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Years ago a landmark study proved that not all pinched nerves hurt. By looking at multiple cadavers, researchers found many flattened, pinched, crushed nerves that caused no evidence of pain in the person's medical records (Neary and Ochoa 1975). That really puzzled the medical community because the popular thought, at the time, was that all pinched nerves hurt . Since that theory was disproven, scientists have been trying to explain why some nerve damage hurts and some does not.
Within the past 15 years, many studies have shown the effects of inflammation on the nerve. Without any source of physical, mechanical pinching, a nerve can be damaged by the inflammatory chemicals. Such chemicals are equivalent to throwing acid on a nerve. That is why steroid injections work. The steroids block the chemical reaction and cool the nerve. However, some people know that even injections do not help all types of nerve pain. So, there must be more to this puzzle; inflammation is not the only...
Neuropathy - distal median nerve
Pain in the wrist or hand that wakes you up at night
May be severe Pain may be felt in other areas, for example in the upper arm (this is called referred pain)
Sensation changes in the thumb and pointer (index), middle, and part of the ring fingers, such as:
Weakness of the hand that causes you to:
Drop things Have difficulty grasping objects
Signs and tests
Your doctor will examine your wrist and ask questions about your medical history. The examination may show decreased sensation in the thumb side of the hand. This is called the "radial" side. There may be weakness of the thumb and difficulty using it to pinch.
Tests that reveal distal median nerve dysfunction may include:
Nerve conduction tests
Tests are ...
More and more studies show that controlling patients' pain and getting them moving after a total knee replacement (TKR) gives the best results. Doctors are looking for ways to do this. Managing patient's pain in the first 24 hours after surgery seems to be an important key. Better pain control is gained by giving the patient general anesthesia along with a local nerve block at the time of surgery. One of the nerves often blocked is the femoral nerve, which forms from nerve roots in the low back and runs down the front of the thigh. Blocks are also done to the sciatic nerve. The sciatic nerve is a major nerve that goes down the back of the thigh to the lower leg and foot. This study compared a femoral nerve block alone to a "double block" of the femoral nerve and the sciatic nerve. Pain levels and amount of opiate used were measured every four hours for the first 24 hours. The authors found that patients receiving the double blocks used less pain medication after TKR than those getting ju...
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