Peripheral nerves are the nerves within the body that exist outside of the brain and the spinal cord. The main purpose of these nerves is to communicate messages relating to pressure, temperature and pain between the body parts and the brain. The nerves in your body are constructed much like cable, with the outer layer being the protective agent, called the outer wrap, where the nerves are wires grouped beneath the protective layer. Even minor injuries can disrupt the way the peripheral nerves function.
Peripheral nerves may be injured in several ways. Too much pressure, a cut or even stretching can mildly or severely affect them depending on the nature of the injury. Mild burns usually only affect the outer wrap area, and these are often the simplest traumatic injury to the peripheral nerves. More serious injuries, such as deep cuts, are likely to slice the nerve in half, which breaks through both the outer wrap and inner fibers of the nerves. This type of injury almost always requires surgery to stitch the nerves back together.
The most common symptoms of peripheral nerve injuries are either loss of sensitivity in the hand or a significant amount of pain. In some instances, a nerve that is badly damaged may form what is called a neuroma, also known as a nerve scar, which may cause both an uncomfortable shocking feeling and pain when touched.
Loss of sensation and pain does not always mean that you have a traumatic injury to the peripheral nerves. It is always best to have your doctor evaluate your hand first to rule out any other problems that may affect your nerve function, especially in the absence of a notable injury.
There are several treatment options for peripheral nerve injuries, each dependent upon the type of injury sustained. A mild injury often heals on its own, especially when it only involves the protective outer layer. Other injuries, especially those involving lacerations and severe burns, may require more extensive treatment including surgery to repair the nerves and surrounding muscle.
In order to test the nerves, doctors often run a series of tests including an EMG/NCV, which is an electrical conduction test that helps to determine if the nerves are communicating properly. Other tests may include an MRI or a CT scan. There are a few types of surgical procedures used to repair nerves. In one procedure, nerves are stitched together, realigning the nerve fibers. Sometimes, there is a gap between the nerves which may result in having to graft a section of nerves from another part of your body to close the gap.
If your peripheral nerve injury requires surgery, you’ll likely be in a splint or protective covering until the stitches are removed. After the sutures are removed, to prevent stiffness, you’ll likely be prescribed physical therapy. While some feeling may be evident in the affected areas after surgery, it can take several years before feeling completely returns.
If you experience a loss of strength in the area of the trauma, physical therapy can help regain that strength. In addition, physical therapy also promotes joint movement which can relieve stiffness and other pain. The amount of physical therapy you’ll undergo depends on the severity of the injury. Some people undergo a few weeks, while others require months of ongoing services.
Like treatment options, recovery times vary on the nature of the injury. Mild injuries involving the outer wrap can take only seconds to repair themselves. Severe injuries, especially those instances where nerves are severed and require surgical repair, can take on the upwards of several years. It is important during the recovery process, especially where there is loss of feeling, that you consistently check numb areas for signs of injury including burns and cuts, until your nerves have healed and feeling has returned.
Please call our office at (703) 574-2588 for more information, or to schedule an appointment with Dr. Fadi Nukta in Northern Virginia.