuries
The axillary nerve allows you to elevate your arm away from your body and rotate your shoulder. When an injury occurs in the axillary nerve, the shoulder loses mobility or sensation. In most cases, if axillary nerve injury occurs after dislocation of the glenohumeral joint, it heals on its own.
Causes of Axillary Nerve Injuries
Putting excessive strain on a nerve for a long time is one of the major causes of axillary nerve injury. If the nerve is under pressure from adjacent body structures, it will also cause damage to the nerve. Other axillary nerve injury causes include sports collisions, car accidents, and fall from heights.
Symptoms of Axillary Nerve Injuries
- Have difficulty raising your arms up
- Loss of range of motion in the shoulder
- Numbness on the outside of the upper arm over the deltoid muscle
Axillary nerve damage can be checked with tests such as X-ray, MRI, nerve conduction test, or EMG.
The majority of the patients can heal without surgery. It is essential to continue physical therapy throughout this time to maintain shoulder joint flexibility. Surgical exploration may be necessary if the axillary nerve injury has not recovered within 3 to 6 months, especially if several months have passed with no substantial improvement.
Cranial Nerve Injury
Through cranial nerves, your brain is connected to various parts of your head, neck, and trunk. It is responsible for various tasks, including sensation, facial movement control, and the initiation of defensive reflexes. Cranial nerve injury is characterized by the loss of function of one or more cranial nerves, which can be partial or full. When the cranial nerve gets injured, it will affect the facial movement control and sensation.
Causes of Cranial Nerve Injuries
- Strokes, hypertension, diabetes, tumors, infections, and other factors can cause cranial nerve damage.
- After a catastrophic vehicle collision, there is a risk of cranial nerve injury if someone has a head injury.
Symptoms of Cranial Nerve Injury
- Hearing loss
- Facial twitch
- Skin that has a high sensitivity to touch
Diagnosis of Cranial Nerve Injury
To identify nerve injury, a medical practitioner will perform various tests. They are,
- Hearing test
- Biopsies of the nerve and skin
- CT scan
- MRI scan
- Nerve conduction velocity test
Depending on the level of the injury, the effects of cranial nerve injury may be transitory or permanent. It is impossible to restore a cranial nerve that has been cut into two pieces. It can, however, recover if the nerve is stretched or injured but not broken. Mild injury can be healed within 30 days. For severe injury, surgery may be required.
Facial Nerve Injury
When the facial nerve is injured, it loses its ability to move. So that, the person who is affected by facial nerve injury will lose the ability to operate the muscles that control blinking, smiling, and other facial motions. The quality of life of a patient is affected as it leads to the problem in expressing one’s emotion.
Causes of Facial Nerve Injury
Facial nerve injury can be caused by various factors, including nervous system disease, middle ear injury, facial injuries, skull fracture, and tumor. Cosmetic surgical procedures, such as facelifts, also cause facial nerve injuries.
Motor vehicle accidents are the most common cause of facial nerve injury, accounting for 31% of all cases, followed by slip and falls. Face fractures can be caused by shattered glass, steering wheels, and airbags.
Signs and Symptoms of Facial Nerve Injury
- Dryness in the mouth or eyes
- Taste changes on the affected side
- Drooping of the face and difficulties making facial gestures such as closing your eyes or smiling
- Changes in tear and saliva production
The tests utilized to diagnose the patient will differ from one to the next, but they will involve,
- Electromyography test
- Magnetic Resonance Imaging,
- CT scan
- Ear test
- Blood test
The above test will help the physician know more about the injury level in the facial nerve.
Physical therapy and medications are the non-surgical treatments for facial nerve damage. A physical therapist can teach you how to massage and strengthen your facial muscles. Corticosteroids and antiviral medicines are some of the medications used to treat the condition.
In surgical treatment, plastic surgery may help you correct facial nerve problems. Facial reanimation treatment is used to regain the lost movement in your facial nerve. An eyelid lift, nerve grafts, and facial implants are some of the procedures used in reanimation treatment.
If you experience the above nerve injury symptoms, don’t delay getting medical care. Doctor’s recommendations such as physical therapy, acupuncture, and home remedies will help your nerves regain function soon. If you have sustained severe nerve injuries in an accident caused by someone else, you should immediately consult a personal injury lawyer. They will help you safeguard your right to a complete and equitable ulnar nerve surgery settlement.