It is essential that these procedures are implemented as soon as possible to avoid permanent damage. Nerve compression associated with a Carpal Tunnel Syndrome can cause several physiological changes to the median nerve especially if this compression is left for long periods of time. Some of these physiological changes are:
o Microvascular (ischemic) changes – Ischemic changes refer to a decrease in the blood supply to the nerve which decreases oxygen supply and vital nutrients getting to the nerve.
o Myelin sheath injury – Myelin is an electrically-insulating layer that surrounds the nerves that aids in nerve transmission. Decreased nerve transmission means decreased function.
o Demyelination – This refers to loss of the myelin covering of nerve fibers which results in their impaired function. Chronic cases of nerve compression can cause Wallerian degeneration. Wallerian degeneration is the process of degeneration of the nerve. Wallerian degeneration is also where permanent fibrotic changes can prevent reinnervation and restoration of nerve function. Reinnervation is the process that occurs when a nerve dies and a nearby nerve grows a new connection (new axon) to the affected muscle in order to take over the function of the dead nerve.
Nerve Entrapment Syndromes: James S Harrop, MD, Hanna, MD, Dachling Pang, MD, FRCS(C), Kamran Sahrakar, MD, http://emedicine.medscape.com/article/249784-overview
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