Peripheral nerve injuries - Diagnosis and treatment (2024)

Diagnosis

Your doctor will review your medical history, ask about any accidents or previous surgeries, and discuss your symptoms with you. Your doctor will also conduct a physical and neurological examination. If your neurological examination shows signs of a nerve injury, your doctor may recommend diagnostic tests, which may include:

• Electromyography (EMG). In an EMG, a thin-needle electrode inserted into the muscle records the muscle's electrical activity at rest and in motion. Reduced muscle activity can indicate nerve injury.
• Nerve conduction study. Electrodes placed at two different points in the body measure how well electrical signals pass through the nerves.
• Magnetic resonance imaging (MRI). MRI uses a magnetic field and radio waves to produce detailed images of areas affected by nerve damage.
• Ultrasound. Like MRI, these high-frequency sound waves produce detailed images of the area affected by nerve damage.

Treatment

If a nerve is injured but not cut, the injury is more likely to heal. Injuries in which the nerve has been completely severed are very difficult to treat, and recovery may not be possible.

Your doctor will determine your treatment based on the extent and cause of your injury and how well the nerve is healing.

• If your nerve is healing properly, you may not need surgery. You may need to rest the affected area until it's healed. Nerves recover slowly, and maximal recovery may take many months or several years.
• You'll need regular checkups to make sure your recovery stays on track.
• If your injury is caused by a medical condition, your doctor will treat the underlying condition.
• Depending on the type and severity of your nerve injury, you may need medications such as aspirin or ibuprofen (Advil, Motrin IB, others) to relieve your pain. Medications used to treat depression, seizures or insomnia may be used to relieve nerve pain. In some cases, you may need corticosteroid injections for pain relief.
• Your doctor may recommend physical therapy to prevent stiffness and restore function.

Surgery

If your injury does not seem to be healing properly, your surgeon can use EMG testing in the operating room to assess whether scarred nerves are recovering. Doing an EMG test directly on the nerve is more accurate and reliable than doing the test over the skin.

Sometimes a nerve sits inside a tight space (similar to a tunnel) or is squeezed by scarring. In these cases, your surgeon may enlarge the tight space or free the nerve from the scar.

Sometimes a section of a nerve is cut completely or damaged beyond repair. Your surgeon can remove the damaged section and reconnect healthy nerve ends (nerve repair) or implant a piece of nerve from another part of your body (nerve graft). These procedures can help your nerves regrow.

If you have a particularly severe nerve injury, your doctor may suggest surgery to restore function to critical muscles by transferring tendons from one muscle to another.

Restoring function

A number of treatments can help restore function to the affected muscles.

• Braces or splints. These devices keep the affected limb, fingers, hand or foot in the proper position to improve muscle function.
• Electrical stimulator. Stimulators can activate muscle served by an injured nerve while the nerve regrows. However, this treatment may not be effective for everyone. Your doctor will discuss electrical stimulation with you if it's an option.
• Physical therapy. Therapy involves specific movements or exercises to keep affected muscles and joints active. Physical therapy can prevent stiffness and help restore function and feeling.
• Exercise. Exercise can help improve your muscle strength, maintain range of motion and reduce muscle cramps.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Preparing for your appointment

A number of tests may be used to help diagnose the type and severity of peripheral nerve injury. When you make your appointment, be sure to ask whether you need to prepare for these tests. For instance, you may need to stop taking certain medications for a few days or avoid using lotions the day of the test.

If possible, take along a family member or friend. Sometimes it can be difficult to absorb all the information you're given during an appointment. Someone who accompanies you may remember something that you forgot or missed.

Other suggestions for getting the most from your appointment include:

• Write down all your symptoms, including how you were injured, how long you've had your symptoms and whether they've gotten worse over time.
• Make a list of all medications, vitamins and supplements that you're taking.
• Don't hesitate to ask questions. Children and adults with peripheral nerve injuries have several options for restoring lost function. Be sure to ask your doctor about all the possibilities available to you or your child. If you run out of time, ask to speak with a nurse or have your doctor call you later.

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