Nerve damage is a deceptively simple “catch-all” term that describes a wide range of accidents and injuries that can result in devastating harms that affect people for the rest of their lives. Nerve damage is tricky because it sneaks up on people, the initial injury could start a chain reaction that does not result in substantial pain or damage for weeks or months. Moreover, once nerve damage is ascertained, it is often permanent and can result in debilitating pain, loss of motor functions, and feeling.
Causes of Nerve Damage
Nerves are remarkably sensitive organs. They snake throughout the human body and are responsible for every sensation a human can experience from warm and cold to sharp and dull. Nerves are also intimately connected to the spine and brain and are responsible for alerting the brain when something is wrong with a part of the body. Therefore when nerves suffer damage, these damaged nerves send confusing or contradictory instructions to the brain which results in ghost pain and other issues commonly associated with nerve damage.
Injury to peripheral nerves (those spread throughout the body) can occur through a broad range of trauma including:
- Lacerations that damage or sever a nerve: such as cuts due to car accidents and in the kitchen;
- Focal contusion (gunshot wounds);
- Stretch/traction injury: these are commonly associated with athletic or sports injuries and are also frequently seen in car accidents (i.e. ‘whiplash’);
- Compression (car or work accidents): for example, lifting with the back, rather than the legs or back injuries suffered in a car accident;
- Drug injection injury: typically, damaged nerves from repeated intravenous drug use; and
- Electrical injury: electricity searches for the easiest routes to travel, even in a human body, which means the damage from an electrical shock can quickly spread to every part of a person’s body.
Each of these injuries describes a generic harm the body can suffer from cuts to compression. However, each of these injuries can arise in an infinite number of situations from car accidents to slipping on a patch of ice. Nerves are exposed to numerous dangers every day, and usually, they come out relatively unscathed or can repair themselves. But, nerves that suffer severe trauma, such as spinal compressions, can result in prolonged and substantial pain.
Diagnosis of Nerve Damage: The Classifications
According to Johns Hopkins, nerve damage is measured using the Sunderland Classification System. The Sunderland Classification System divides nerve damage into five degrees from minor to severe.
- First degree injuries describe reversible, local damage. These injuries are limited to the site of the injury and people usually recover within hours or days. For instance, a bruise from bumping into a table will last no more than a day or two.
- Second-degree injuries denote a loss of continuity of the axons (clusters of nerves) within the nerve. Second-degree injuries are also not too severe and don’t usually require surgery to recover.
- Third-degree injuries describe damage to the axons and the supporting nerve structures. Here, recovery is not inevitable. Doctors use a variety of techniques to ascertain the seriousness of the injury and the need for repair.
- Fourth-degree injuries denote substantial damage to the axons and supporting nerve structures sufficient to result in scarring that inhibits nerve regeneration. Testing will reveal that no electrical pulses can pass along the neural pathways (i.e. the nerve is no longer able to send or receive sensations). Surgical nerve grafting is necessary to repair the damage and recovery isn’t assured.
- Finally, fifth-degree injuries are usually found in severe lacerations (cuts) and stretch injuries. In these injuries, the nerve is split into two, and the only way to repair is through surgery.
To measure the extent of the injury, doctors rely on a variety of tools including CT scans and MRI’s. These devices measure and record electrical output from the nervous system, darkened areas mean that there is little or no electrical pulses being sent. Additionally, for specific nerve injuries, doctors will also use an EMG/NCV device which conducts electrical pulses through the body. The EMG/NCV measures where these pulses travel, how quickly, and if they are blocked anywhere. The nature of the response can tell the doctor how severe the nerve damage is and how to treat it.
Treatments for Nerve Damage
Aside from surgical grafting, nerve cleaning, and reconstruction, there are a variety of nonsurgical treatments to repair nerve damage. Depending on the location and severity of the injury a doctor may order:
- Acupuncture: which is a procedure in which ultra-fine needles are placed at strategic points throughout the body to stimulate nerve regeneration, nerve response, or to relieve scar tissue.
- Medications can also stimulate nerve repairs.
- Physical therapy is a months-long process in which the patient exercises the affected area to stimulate nerve regeneration.
- Weight loss management.