Tunnel neuropathies
Tunnel neuropathies are damage to peripheral nerves due to compression of the latter in anatomical constrictions or tunnels: fibromuscular canals, rigid bone-fibrous canals, aponeurotic gaps and openings in ligaments.
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Clinical manifestations
- Sensory disorders (pain, paresthesia, numbness)
- Motor (decreased function, weakness, atrophy)
- Trophic disorders
- Professional activity associated with long-term static load (monotonous work at the computer for office workers) or constant stereotypical movements and injuries (professional activity of musicians, artists, athletes)
- Anatomically narrow canal ("tunnel"), the presence of additional muscles, fibrous strands in it
- Violation of the rules for intramuscular injections and other medical interventions
- Tunnel neuropathies are often combined with endocrine diseases (diabetes mellitus, hypothyroidism, acromegaly) and joint pathologies (gout, deforming osteoarthrosis, rheumatoid arthritis)
Diagnostics
- Electroneuromyography of the affected nerve - to determine the speed of impulse conduction along the nerve and to clarify the level of nerve damage
- Ultrasound of the nerve in the suspected area of compression - to determine the morphological structure of the nerve and pathological changes causing tunnel syndrome
Treatment
- Conservative - the first stage of treatment, at the beginning of the development of pain syndrome. This type of treatment includes NSAIDs, immobilization with special splints, injection of hydrocortisone drugs
- Surgical treatment - decompression of the nerve leads to an immediate cessation of characteristic symptoms and the process of nerve damage
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Epidemiology
Tunnel neuropathies account for up to 40% of all diseases of the peripheral nervous system.
People of the most working age – 30-50 years – are most often affected.
The most common tunnel syndromes: