Nerve entrapment syndromes occur when peripheral nerves become compressed at specific anatomical locations, causing pain, numbness, and weakness. Understanding these conditions can help you recognize symptoms early and seek appropriate treatment. At M.O. Therapy in Markham, we help patients with nerve entrapment through comprehensive conservative care.
Understanding Nerve Entrapment
What Is Nerve Entrapment?
Nerve entrapment occurs when a nerve becomes compressed or irritated as it passes through a narrow anatomical space.
Key Features:
- Compression at specific sites
- Symptoms follow nerve distribution
- May be acute or chronic
- Often responds to conservative treatment
Common Causes
Anatomical:
- Narrow tunnels or passages
- Bone spurs
- Thickened ligaments
- Ganglion cysts
Acquired:
- Repetitive movements
- Prolonged positions
- Trauma
- Swelling/inflammation
- Pregnancy
- Systemic conditions (diabetes, thyroid)
Upper Extremity Nerve Entrapments
Carpal Tunnel Syndrome
The most common nerve entrapment
Anatomy:
- Median nerve compressed at wrist
- Passes through carpal tunnel
- Tunnel formed by carpal bones and transverse carpal ligament
Risk Factors:
- Repetitive hand use
- Pregnancy
- Diabetes
- Thyroid disorders
- Rheumatoid arthritis
- Obesity
Symptoms:
- Numbness/tingling in thumb, index, middle fingers
- Pain in hand and wrist
- Night symptoms common (waking with numbness)
- Weakness of thumb
- Dropping objects
Treatment:
- Wrist splinting (especially at night)
- Activity modification
- Nerve gliding exercises
- Physiotherapy
- Corticosteroid injection (if needed)
- Surgery (if conservative fails)
Cubital Tunnel Syndrome
Second most common upper extremity entrapment
Anatomy:
- Ulnar nerve compressed at elbow
- Runs through cubital tunnel
- "Funny bone" nerve
Risk Factors:
- Prolonged elbow flexion
- Leaning on elbows
- Previous elbow injury
- Repetitive elbow use
Symptoms:
- Numbness/tingling in ring and little fingers
- Pain at inner elbow
- Weakness of grip
- Hand clumsiness
- Worse with elbow bent
Treatment:
- Avoid elbow flexion
- Elbow pad protection
- Night splinting
- Nerve gliding exercises
- Activity modification
- Surgery (if severe/progressive)
Radial Tunnel Syndrome
Anatomy:
- Radial nerve or posterior interosseous nerve
- Compressed near elbow
- Often confused with lateral epicondylitis
Risk Factors:
- Repetitive forearm rotation
- Forceful gripping
- Direct trauma
Symptoms:
- Pain on outer forearm
- Aching rather than sharp
- May have finger/wrist extension weakness
- Tender over radial tunnel
Treatment:
- Activity modification
- Splinting
- Physiotherapy
- Anti-inflammatory measures
- Surgery (rarely needed)
Thoracic Outlet Syndrome
Anatomy:
- Brachial plexus and vessels
- Compressed between collarbone and first rib
Symptoms:
- Arm pain and numbness
- Weakness
- Cold or discolored hand (vascular)
- Worse with arm elevation
Treatment:
- Posture correction
- Stretching (especially scalenes, pec minor)
- Strengthening
- Ergonomic modifications
Lower Extremity Nerve Entrapments
Piriformis Syndrome
Anatomy:
- Sciatic nerve compressed by piriformis muscle
- In deep buttock
Symptoms:
- Buttock pain
- Radiating leg pain
- Worse with sitting
- Pain with hip rotation
Treatment:
- Piriformis stretching
- Hip strengthening
- Manual therapy
- Activity modification
Peroneal Nerve Entrapment
Anatomy:
- Common peroneal nerve at fibular head
- Just below outer knee
Risk Factors:
- Leg crossing
- Prolonged kneeling
- Cast/brace pressure
- Weight loss
- Trauma
Symptoms:
- Numbness on outer lower leg and foot top
- Foot drop (weakness lifting foot)
- Slapping gait
Treatment:
- Avoid pressure on outer knee
- Protective padding
- Ankle-foot orthosis (if foot drop)
- Strengthening exercises
Tarsal Tunnel Syndrome
Anatomy:
- Posterior tibial nerve at inner ankle
- Passes through tarsal tunnel
Symptoms:
- Burning/tingling in sole of foot
- Worse with standing/walking
- Night symptoms
- May radiate up calf
Treatment:
- Supportive footwear
- Orthotics
- Activity modification
- Night splinting
- Anti-inflammatory measures
Meralgia Paresthetica
Anatomy:
- Lateral femoral cutaneous nerve
