Peripheral nerve injury

Human nervous system is divided into three parts-

  1.  Central nervous system
  2.  Autonomic nervous system
  3.  Peripheral nervous system
Central nervous system consists of brain and spinal cord.

Autonomic nervous system is consists of parasympathetic and sympathetic nervous system.

Peripheral nervous system consists of peripheral nerves includes the cranial and spinal nerves.
There are total 43 peripheral nerves. Twelve pairs of Cranial nerves, originates from hind brain and 31 pairs of spinal nerves which originates from spinal cord.
Peripheral nerves connects the body periphery to the higher centers through theses motor and sensory nerves.

Peripheral Neuropathy        

When the peripheral nerves disrupted for the normal functioning because of following conditions-
  • an injury
  • any infection
  • autoimmune disorder
  • inherited disorder

Symptoms of Peripheral Neuropathy

Symptoms depends upon the types of nerve injured-
  • Spinal nerves which carry sensation from organs to the higher centers.
  • Motor nerves which carry motor impulses to the organs from the higher centers.
  • Autonomic nerves supply to the internal visceral organs.

Symptoms-

  • sharp and stabbing pain
  • tingling sensation
  • numbness in hands and feet
  • sensory loss
  • muscular atrophy
  • altered blood pressure
  • abnormal sweating
  • changing of vitals- heart rate, respiratory rate
  • digestive dysfunction
  • diarrhea
  • sexual dysfunction

Causes of Peripheral Neuropathy 

(1) Generalized diseases-  

some of the chronic disorders which causes the injury to the peripheral nerves after long period of time like diabetes, obesity, hypertension, renal diseases, thyroid disorders etc.
  • 60% of nerve injury is caused by the high blood sugar level in blood.
  • In obesity excess muscle mass and fluid retention creates pressure over the nerves.
  • In renal diseases high amount of toxins build up in the body that damages the nerve fibers.
  • Deficiency of multivitamins- vitB1, vitB6, vitB12 leads to weaknining of neural tissues.

(2) Trauma 

Physical trauma is major cause of nerve injury by road traffic accident, fall from height, violence, gun shoot, cut or burn.
Example-  Injury to radial nerve causes the radial nerve palsy.
Compression injury to median nerve causes the carpel tunnel syndrome.

(3) Autoimmune disorders and infections-  

Certain pathogens directly attacks the nerve fibers such as some virus such as herpes simplex virus, Epstein-Barr virus, shingles, chicken pox, HIV or AIDS. Some bacteria- staphylococcus aureus causes Gullian barre syndrome, lyme disease.

(4) Medications-      
Some of the medication in which excess use causes the peripheral neuropathy- 
Antihypertensive drugs, Cancer drugs, Antibiotics, Anticonvulsants.

Diagnosis of Peripheral Neuropathy

Diagnosis of peripheral neuropathy is based on the physical examination, medical history and pathological investigation.
  • Blood test- blood sugar, thyroid functions, multivitamins.
  • MRI and CT scan
  • Nerve biopsy or nerve conduction velocity

Treatment/medications of Peripheral Nerve Injury
  • Treatment of the neuropathy depends upon the type of cause. According to that treatment is planned. If patient is diabetic, blood sugar level should be controlled or other autoimmune disorder should be moderated.
  • Some of the medications prescribed to control the pain of nerves. Theses includes the narcotics, antiepileptic medicines, antidepressants.

Peripheral nerve injury Physiotherapy Management

  • Physiotherapy treatment also works good in peripheral neuropathy. 
  • Transcutaneous electrical stimulation (TENS), Interferential therapy(IFT) and supportive devices such as splints support the part of the body that is affected and uncomfortable.
  • Splints used in radial nerve palsy is cockup splint, in brachial plexus injury aero-plane splint is used.
  • Self care is also important part of management dropping of personal habits such as smoking, drinking, tobacco aggravates nerve pain.
  • Do exercise daily and maintain self hygiene. Always wear gloves, shoes to protect the hands and feet.
  • Eating should be healthy includes the multivitamins, calcium, and full of minerals. 

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