When peripheral nerves become repeatedly or continuously compressed or entrapped by other structures near them, nerve damage can occur. Such entrapment is the cause of the following conditions.

Carpal Tunnel Syndrome:
The carpal tunnel is a narrow, rigid passageway of ligament and bones at the base of the hand, through which the median nerve and tendons run. Carpal tunnel syndrome occurs when the median nerve becomes pressed or squeezed at the wrist by the inflamed tendons in the tunnel. This injury is commonly associated with repetitive motions such as excessive keyboard use, but it can also be triggered by other conditions such as rheumatoid arthritis. Women are more at risk than men, possibly because their carpal tunnel is smaller.

Symptoms of carpal tunnel syndrome include pain and numbness in the hand--especially the thumb and first two fingers--that worsen during the night. As the entrapment condition develops, people might experience decreased grip strength and increased intensity of symptoms during the day.

The treatment for carpal tunnel syndrome begins with the patient wearing a brace at night to take pressure off the median nerve. Anti-inflammatory drugs and cortisone injections can also help decrease the swelling. When these therapies are ineffective, surgery becomes an option.

During surgery for carpal tunnel syndrome, the Center’s surgeon relieves pressure on the nerve by cutting the ligament at the base of the wrist. Patients typically undergo physical therapy after surgery to restore wrist strength.

Cubital Tunnel Syndrome:
The ulnar nerve is a connection between the spinal cord and muscles of the forearm and hand. The ulnar nerve passes across the back of the elbow and behind a bump on the inner side of the upper arm bone. The "funny bone" is actually the corner of the nerve as it makes its way around the elbow. Hitting the elbow at this spot produces a brief tingling. Cubital tunnel syndrome occurs when the ulnar nerve becomes entrapped at the elbow, often from repetitive use of the elbow, arthritis or trauma.

Symptoms of cubital tunnel syndrome include weakness, pain and numbness in the hand or elbow.

Resting the elbow can provide relief, as well as wearing a splint and taking anti-inflammatory drugs to reduce swelling. If these non-invasive approaches don’t result in significant reduction of pain and improvement of function, surgery may be necessary.

Meralgia Paresthetica:
The cause of meralgia paresthetica is entrapment of a nerve — the lateral femoral cutaneous nerve — that supplies sensation to the skin surface of the upper leg.

Symptoms include numbness or tingling in the outside of the thigh and at the hip. There may also be sharp, shooting pain and a burning feeling. Meralgia paresthetica is often a byproduct of obesity, but it is also found in people who wear restrictive clothes or in athletes who repeatedly extend their hips.

Heavy patients are advised to lose weight and do exercises to strengthen core abdominal muscles. Wearing looser clothing and taking measures to protect the hips during exercise may also be recommended. Rest can be helpful, as well as taking anti-inflammatory drugs.

This condition usually improves with time and the above interventions. In chronic and long-term cases, surgery may be considered to release the entrapped nerve.

Tarsal Tunnel Syndrome:
The tibial nerve runs down the back of the leg to the ankle, where it turns and wraps below the inside of the ankle through a space called the tarsal tunnel. If any of the muscles, ligaments or fibrous tissue near this tunnel becomes enlarged, the tibial nerve can become entrapped, resulting in tarsal tunnel syndrome.

Tarsal tunnel syndrome causes numbness, burning and pain in the sole of the foot, and is most commonly found in active adults.

Resting and elevating the foot, wearing arch supports and wider shoes, and taking anti-inflammatory drugs is the first course of action. When these measures are ineffective, the Center’s physicians may recommend surgery to cut a ligament and release the entrapped nerve.

Other Entrapments:
Any nerve in any part of the body may become entrapped. Suprascapular, superficial radial nerve, anterior interosseous nerve, posterior interosseous nerve, peroneal nerve and superficial peroneal nerve are examples of nerves throughout the body that may become entrapped and may be amenable to surgical intervention when appropriate.
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Phillips Ambulatory Care Center
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Suite 5E
New York, NY 10003
Phone: (212) 844-8383
Fax: (212) 844-6119
Email: AManiker@chpnet.org