Nerve Entrapment (Pinched Nerve)
Nerve entrapment — also known as a compressed or pinched nerve — occurs when a peripheral nerve is subjected to sustained pressure from surrounding structures, impairing its ability to conduct signals normally. While the spine is often the source of nerve-related symptoms, entrapment can occur at numerous sites throughout the body where nerves pass through narrow anatomical corridors bounded by bone, muscle, tendon, or ligament.
Common sites and syndromes
The most frequently encountered peripheral nerve entrapment is carpal tunnel syndrome, in which the median nerve is compressed as it passes through the carpal tunnel at the wrist. This is particularly common in women, in people who perform repetitive hand and wrist movements, and during pregnancy. Cubital tunnel syndrome involves compression of the ulnar nerve at the elbow, causing numbness in the ring and little fingers. Tarsal tunnel syndrome affects the tibial nerve at the ankle. Meralgia paraesthetica involves compression of the lateral femoral cutaneous nerve in the groin, causing burning or numbness over the outer thigh — often associated with obesity, tight clothing, or prolonged standing. Thoracic outlet syndrome results from compression of nerves or blood vessels in the space between the clavicle and the first rib.
In the spine, nerve roots can be compressed by disc herniation, osteophytes (bony spurs), or spinal stenosis — giving rise to radiculopathy, in which symptoms follow the distribution of the affected nerve root (for example, sciatica from lumbar nerve root compression, or cervical radiculopathy causing arm pain).
Symptoms
The hallmark symptoms of nerve entrapment are pain, tingling, numbness, and a burning sensation along the distribution of the affected nerve. Weakness or clumsiness of the muscles supplied by that nerve develops in more severe or prolonged cases. Symptoms are often worse at night, with certain positions or activities, and may be reproduced by specific provocative manoeuvres.
Diagnosis
Clinical assessment — including careful history-taking and neurological examination with specific provocative tests (such as Tinel's sign and Phalen's test for carpal tunnel syndrome) — is the foundation of diagnosis. Nerve conduction studies and electromyography (EMG) objectively assess nerve function and localise the site of compression. MRI or ultrasound may be used to visualise the nerve and identify compressing structures.
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