Peripheral Nerve Compression

If you experience tingling, numbness or weakness in your hands, arms, legs or feet, it could be a sign of peripheral compression neuropathy. This condition happens when a nerve outside the brain or spinal cord is compressed or squeezed.

Peripheral compression neuropathies can make everyday activities more difficult. You may find it difficult to grip objects, button your shirt or walk without discomfort. Banner Health is here to help you understand what’s going on and find treatments to relieve your symptoms.

What is peripheral compression neuropathy?

Peripheral nerves carry messages between your brain, spinal cord and the rest of your body. Each nerve controls different sensations and movements. 

Compression neuropathies happen when a nerve is compressed or trapped by nearby tissue, like bones, muscles, tendons or ligaments. This pressure slows or blocks the nerve’s ability to send signals. As a result, it can cause pain, weakness or numbness in the area it controls. 

These conditions are sometimes called:

• Compressive neuropathies
• Entrapment neuropathies
• Nerve compression syndromes
• Nerve entrapment syndromes

Lesser-known types of peripheral nerve compression

While carpal tunnel syndrome (compression of the median nerve at the wrist) and cubital tunnel syndrome (compression of the ulnar nerve at the elbow) are more common, many people experience other, less familiar types of nerve compression. 

These conditions often depend on the type of nerve involved and the location in the body where the pressure is occurring. 

Some lesser-known conditions include:

• Pronator teres syndrome: Compression of the median nerve at the elbow or forearm.
• Radial nerve compression (radial tunnel syndrome): Pressure on the radial nerve in dorsal aspect of the forearm (top side closer to the elbow). There may be pain with wrist or finger extension. This can also occur in conjunction with lateral epicondylitis (tennis elbow).
• Thoracic outlet syndrome: Compression of nerves in your lower neck and upper chest. This compression can cause numbness in part or all of the hand and/or forearm. It can also cause a heavy feeling that is worse with overhead activities.
• Peroneal nerve entrapment: Pressure on the peroneal nerve near the knee or lower leg.
• Tarsal tunnel syndrome: Compression of the tibial nerve in your heel or the bottom of your foot.
• Sciatic nerve compression: Pressure on the sciatic nerve in the lower back, butt or leg.
• Suprascapular nerve entrapment: Compression of a nerve in the shoulder blade area.
• Anterior interosseous nerve syndrome: A rare compression of a branch of the median nerve in the forearm.

What causes nerve compression?

There are many reasons why a nerve might become compressed. It often affects nerves that travel through small openings (tunnels or canals) in your joints. 

Possible causes may include:

• Repetitive hand, arm or leg movements
• Sports injuries or accidents
• Fractures (broken bones) or dislocations that change the shape of joints or bones
• Bone spurs, tumors or cysts that press on a peripheral nerve
• Inflammation due to arthritis or swelling
• Inflammation that develops during a severe sickness in which a patient is hospitalized and needs to be resuscitated with IV fluids
• Conditions like diabetes, lupus or thyroid disease
• Obesity or fluid retention
• Infections like shingles, HIV, Lyme disease and viral illnesses
• Alcoholism
• Long periods of poor posture or putting pressure on a joint

In some cases, damage to the myelin sheath (the protective layer surrounding a nerve) can make the nerve more likely to become irritated or squeezed.

Who is at risk for compression neuropathies?

Anyone can develop nerve compression syndrome, but some people are more likely to experience it than others. 

You may be at higher risk if you:

• Perform repetitive motions, such as typing, using tools or playing sports (like tennis, golf, baseball)
• Have had an injury or surgery near a joint or nerve
• Spend long periods in positions that involve putting pressure on a nerve
• Have conditions like diabetes, rheumatoid arthritis or thyroid disorders
• Are pregnant or retain fluid, which can increase swelling around nerves
• Are overweight or have poor posture
• Have a family history of entrapment neuropathies
• Use crutches or have a cast or splint

Symptoms of peripheral compression neuropathy

Signs of nerve compression syndrome often depend on the nerve involved. 

Common symptoms include:

• Tingling or “pins and needles” feeling 
• Numbness in the hands, arms, legs or feet
• Burning or sharp pain
• Muscle cramping or twitching
• Muscle weakness, especially when trying to grip or lift
• Pain that worsens at night or with activity

Symptoms may come and go at first. Over time, they may become more frequent and more intense.

When should I see a health care provider?

If your symptoms last more than a few days or start to affect your daily activities, it’s time to see a health care provider. Waiting too long can lead to permanent nerve damage or long-term loss of movement. 

At Banner Health, we offer expert care from a team that understands compression neuropathies and can guide you toward the best treatment. Find a Banner Health specialist near you.

How do you diagnose peripheral nerve compression?

Your health care provider will review your symptoms, ask about your health history and perform a physical exam. They may check your strength, flexibility and ability to feel different sensations. 

Other tools include:

• Imaging tests: MRIs, neuromuscular ultrasounds or X-rays can help show where the nerve entrapment is happening and what may be causing it.
• Nerve conduction study (NCS) and electromyography (EMG): These tests measure how fast electrical signals move within your nerves and muscles.

Together, these tests can help locate the compressed nerve and decide on the best treatment approach. 

Treatment options for compressive neuropathies

Nerve entrapment syndromes are treated using both non-surgical and surgical options, depending on your symptoms and the cause of the nerve compression.

Non-surgical treatments

Most people begin with non-surgical care, especially if the nerve hasn’t been compressed for a long time. These treatments may include:

• Rest and activity changes: Avoiding movements that put pressure on the nerve
• Splints, orthotics or braces: To keep the joint in a position that reduces irritation
• Physical or occupational therapy: Guided exercises, including stretching and nerve flossing (gentle movements that help a nerve glide more freely), to reduce pain, improve flexibility and restore movement. 
• Nonsteroidal anti-inflammatory drugs (NSAIDs) and steroid injections: To relieve pain and reduce swelling

These approaches can often relieve symptoms and help prevent the need for surgery. 

Surgical options

If non-surgical treatments don’t improve symptoms or if the nerve compression is severe, surgery may be recommended. Surgery aims to release the compressed nerve and reduce pain or muscle weakness. 

Surgeons at Banner Health use minimally invasive techniques, which involve smaller incisions (cuts) and specialized tools, whenever possible. This often means a faster recovery, less pain and fewer complications.

What is the outlook for peripheral compression neuropathy?

Recovery depends on the type of treatment you receive, how long the nerves have been compressed and your overall health. Some people feel better right away. Others may take weeks or months to recover fully. 

After treatment, your health care provider may recommend:

• Follow-up visits to track your healing
• Therapy to rebuild strength, flexibility and coordination
• Lifestyle changes to prevent future issues

Take the first step toward relief

If you’re experiencing tingling, weakness or pain caused by nerve compression, we’re here to help. Banner Health offers personalized, expert care to diagnose and treat compression neuropathies before they lead to long-term damage.

Find a specialist near you or schedule an appointment today.