Tingling, Weakness, Pain: Could You Have Peripheral Nerve Injury?

John F. Hamilton, MD, PhD, is Medical Director of the Inova Peripheral Nerve Program, Co-Medical Director of the Inova Spine Program at Inova Fairfax Hospital, Section Chief of Neurosurgery at Inova Fairfax Hospital and is a physician in the Inova Neurosurgery practice. He is board-certified in neurological surgery.

If you’ve experienced numbness and pain in your fingers or toes, you might be tempted to wait it out to see if it gets better on its own. But those symptoms might indicate a peripheral nerve injury, also known as peripheral neuropathy.

There are dozens of types of peripheral nerve injuries, with various causes. In many cases, these injuries are caused by a nerve that’s compressed due to injury or repetitive movements (like typing or swinging a golf club). The longer these injuries go untreated, the worse they can get. And in some cases, if you wait too long to treat them, you can end up with permanent damage to your nerves.

If you’re concerned you might be experiencing signs of peripheral nerve injury, here’s what you should know.

Peripheral Nerves: What’s Their Function?

Nerves carry information to and from the brain. The spine and brain make up the central nervous system, while peripheral nerves connect the brain and spinal cord to the rest of the body. There are three types of peripheral nerves, each with an important function:

• Motor nerves send messages between the brain and muscles, allowing you to move your muscles.
• Sensory nerves send signals about feelings such as touch, temperature and pain.
• Autonomic nerves control automatic processes like heart rate, sweating and digestion.

Many nerve problems affect all three types of nerves, while some involve just one or two.

Types of Peripheral Neuropathy

There are many ways that peripheral nerves can be injured. They can be damaged as a result of diseases such as diabetes, blood vessel problems or autoimmune diseases. But when a single nerve is injured, the cause is usually some kind of trauma, compression or repetitive movement.

That nerve damage may happen suddenly, such as during a car accident or sports injury. Often, though, peripheral nerve injuries develop over time because of injuries or repetitive movements that compress the nerve. There are many examples, but some common ones include:

• Carpal tunnel syndrome. This occurs when one of the major nerves in the hand is compressed, causing tingling, numbness, pain and weakness in the hand and arm.
• Ulnar nerve entrapment. This condition occurs when the ulnar nerve in the arm becomes compressed either at the elbow or the wrist, causing pain, numbness and tingling in the hand and fingers.
• Peroneal nerve dysfunction. This condition occurs when the peroneal nerve in the leg becomes compressed, causing numbness and tingling in the foot or leg, and an inability to lift the foot.

Treating Peripheral Nerve Injuries

Some people with symptoms of peripheral nerve disorders might put off getting treatment because they want to avoid surgery. In reality, we try to manage the symptoms with conservative measures such as behavior modification or splinting, with the understanding that surgery is a last resort. But the longer symptoms go untreated, the more likely it is you’ll develop permanent damage to the nerves.

When nerves are being compressed, as in conditions like carpal tunnel syndrome or ulnar nerve entrapment, the first step is usually to cut back on the activity that’s causing the injury. That might mean taking some time off work, or finding workarounds (like improving the ergonomics of your workstation, or using voice memos instead of typing whenever possible). Doctors will usually recommend using a brace or splint on the injured area. Physical therapy may also help.

For mild to moderate cases, these treatments can often reverse the compression and restore the feeling and function to your damaged nerve. But in more severe cases, surgery may be the only option to relieve compression on the nerve.

Such surgeries usually improve pain right away. But it can take time for numbness to fade, and sometimes it doesn’t go away completely. If you’ve experienced atrophy in the muscles as a result of nerve injury, you may never fully recover your previous level of muscle endurance.

In other words, the sooner peripheral nerve injuries are treated, the better. You’ll be more likely to avoid surgery, and have a better long-term outcome, if you don’t put it off. The Inova Neuroscience and Spine Institute has an excellent peripheral nerve team specialized in treating these injuries.

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