Entrapment neuropathy is a term describing a type of neuropathy that is rather commonly encountered in clinical practice (carpal tunnel syndrome is one of the examples) and results from either compression, traction or structural impairment of the nerve [1] [2] [3]. As the nerve becomes compressed or "entrapped" in tissues after trauma or some other form of injury, the blood supply to the nerve is diminished, eventually causing edema, ischemia, necrosis and death of neuronal tissue if the structural deformity is not repaired promptly [4] [5]. During this process, typical symptoms of neuronal injury arise, such as pain, paresthesia, and numbness [1]. Depending on the affected nerve, both sensory and motor deficits can be observed. For example, deltoid weakness indicates axillary nerve entrapment; restriction of wrist flexion is present in the setting of median nerve compression, whereas loss of sensation in the dorsal proximal areas of the index finger, middle finger and the thumb suggests radial nerve entrapment [1] [2]. It must be noted that several nerves could be entrapped at more than one anatomical location, which is why recognizing associated signs and symptoms is pivotal for identifying the affected nerve [1] [2] [6]. The appearance of symptoms can be abrupt or slowly progressive [1].

• Severe Pain

  If symptoms persist or pain is severe, see your doctor. You may need one or more types of treatment to shrink swollen tissue around the nerve. [webmd.com]

  spontaneous tingling or burning pain, or skin allodynia (severe pain from normally nonpainful stimuli, such as light touch); and autonomic neuropathy may produce diverse symptoms, depending on the affected glands and organs, but common symptoms are [en.wikipedia.org]

  It can be caused by pain receptors firing spontaneously without any known trigger, or by difficulties with signal processing in the spinal cord that may cause you to feel severe pain (allodynia) from a light touch that is normally painless. [ninds.nih.gov]

• Limb Pain

  Página 212 - Jensen TS, Krebs B, Nielsen J, Rasmussen P: Immediate and longterm phantom limb pain in amputees — incidence, clinical characteristics and relationship to pre-amputation limb pain. Pain 21:267278, 1985. ‎ [books.google.es]

• Painter

  […] motion Scapular fractures or other direct trauma Posttraumatic calcification of the suprascapular ligament Adduction and internal rotation caused stretching of the suprascapular nerve underneath the spinoglenoid ligament 14 Overhead activities (e.g., painters [musculoskeletalkey.com]

• Abdominal Pain

  Other causes of abdominal pain and the evaluation of patients with abdominal pain are discussed in detail, separately. (See "Causes of abdominal pain in adults" and "Evaluation of the adult with abdominal pain" .) [uptodate.com]

  ACNES Anatomy (www.aerzteblatt.de) Definition: Abdominal cutaneous nerve entrapment syndrome (ACNES) is an under recognized cause of chronic abdominal pain. [coreem.net]

  Summary Epidemiology Around 20% of patients with chronic abdominal pain have abdominal wall pain, which is often caused by ACNES. The prevalence in patients alleged to have functional abdominal pain is estimated to be 3-4%. [orpha.net]

  Up to 30% of patients with chronic abdominal pain have pain originating in the abdominal wall 1, 2 and abdominal cutaneous nerve entrapment syndrome (ACNES) is the most frequent cause of pain in these cases. 3 This diagnosis can be established from the [academic.oup.com]

• Diarrhea

  If the nerves serving the organs are involved, diarrhea or constipation may result, as well as loss of bowel or bladder control. Sexual dysfunction and abnormally low blood pressure also can occur. [webmd.com]

  Symptoms may include problems with blood pressure, voiding, passage of stools ( diarrhea, or constipation ), heart rate, or sweating. Cranial neuropathy is similar to peripheral neuropathy, except that the cranial nerves are involved. [medicinenet.com]

• Muscular Atrophy

  Inspection should focus on limb asymmetry, muscular atrophy, or abnormal posture (both spinal and peripheral). [physio-pedia.com]

  Inspection may reveal atrophy of the supraspinatus, infraspinatus, or both.6 If the atrophy is localized to the infraspinatus, it becomes more likely that the entrapment is distal to the suprapinatus branch, possibly at the spinoglenoid notch. [healio.com]

• Myalgia

  […] vasculitis and subsequent ischemia or nerve infarction) Asymmetric vs stocking-glove Edema leading to compression/entrapment The typical signs of systemic lupus erythematosus are butterfly rash, fatigue, alopecia, pericarditis/pleuritis, kidney failure, and myalgia [spineuniverse.com]

• Kidney Failure

  Many other diseases and conditions can cause peripheral neuropathy, for example, drugs, diabetes, shingles, kidney failure, and vitamin deficiency. [medicinenet.com]

  Polyneuropathy can have a wide variety of causes, including exposure to certain toxins such as with alcohol abuse, poor nutrition (particularly vitamin B deficiency), and complications from diseases such as cancer or kidney failure. [webmd.com]

  failure, porphyria, amyloidosis, liver failure, hypothyroidism Toxic causes: drugs ( vincristine, metronidazole, phenytoin, nitrofurantoin, isoniazid, ethyl alcohol, statins ), [ medical citation needed ] organic herbicides TCDD dioxin, organic metals [en.wikipedia.org]

