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Understanding Peripheral Nerve Injuries: Causes, Symptoms, and Physiotherapy

Peripheral nerve injuries (PNIs) occur when the nerves outside the brain and spinal cord are damaged. These nerves are responsible for movement, sensation, and other vital functions.

 

When injured, they can cause pain, weakness, or numbness, often limiting daily activities. Physiotherapy can help patients recover and regain their function.

A very simplified nervous system

Causes of Peripheral Nerve Injuries

Peripheral nerve injuries can happen due to several reasons, with the most common being:

  1. Stretch-Related Injuries
    • Caused by excessive pulling or traction on the nerve.
    • The nerve may stretch without tearing, but severe cases can result in complete tears.
  2. Lacerations
    • Caused by sharp objects, like knives or broken glass, partially or fully severing the nerve.
  3. Compression Injuries
    • Pressure on nerves from prolonged positions or repetitive activities.
    • Examples include carpal tunnel syndrome or Saturday Night Palsy.

Other causes include metabolic disorders like diabetes, infections, or trauma from accidents.

Classification of Peripheral Nerve Injuries

  1. Mild (Neuropraxia):
    • Temporary compression of the nerve, leading to tingling or weakness.
    • Recovery is quick and usually complete.
  2. Moderate (Axonotmesis):
    • Damage to the inner nerve fibers, causing muscle weakness and sensory loss.
    • Recovery with physiotherapy takes longer but is often achievable.
  3. Severe (Neurotmesis):
    • Complete disruption of the nerve, leading to loss of function.
    • May require a combination of physiotherapy and surgical intervention for recovery.

Symptoms of Peripheral Nerve Injuries

The symptoms depend on the type and severity of the injury but commonly include:

  • Tingling or numbness: Gradual loss of sensation in hands or feet, spreading upward.
  • Weakness or paralysis: Difficulty moving affected limbs.
  • Pain: Sharp, throbbing, or burning sensations.
  • Coordination issues: Problems with balance or fine motor tasks.

Physiotherapy Management of Peripheral Nerve Injuries

Physiotherapy is a key component of recovering from peripheral nerve injuries. A customized treatment plan helps patients regain nerve function, move the affected muscles and joint, improve mobility and function while preventing further complications.

  1. Restoring nerve function and muscle strength
  2. Nerve stimulation: Can help improve the function in the affected nerve and help reduce peripheral nerve related pain, while improving muscle strength
  3. Passive and Active Range of Motion (ROM) Exercises: These exercises help maintain flexibility and prevent stiffness.
  4. Support Devices: Slings or splints may assist in positioning and reducing strain on affected muscles.
  5. Sensory Re-education- Physiotherapy focuses on retraining the brain to respond to sensory inputs.
  6. Functional Rehabilitation- Functional exercises, like balance and coordination training, help patients regain independence. Upper body tasks may include fine motor skills, while lower body work focuses on walking and stability.
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In Summary

Peripheral nerve injuries can be quite challenging to deal with; it is important to have a full range of specialists on your team. If you are experiencing any symptoms, you should chat about your condition with your physiotherapist or family doctor as soon as possible!

We specialize in neurological rehabilitation of peripheral nerve issues. If you have any questions or need to see us, please get in touch!

About the author

Arjun Patel, PT, MScPT, MCPA is an orthopedic, neuro, and vestibular physiotherapist. He is the director of Blue Space Clinic Physiotherapy and sees complex cases on a daily basis. He is also an adjunct lecturer at the faculty of medicine at University of Toronto.

To learn more about Arjun and our clinic, click here!

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