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Complete Guide To Mononeuropathy

Mononeuropathy is a term that describes damage to a single nerve. Because of this damage, we may experience a loss of sensation, movement, or other nerve function. Generally, patients complain of tingling, prickling, a numbing sensation, or pain in a specific area. 

At times, this pain may radiate into other areas. In addition to other complaints, this condition can cause other complications such as weakness of hand muscles (in ulnar neuropathy), foot drop (in peroneal neuropathy), and wrist drop in case of radial neuropathy.

An Overview of Mononeuropathy 

External or internal compression can cause mononeuropathy. Entrapment, trauma, or compression of a peripheral nerve is the most common cause of mononeuropathy. In some cases, trauma leads to nerve lesions, whereas compression gradually leads to injury. Some other causes include endocrine and metabolic disorders such as hypothyroidism and diabetes mellitus. Other causes include:

  • Inflammation (vasculitis, neuralgic, amyotrophy)
  • Infection (leprosy, Lyme disease, HIV)
  • Toxins and drugs

Mononeuropathy involves the dysfunction or damage of a single peripheral nerve. Hence, it includes any spinal nerve, cranial nerve, or nerve branch, which connects the body’s central nervous system. Most mononeuropathies lead to sensory and motor impairment affecting the arms, hands, and feet.

The two most common mononeuropathies are carpal tunnel syndrome and cubital tunnel syndrome. Cubital tunnel syndrome is the neuropathy of the ulnar nerve, which sends sensations to the fourth and fifth fingers of our hands. It is also responsible for functioning the underside of the forearm and part of the palm. Peroneal nerve dysfunction is also a type of mononeuropathy that damages the peroneal nerve. This nerve is a branch of the sciatic nerve responsible for sending sensation and movement to the toes, lower leg, and foot.

The Difference between Polyneuropathy and Mononeuropathy 

Typically, the main difference between polyneuropathy and mononeuropathy is that the latter involves damage to one nerve. But in polyneuropathy, multiple nerves receive damage. However, both conditions are types of peripheral neuropathy. The accumulation of multiple mononeuropathies or mononeuritis multiplex makes it a bit complicated to differentiate it from polyneuropathy.

Major Causes of Mononeuropathy

In most cases, the underlying cause for most mononeuropathies with an acute presentation is difficult to define. That’s because they usually resolve rapidly, and there is no opportunity to plan an examination. 

Nevertheless, the most common reason is local nerve damage due to compression-related events, which are either fixed or transient.

When it comes to fixed mononeuropathies, they are mainly due to nerve compression against a hard surface. For example, a cast, a tumor, or prolonged cramps, due to surgery or hospitalization. Consequently, it could be due to a change in movement or sensation of the affected part of the body. 

In comparison, fixed mononeuropathies affect superficial nerves, such as the peroneal nerve, extending into the lower leg or the radial nerve that extends along the forearm. Fixed mononeuropathies are often present in thin individuals because of the direct compression of nerves against the bones. 

The constant pressure, causing fixed mononeuropathies, can gradually thin the myelin sheath or the protective covering of the nerve. We refer to this process as segmental demyelination. Persistent pressure can cut through the myelin sheath and damage the nerve axon. This condition is called Wallerian degeneration, which may also happen because of a local injury—for example, a deep cut through a nerve. 

Furthermore, when nerves present in narrow anatomical spaces get trapped, it leads to fixed mononeuropathies. For instance, carpal tunnel syndrome is when there is an entrapment of the median nerve. In addition to that, cubital tunnel syndrome occurs where there is an entrapment of the ulnar nerve.

Multiple risk factors can cause the entrapment of a nerve in an anatomical structure, for example, during hypothyroidism, pregnancy, and rheumatoid arthritis. Unlike fixed mononeuropathies, transient mononeuropathies are due to repetitive actions, which often lead to trauma. Generally, it is because of sudden overextension of a muscle or an aggressive muscular activity. 

Sometimes, mononeuropathies occur due to causes that do not relate to any type of compression at all. Infections localized to an individual nerve or exposure to radiation or cold can damage a single nerve. In rare cases, early HIV infection can lead to mononeuropathy through facial palsy. However, it improves within a short time.

Generally, the clinical presentation of mononeuropathy is according to its underlying cause and the affected nerve. All motor and sensory symptoms relate to the single nerve, which receives damage. While some presentations of mononeuropathies are very painful and abrupt, others may appear slowly and intensify over time. 