• Tingling

  Pain is less common than tingling or numbness as a symptom of nerve entrapment, although a burning sensation, if it occurs, may (subjectively) be classified as pain. [en.wikipedia.org]

• Paresthesia

  Entrapment neuropathy is a rather common type of nerve injury in which mechanical factors lead to compression of the nerve and subsequent appearance of pain, paresthesias, and associated muscle abnormalities. [symptoma.com]

  When evaluating patients with unilateral leg pain and paresthesias, one should consider the possibility of entrapment of peripheral nerve. Electrodiagnostic studies are helpful in establishing the diagnosis. [ncbi.nlm.nih.gov]

• Polyneuropathy

  Polyneuropathy was diagnosed in 45 subjects (70%). UNE was detected in 22 patients (34%) (4 did not have polyneuropathy), in the abductor digiti minimi in 16, the first interosseus in 14 and in both in 8. [ncbi.nlm.nih.gov]

  Of the many patterns of peripheral nerve disorders in diabetes mellitus (DM), isolated clinical involvement of single nerves, though less common than distal symmetric polyneuropathy and perhaps polyradiculoneuropathy, constitute an important collection [mayoclinic.pure.elsevier.com]

• Peripheral Neuropathy

  Rheumatoid Arthritis Peripheral neuropathy associated with rheumatoid arthritis was described by Lisak in 2014. Peripheral neuropathy occurs in 10% of patients with rheumatoid arthritis. [spineuniverse.com]

  Peripheral neuropathy definition and facts Peripheral neuropathy is a condition in which the nerves in the peripheral nervous system become damaged. Peripheral neuropathy symptoms and signs depend upon the cause. [medicinenet.com]

  In the future, the molecular bases of peripheral neuropathies and motor neuron diseases should be determined not only in cultured cells but also in human nerves in vivo. [ncbi.nlm.nih.gov]

  Peripheral neuropathy, often shortened to neuropathy, is a general term describing disease affecting the peripheral nerves, meaning nerves beyond the brain and spinal cord. [en.wikipedia.org]

• Radiculopathy

  This entrapment neuropathy remains poorly diagnosed and it might be misleading when performing a diagnostic EMG-ENG examination for suspected polyneuropathy or lumbosacral radiculopathy. [ncbi.nlm.nih.gov]

  This is one of the key distinctions between the saphenous nerve neuropathy and lumbar radiculopathy. [dynamicchiropractic.com]

  Entrapment neuropathies of the upper limb Clinical reasoning of neuropathic pain Thoracic outlet syndrome: Clinical presentation A neurodynamic approach to treatment A scapula mechanics approach to treatment Carpal tunnel syndrome Cervical radiculopathy [raynersmale.com]

A delayed diagnosis of entrapment neuropathy and nerve compression may lead to irreversible neuronal injury and cause a significant impairment in daily life, thus early recognition of this clinical entity is of absolute necessity [3] [6]. One of the first steps toward the diagnosis is a detailed patient history that will determine the duration of symptoms and their severity, followed by a thorough physical examination, perhaps the pivotal part of the diagnostic workup [1] [6]. Depending on the cause and location of symptoms, a complete motor evaluation of muscle groups and the sensorium in the areas where the patient reports pain, paresthesias, or numbness, is the mainstay in revealing which nerve is injured [1] [6]. A presumptive diagnosis might be made solely on clinical findings, but imaging and electrophysiologic studies are highly useful in confirming entrapment neuropathy. Plain radiography, although important in delineating skeletal injuries as potential causes, is of no use in assessing nervous tissues [1]. For this reason, ultrasonography (US) and magnetic resonance imaging (MRI) are recommended but are not equally effective for all anatomical sites [1] [2] [6] [7]. A hypoechogenic appearance of the nerve, as well as edema, thickening, and fatty atrophy of the muscles supplied by the injured nerve, are frequent findings on US, whereas swelling and hyperintensity are seen on MRI studies [1] [4] [7]. Conversely, electromyography (EMG) and nerve conduction studies are often used in the setting of peripheral nerve injury and provide important clues in discerning between peripheral and central nerve injuries [1] [6].

Below, we describe the decision making process for the diagnosis and treatment of his pudendal neuropathy. [ncbi.nlm.nih.gov]

Surgical treatment of superior cluneal nerve entrapment neuropathy. J Neurosurg Spine. 2013. 19: 71-5 [surgicalneurologyint.com]

Each of these groups of mononeuropathies has its own ensemble of epidemiologic patterns, clinical presentations, laboratory and radiologic findings, differential diagnosis, management principles and prognosis. [mayoclinic.pure.elsevier.com]

EMG and nerve conduction studies are typically performed to diagnose the extent and distribution of the damage, and to help with prognosis for recovery. [en.wikipedia.org]

However, the little research that has been done to determine the prognosis for individuals who have undergone surgery has focused on the patency rate of the arteries after surgery and the presence or absence of complications. [ncbi.nlm.nih.gov]