- Compressed at groin/upper thigh
Risk Factors:
- Tight clothing/belts
- Pregnancy
- Obesity
- Prolonged standing
Symptoms:
- Burning/numbness on outer thigh
- No weakness
- Worse with standing/walking
Treatment:
- Loose clothing
- Weight management
- Avoid prolonged standing
- Usually self-limiting
Diagnosis
Clinical Examination
Components:
- Symptom pattern analysis
- Nerve distribution knowledge
- Provocative tests (Tinel's, Phalen's)
- Strength testing
- Sensory examination
- Comparison to other conditions
Electrodiagnostic Studies
Nerve Conduction Studies:
- Measures nerve function
- Identifies location of compression
- Assesses severity
- Guides treatment decisions
EMG (Electromyography):
- Evaluates muscle function
- Shows nerve damage
- Helps with prognosis
Imaging
Ultrasound:
- Visualizes nerve
- Shows compression
- Dynamic assessment
MRI:
- Detailed imaging
- Identifies masses or abnormalities
- Less commonly needed
General Treatment Principles
Conservative Management
Activity Modification:
- Identify aggravating factors
- Modify or avoid triggers
- Ergonomic changes
- Postural adjustments
Positioning:
- Avoid positions that compress nerve
- Splinting/bracing
- Ergonomic supports
Nerve Gliding Exercises:
- Gentle nerve mobilization
- Reduces adhesions
- Improves nerve mobility
- Done carefully, not forcefully
Manual Therapy:
- Soft tissue work around nerve
- Joint mobilization
- Improve tissue mobility
Medications
Options:
- Anti-inflammatory medications
- Nerve pain medications
- Corticosteroid injections (specific sites)
Surgery
When Considered:
- Failed conservative treatment
- Progressive weakness
- Significant nerve damage
- Muscle wasting
Exercise and Prevention
Nerve Gliding Exercises
General Principles:
- Gentle movements
- Not painful
- Done regularly
- Specific to affected nerve
Median Nerve Glide:
- Arm at side, elbow bent
- Extend wrist and fingers
- Straighten elbow
- Tilt head toward then away
- Smooth, gentle movements
Ulnar Nerve Glide:
- Arm at side
- Make fist, flex wrist
- Bend elbow
- Extend and rotate arm
- Gentle oscillations
Strengthening
Around Affected Area:
- Strengthen supporting muscles
- Address imbalances
- Improve joint stability
Stretching
Flexibility Work:
- Address tight structures
- Reduce tension on nerves
- Maintain mobility
Ergonomics
Workplace:
- Neutral wrist position
- Elbow support
- Regular breaks
- Proper equipment setup
Treatment at M.O. Therapy
Physiotherapy
Our physiotherapists provide:
Assessment:
- Comprehensive nerve testing
- Functional evaluation
- Contributing factor identification
Treatment:
- Nerve gliding exercises
- Manual therapy
- Strengthening program
- Ergonomic education
Massage Therapy
Our RMTs help with:
- Soft tissue around nerves
- Reducing muscle tension
- Improving circulation
- Pain management
Chiropractic Care
May include:
- Joint assessment
- Mobility optimization
- Soft tissue therapy
- Postural correction
Frequently Asked Questions
How long does nerve entrapment take to heal? Recovery time varies by severity. Mild cases may improve in weeks with conservative treatment. Moderate cases may take several months. Severe cases with significant nerve damage may take longer or require surgery.
Can nerve damage from entrapment be permanent? If treated early, most nerve entrapments recover fully. Prolonged, severe compression can cause permanent damage, which is why early treatment is important.
Do nerve gliding exercises work? Yes, nerve gliding exercises are evidence-based and effective for many entrapment syndromes. They help reduce adhesions and improve nerve mobility when done correctly.
When should I consider surgery for nerve entrapment? Surgery is typically considered when conservative treatment fails after 3-6 months, when there's progressive weakness, or when there's significant nerve damage on testing.
Book Your Assessment
If you're experiencing symptoms of nerve entrapment, M.O. Therapy in Markham can help. Our team will assess your condition and develop an appropriate treatment plan.
Call (905) 201-5827 or book online for your assessment. We offer direct billing and same-day appointments.