Peripheral nerve damage

Peripheral nerve damage

The peripheral nervous system includes all nerves and branches located outside the brain and spinal cord, that is, on the periphery. The peripheral nervous system is subordinate to the central nervous system, performing no less essential functions for the functioning of the human body.

Peripheral nerve damage refers to a vast range of pathological conditions characterized by organic or mechanical damage to nerves of various locations. Each violation from this group has several similar features that are randomly combined depending on the nature and degree of damage:

• pain syndrome;
• decrease or absence of motor functions;
• dullness of sensory functions;
• lack or decline in trophic and vegetative functions.

These problems always occur distally concerning the point of injury. That is, there is a violation of innervation in a specific part of the body. For example, if a peripheral nerve injury occurs in the knee area, the damage will affect the part of the limb below the knee.

Peripheral nerve injuries have varying degrees of severity and consequences; in the most severe cases, there is a risk of patient disability. Conservative and surgical methods carry out treatment of such pathologies. Rehabilitation plays a crucial role in restoring innervation and lost functions.

Causes of damage to peripheral nerves

All causes of damage to peripheral nerves are conditionally divided into two broad groups: caused by a disease (inflammatory, infectious, etc.) and post-traumatic (consequences of injuries of varying severity). If we single out the most common causes from both groups, they include:

• bruises (nerve contusion);
• compression damage;
• injuries of varying severity and the occurrence of an anatomical break;
• infectious and allergic diseases;
• infectious pathologies;
• toxic nerve damage;
• vertebrogenic disorders;
• idiopathic damage (genetically determined);
• dysmetabolic conditions and illnesses.

After the injury, the anatomical break can be intra-trunk, incomplete, and complete. In the first two cases, there is the possibility of regeneration and restoration of nerves in the damaged area. A complete break is understood as a rupture of nerve fibers. As a result, a complete violation of conduction occurs, or a neuroma is formed.

Treatment

In each case of damage to the peripheral nerves, treatment tactics are determined individually. The localization, severity, nature of the damage, and the causes of the pathological condition are taken into account. The main areas of treatment have the following key features:

Conservative therapy – is carried out in cases of minor injuries, infectious and other diseases, and after a patient has undergone surgery. The main goal of conservative therapy is to eliminate the cause of damage to nerve fibers and stimulate their recovery processes. As part of conservative treatment, analgesics, NSAIDs, vitamin preparations, various methods of apparatus physiotherapy, as well as exercise therapy and massages, are used.
Surgical treatment – in case of open injuries and various complications with damage to the peripheral nerves, the patient is shown surgical intervention. In such cases, the method of the operation is also chosen individually. The surgeon’s goals are reduced to restoring innervation, including reconstructing the nerve trunk. Depending on the characteristics of the clinical case, decompression surgery, interfascicular plastic surgery of the nerve, neurolysis, nerve suturing, etc., are performed.
Rehabilitation after injuries to peripheral nerves

Neurological disorders, including those on the structures of the peripheral nervous system, are often accompanied by complications even with effective treatment. Patients have decreased sensitivity in some body regions and impaired motor and sensory functions. Such complications are eliminated through rehabilitation, which experienced specialists carry out at the Schmider Clinic, and rehabilitation programs are compiled for each patient individually.

The specificity and duration of rehabilitation depend on the severity and characteristics of damage to the peripheral nerves. However, most rehabilitation programs include the following areas:

Exercise therapy classes with an instructor – all exercise methods are developed individually, considering the localization of nerve damage and the causes of the pathology that has arisen. Physical activity allows you to strengthen the muscular frame and restore nerve conduction in the affected areas. Loads are increased gradually, in accordance with the recovery period, the patient’s feelings, and the level of his physical fitness.
Apparatus physiotherapy – depending on the characteristics of the clinical case, includes a wide range of procedures for which specialized equipment is used. This direction allows accelerating the recovery of damage to peripheral nerves significantly. The most popular methods include magnetotherapy, laser therapy, electrophoresis, myostimulation, etc.
Physical methods of physiotherapy – within the framework of comprehensive rehabilitation programs, the patient is prescribed massage courses, acupuncture, manual techniques, etc. Such rehabilitation options are especially effective after conservative treatment and in the later stages of patient recovery after surgery.

An important aspect of rehabilitation programs is an integrated approach. Various methods of influence are applied in accordance with how well the patient has recovered and what goals are being pursued.

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