Nowadays, many people visit the practice due to pain in certain areas of the upper and lower limbs. Online work involves sitting for long hours in non-ergonomic postures, causing compressions of the different nerves that run through anatomical channels and can cause a decrease or absence of sensitivity and movement problems when it becomes chronic, even paralysis of some region or the entire limb if not treated on time.

“At least twenty to twenty-three Canalicular Syndromes or nerve entrapment syndromes are known and described, both in lower and upper limbs, the latter being more frequent”, says Dr. Raúl Gutiérrez, a specialist in Orthopedic Surgery and Traumatology at Clínica Ricardo Palma

Among the known canalicular syndromes, only compression of three nerves is common:

Upper limbs:

• The median nerve in the carpal tunnel at wrist level: This causes sensitivity and mobility disorders in the hand and fingers, which is described as Carpal Tunnel Syndrome.
• The ulnar nerve at the elbow: Caused by the constant flexion of the elbow in many cases, and in others, by inflammatory, degenerative, post-traumatic pathologies or injuries that limit its mobility.

Lower limbs:

• The interdigital nerve, especially in the third metatarsal space, which is known as Morton’s Neuroma. This occurs due to thickening of the transverse metatarsal ligament that compresses this nerve.

How is it diagnosed?

The diagnosis of the other compression syndromes can be complicated in some cases. Therefore, it is important to perform an exhaustive clinical history and Electroneurography (ENG) studies, which indicate the site and intensity of compression. In more severe cases, which present signs of motor denervation, loss of sensitivity or movement of the regions that depend on the different nerves, Electromyography (EMG) is performed, in addition to motor tests, diagnostic tests and magnetic resonance imaging.

Treatment

If there are no motor disorders or muscle atrophy, initial treatment should be conservative. If unsuccessful, a surgical treatment will have to be performed

Conservative treatment:

• Anti-inflammatories
• Vitamin B Complex
• Immobilization with night splints that relax the flexion position
• Infiltration with anesthetics and corticosteroids
• Ortho podiatric treatment, which corrects or compensates for poor plantar support

Surgical treatment:

It is performed by External Neurolysis to release the nerve from the structures that compress it

Remember that at Clínica Ricardo Palma we have an excellent staff of specialists in Orthopedic Surgery and Traumatology with specialized units in hip and pelvis, spine, shoulder, upper limb, hand and wrist, foot and ankle, trauma and fractures, knee, pediatric orthopedics and oncological orthopedics

Dr. Raúl Gutiérrez
Orthopaedic Surgeon at Clínica Ricardo Palma