Fixed mononeuropathies have more persistent symptoms. But the symptoms of transient mononeuropathies are prominent with the motion of the damaged nerve.

People with mononeuropathy usually complain of numbness and paresthesia, which is a tingling sensation. You feel as if someone is inserting pins and needles in your hands or feet. Mononeuropathy also leads to a burning or stabbing sensation and pain. While it is rare to experience complete sensory loss, some individuals with this condition may experience this symptom. 

Motor symptoms, such as changes associated with movement, are usually present with this condition. Such symptoms may include atrophy or muscle weakness and the loss of muscle mass. Besides, some people may observe poor coordination of limbs. Sometimes, advanced nerve damage progresses to the loss or reduction of tendon reflexes. That means the muscles fail to contract right after the tendon is tapped.

How do you Get a Diagnosis for Mononeuropathy?

A doctor will review a patient’s medical history and conduct a physical exam to diagnose the condition. In case there’s any requirement for a neurological assessment, the doctor will suggest some other tests and exams. For example, Electrodiagnostic testing is a method that evaluates the electrical activity of nerves and muscles. A doctor cannot detect the changes due to mononeuropathy with physical examination alone. Hence, these tests help localize the nerve injury for assessing its severity and estimating the prognosis.

Treatment Methods for Mononeuropathy

It is crucial to diagnose the condition accurately before suggesting the right course of treatment. For most patients, mononeuropathies show mild symptoms which usually subside quickly. Heat application, anti-inflammatory drugs, adequate rest, and removal or avoidance of casual activity can help an individual manage the effects of mononeuropathy. In some cases, a doctor will immobilize the affected area using medical equipment to improve symptoms. They may suggest using braces or splints. 

Other treatment methods may include injected or oral corticosteroids and therapeutic ultrasounds to boost circulation, improve mobility, and reduce pain. 

The newest treatment for carpal tunnel syndrome is hydrodissection under ultrasound guidance. This process is nonsurgical and relieves tension through a solution for separating the damaged nerve from the nearby tissues.

Surgical decompression may help when traditional treatments fail to resolve the condition. For example, when a tumor applies external pressure to a nerve, conducting surgery is the only method to relieve this pressure. 

How to Treat Cubital Tunnel Syndrome

People who suffer from cubital tunnel syndrome experience pain that normal people feel when they hit the ‘funny bone.’ This funny bone in our elbow is the ulnar nerve, which crosses the elbow. This nerve begins from the side of the neck and ends in the fingers. 

Treatment Methods

Stopping the activity that causes pain in the ulnar nerve is the best way to treat the syndrome. For example, if driving or typing for prolonged periods leads to ulnar nerve pain, it’s best to give your elbow some rest. Here are some other effective remedies that can help you treat cubital tunnel syndrome. 

  • Wearing a splint or a foam elbow brace at night for limiting movement and reducing irritation
  • Protecting your elbow from hard surfaces by using an elbow pad
  • Consuming anti-inflammatory medicines, such as naproxen and ibuprofen
  • Performing nerve gliding exercises 
  • If none of these remedies work, your doctor may recommend surgery.

Prevention

Here are few steps to prevent cubital tunnel syndrome.

  • Keep your arms strong and flexible
  • Avoid resting your elbows on a hard surface
  • Warm-up using before playing sports or before exercise to reduce the chances of any injury
  • When to Seek Medical Help
  • Contact your healthcare provider if you experience:
  • Trouble or difficulty during walking or working
  • Pain that doesn’t go away
  • Tingling, numbness, or pain in the hand or arm

How to Treat Carpal Tunnel Syndrome 

Since carpal tunnel syndrome is the most common type of mononeuropathy, let’s take a look at how to treat it. There are many options available for treating carpal tunnel syndrome, from yoga to surgery.

But one thing to remember is that what works for your friend might not work for you. Hence, you will have to experiment with a few remedies and self-care practices to get relief.

The symptoms of carpal tunnel syndrome may appear gradually but get worse with time. Seeking early treatment is important to prevent the symptoms from getting worse.

Generally, affected individuals start with a few basic remedies, such as applying topical creams and wearing wrist braces. In rare cases, doctors recommend surgery to treat this condition.

Let’s review some easy ways to take care of carpal tunnel syndrome. 