Prognosis [ 11 ] Duration of entrapment and severity of numbness and muscle weakness are important factors in prognosis. Mild cases may resolve without treatment. With early appropriate decompression the result should be a return to normal function. [patient.info]

Treatment and prognosis Acute limb-threatening thrombosis requires urgent bypass surgery. Intermittent occlusion can usually be cured with the release of the popliteal artery alone or with saphenous vein bypass 2. [radiopaedia.org]

Lastly, the etiological structure may be the descriptor, such as pronator teres syndrome. [fadavispt.mhmedical.com]

CONCLUSION: This prospective study depicts the etiologic factors, ultrasonographic features and treatment protocol of MSCNE which is usually an underestimated cause of the low-back pain. [ncbi.nlm.nih.gov]

Common etiologies include posttraumatic fibrosis due to fracture, tenosynovitis, ganglion cysts (Figure 20), space-occupying lesions, and dilated or tortuous veins. [hindawi.com]

Each of these groups of mononeuropathies has its own ensemble of epidemiologic patterns, clinical presentations, laboratory and radiologic findings, differential diagnosis, management principles and prognosis. [mayoclinic.pure.elsevier.com]

Popliteal artery ICD-10 codes A- initial encounter D- subsequent encounter S- sequela Popliteal Artery Entrapment Syndrome ICD-9 904.4 Injury to blood vessels of lower extremity; popliteal blood vessels Popliteal Artery Entrapment Syndrome Etiology / Epidemiology [eorif.com]

Summary Epidemiology Around 20% of patients with chronic abdominal pain have abdominal wall pain, which is often caused by ACNES. The prevalence in patients alleged to have functional abdominal pain is estimated to be 3-4%. [orpha.net]

EPIDEMIOLOGY The estimated incidence of abdominal wall pain is 1 in 1800 individuals [ 8 ]. [uptodate.com]

Therefore, cumulatively, only 69 of our 12,736 cases of CTS and UN-E satisfied the pathophysiologic and one of the anatomic requirements of the DCH. [n.neurology.org]

Published on Dec 5, 2016 Annina Schmid is a Physiotherapist and associate professor whose research focusses on advancing our understanding of the pathophysiology of entrapment neuropathies to ultimately improve management of these patients. [youtube.com]

|Subscribe on iTunes| Session 36 – Moving Beyond ‘Trapped Nerves’ – Entrapment Neuropathy with Annina Schmid Annina Schmid is a Physiotherapist and associate professor whose research focusses on advancing our understanding of the pathophysiology of entrapment [chewshealth.co.uk]

The pathophysiological changes following nerve compression 8 – 21 are dependent on the degree, rate, and duration of compression. [clinicalgate.com]

Pathophysiology of nerve compression. Hand Clin. 18(2): 231-41. ↑ Tapadia, M., Mozaffar, T., & Gupta, R. (2010). Compression neuropathies of the upper extremity: update on pathophysiology, classification, and elecrodiagnostic findings. [physio-pedia.com]

A thorough understanding of the anatomy of these nerves can prevent stapling in the areas of danger and thus greatly reduce the incidence of this complication. [ncbi.nlm.nih.gov]

Prevention Changing physical activities can often help reduce the injury, when nerve entrapment injuries are caught early. [minneapolisclinic.com]

Home remedies and prevention There are lots of things a person who has ulnar nerve entrapment can do at home to promote healing and recovery. These same steps can also prevent ulnar nerve entrapment from recurring or happening in the first place. [medicalnewstoday.com]

My staff and I at the Nebraska Hand & Shoulder Institute, P.C. believe that prevention and elimination of painful or debilitating conditions of the upper and lower extremities can consistently be achieved. [carpaltunnelrelief.net]

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2. Miller TT, Reinus WR. Nerve entrapment syndromes of the elbow, forearm, and wrist. AJR Am J Roentgenol. 2010;195(3):585-594.
3. Choi S-J, Ahn JH, Ryu DS, et al. Ultrasonography for nerve compression syndromes of the upper extremity. Ultrasonography. 2015;34(4):275-291.
4. Deniel A, Causeret A, Moser T, Rolland Y, Dréano T, Guillin R. Entrapment and traumatic neuropathies of the elbow and hand: An imaging approach. Diagn Interv Imaging. 2015;96(12):1261-1278.
5. Kobayashi S, Meir A, Baba H, Uchida K, Hayakawa K. Imaging of intraneural edema by using gadolinium-enhanced MR imaging: experimental compression injury. AJNR Am J Neuroradiol. 2005;26(4):973-980.
6. Fox IK, Mackinnon SE. Adult Peripheral Nerve Disorders—Nerve Entrapment, Repair, Transfer and Brachial Plexus Disorders. Plast Reconstr Surg. 2011;127(5):10.1097/PRS.0b013e31820cf556.
7. Lawande AD, Warrier SS, Joshi MS. Role of ultrasound in evaluation of peripheral nerves. Indian J Radiol Imaging. 2014;24(3):254-258.