Self-Care

A great way to ease the symptoms of carpal tunnel syndrome is to soak your wrist in an ice bath or put ice on your wrist. Try this tip for at least fifteen minutes, 10 to 15 minutes, once or twice a week. Shake your hand or wrist gently. Another way is to place the affected wrist in warm water. Keep the temperature up to 100 F. Flex and extend your hand and wrist after dipping the wrist in the warm water for at least ten minutes. Do this twice or thrice a day.

Don’t forget to give your wrist a break as much as possible. You can also take over-the-counter medicine for easing pain. These may include naproxen, ibuprofen, or aspiring. Remember that these methods offer temporary relief. So do not consider them as permanent ways to cure carpal tunnel syndrome. 

Wear Wrist Braces

Generally, braces work best when you are experiencing mild or moderate carpal tunnel syndrome. This remedy will not work for everyone. However, braces don’t have any side effects, so you can see if they provide you any relief. 

Wear wrist braces for at least three to four days to improve symptoms. Many doctors recommend wearing a wrist brace while sleeping to avoid bending the wrist. That’s because many people bend their wrists while sleeping, which worsens the symptoms. But you can wear the wrist during daytime activities that trigger flare-ups.

Steroids

Corticosteroids are strong drugs that are popular for reducing swelling. For example, cortisone reduces inflammation that causes pain and discomfort. In some cases, you can take these medicines as pills. Your doctor may also give it to you through a shot in the wrist, which goes directly into the carpal tunnel. Although injections can give you temporary relief, they are not long-term solutions. 

Occupational and Physical Therapy

A physical and occupational therapist can come in handy in various ways. These professionals may recommend stretching exercises for strengthening your wrist and hand muscles. They can also help you change your lifestyle and routine for easing stress on your wrists. For example, if you are a DIY crafter or someone who works on the computer for long hours, you can follow their tips to reduce symptoms and relieve pain.

Lifestyle Measures 

Here are a few changes you should make to your current lifestyle to avoid carpal tunnel syndrome. 

  • avoiding repetitive wrist movements
  • taking breaks while typing, playing tennis, or any activity that requires bending of the wrist
  • keeping the wrist in a neutral position
  • avoiding stressing the wrists or hands by using the largest joints possible when lifting objects
  • avoiding power tools that vibrate, such as floor sanders and jackhammers
  • avoiding power tools that vibrate, such as jackhammers and floor sanders

Best Creams for Relieving Pain due to Carpal Tunnel Syndrome

Topical creams and sprays are effective treatment methods for reducing pain due to carpal tunnel syndrome. Here is a review of some of the most popular creams for carpal tunnel syndrome.

Pain Relieving Cooling Gel from J.R. Watkins 

Cooling gels with menthol are a quick and effective way to reduce pain due to carpal tunnel syndrome. This effective gel from J.R. Watkins is one of the brand’s cooling products. Apart from the spray foam and roll-on varieties, the gel offers instant relief for healing and improving swelling. Menthol, arnica, and vitamin E in the gel take care of stiff joints and muscles. Use this cooling gel for relieving pain naturally.

Joint Mud 

If you would like to use a natural solution for the long-term, try Joint Mud. This product contains all-natural ingredients that are safe and effective. Although Joint Mud is mainly used for treating joint issues, it can also help with nerve pain.

Voltaren Gel

There is nothing like Voltaren gel to relieve pain and discomfort. The best thing about this product is that you don’t need any prescription to buy it from your local pharmacy. The formula is gentle on the wrists but takes care of tingling, numbness, and pain.

The medicated gel provides great relief than most pain-relief methods such as wrist braces or cooling sprays. This gel is a great way to reduce inflammation and offers a safe way to relieve pain. However, breastfeeding and pregnant women should avoid using Voltaren gel.

Carpal Tunnel Pain Relief Cream from Vita Sciences Store

This cream offers a synergistic blend of ingredients and three forms of arnica, magnesium, and electrolytes. This effective pain relief cream from the house of Vita Sciences Store penetrates deep into the tissues for instant relief. You can use this pain-relief product regularly and increase the dosage according to the intensity of your pain.

Bottom Line

Now you know everything about mononeuropathy and its common types, follow our guide if you are experiencing any symptoms. Use the popular, topical creams for relieving pain due to carpal tunnel syndrome and make lifestyle changes to prevent this condition. 

Sources

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