Neuropraxia Explained: What You Need to Know About Nerve Injury

Have you ever experienced a sudden tingling feeling in your arm, buzzing like a static noise on the radio or a television losing its signal? If the answer is yes, you may have encountered a condition called neuropraxia.

Neuropraxia is a common diagnosis, but not many people are aware of it. The term may sound daunting, but here we’ll try to provide you with a simple overview of everything you need to know if you suspect you have, or have recently been diagnosed with, neuropraxia.

Definition and causes of neuropraxia

Put simply, neuropraxia is the least serious injury of peripheral nerves. Our nervous system transmits signals around the body. The peripheral nerves allow communication between the brain and the rest of the body.¹

In neuropraxia, the peripheral nerves (the nerves outside of your brain and spinal cord) are disrupted - disrupting their electrical messages. This disruption can be caused by direct pressure or stretching.^2,3 For example, when the nerve in your wrist becomes compressed (whilst typing on a computer, for example) the nerve can lose the ability to transmit electrical signals, resulting in numbness or tingling in your hand. 

Similarly, sports and physical activity can trigger neuropraxia in several ways. If you are doing yoga or stretching poses incorrectly it can lead to nerve compression and reduced blood flow, thus leading to the injury. Further, direct contact or collisions (which are common in sports such as American football, wrestling and boxing), as well as a lot of repetitive movements (such as those performed in tennis, golf or cycling), can lead to injuries like neuropraxia.^4-6,7 Gym activities, such as weight lifting, yoga, and pilates, can also result in nerve injuries - especially if they’re done incorrectly.

Occupational injuries occur due to repetitive motions, such as typing on a computer or assembling parts on the factory line. Playing string instruments or drums is risky for the same reason.

Even holding your phone between your shoulders for too long or choosing the wrong sleeping position can have the same results - so be careful!

Symptoms to look for

Here are the most common symptoms you may experience in the injured region if you have neuropraxia:⁸

• Numbness or loss of sensation in your hands or feet
• Tingling (or 'pins and needles')
• Muscle weakness
• Muscle atrophy (breakdown) in prolonged cases
• Pain (which can range from dull to sharp)
• Burning sensation
• Sensitivity to the touch

When to see a doctor?

Some people decide not to seek medical attention for neuropraxia, especially if their pain isn’t too severe. However, you should see a doctor immediately, if:

• You have a pre-existing condition that affects your nerves.^9,10
• Your symptoms are getting worse, or you are experiencing severe pain, profound muscle weakness or complete loss of sensation. It is uncommon for symptoms to be neuropraxia and it probably is something more serious. Immediate medical examination is essential in this case. Be especially cautious if you experience severe pain right after injury and/or the injured areas including the spine or neck.^8,11
• You have other symptoms, such as problems with bladder or bowel control.

What doctor should I see?

The medical professional you should see varies from country to country. In the UK, the first doctor to see would be either your General Practitioner (GP) or A&E in the nearby hospital, if the pain feels unbearable.

After a consultation, your GP might refer you to a neurologist, orthopedic surgeon, physiotherapist or physical medicine and rehabilitation specialist. Who you are referred to depends on your symptoms, lifestyle, and diagnosis.

Diagnosis, treatment, and recovery - what to expect

Diagnosis

During the appointment, your doctor will likely:¹²

• Discuss your symptoms and medical history: your doctor will ask you about your general health and symptoms to rule out more serious conditions.
• Carry out a physical and neurological examination: these exams will likely involve checking your muscle strength, reflexes, sensation, numbness, and range of motion.
• Additional tests: If your diagnosis is still unclear, the doctor may conduct some additional tests, like a nerve conduction test.¹³ This test will check how quickly and how efficiently your injured nerves transmit electrical signals. The results of this test will help to confirm the neuropraxia and rule out more serious injuries.
• Imaging tests: X-rays, ultrasounds and MRIs can also assist the doctor in ruling out other more serious injuries, like fractures or injuries of the soft tissues.

After the necessary assessments, your doctor will discuss the results with you, suggest  treatment, and plan the next steps.

Treatment options

The most immediate treatment is to rest and avoid activities that can worsen your injury.¹⁰ In some cases, the affected area or limb will have to be immobilised by a splint or a brace.¹⁴ You may be prescribed painkillers if you are in a lot of pain, but applying a hot or cold pack on the affected area may also help.

Over the course of your recovery, you might be referred to a physiotherapist to help you restore strength and flexibility that may have been lost because of the injury and the lack of activity at the beginning of the treatment.¹⁵ Regular follow-ups with your doctor are essential for the most suitable treatment plan and thus a full recovery.

Recovery timeline

Recovery time mainly depends on the severity of the injury, your general health and if treatment is successful.^15,16

In most cases, neuropraxia resolves within a few weeks to a few months. However, in cases where the nerves are substantially damaged, recovery may take up to 6 months. It is important to remember that everyone is different, and that many factors can influence your recovery time. Nonetheless, it is important to stay in touch with your doctor for the best recovery outcomes.

Neuropraxia prevention tips

It’s always best to prevent injuries, rather than treat them. Prevention is specifically important if you are at a higher risk of being injured, either because of your occupation or daily activities.

Here are a few tips you can do to prevent the injury:

1. If you work in front of a computer, make sure that you have a chair with proper back support, your computer screen is at your eye level, and your mouse and keyboard are ergonomic to minimise wrist strain.
2. If your work or daily activities require you to stand or sit for a prolonged time, try to have regular breaks. Stretching and changing positions will help to release pressure on nerves.
3. Some stationary postures are especially risky for nerve injury. This includes crossing legs, leaning on elbows, and holding your phone between your shoulder and ear for a long time. Be mindful not to stay in said postures for a long time.
4. Research the best form and posture for your daily activities. This will help to distribute pressure and weight evenly between different muscles and reduce the risk of your nerves becoming compressed. 
5. Regular exercise. Strong muscles and good flexibility will protect nerves from injuries.¹⁷
6. If you regularly participate in contact sports, remember to wear appropriate protective gear.
7. Be extra cautious, if you have an underlying condition. Effectively managing it will minimise the chance it will lead to a nerve injury.
8. A generally healthy lifestyle, a balanced diet and enough water will support general nerve health.

These simple measures will significantly decrease your risk of injury.

Summary

• Neuropraxia is a nerve injury and should be taken seriously.
• Common symptoms of neuropraxia include numbness, tingling, weakness, pain, and in severe or prolonged cases, muscle atrophy.
• Seeking medical attention is crucial, especially if you have any of the symptoms that can indicate something more serious.
• In most cases, treatment involves limiting movement of the affected area with subsequent gradual recovery of the muscle strength through physiotherapy. Some symptomatic treatment may also be offered by a doctor.
• There are a few things that you can do to minimise your chance of getting neuropraxia. These are simple, but effective (such as having breaks and often changing posture, regular exercise and a balanced diet)

Remember, recognising the symptoms of neuropraxia, and seeking professional advice quickly can substantially improve your recovery time. Incorporating the prevention tips into your daily life is a simple yet effective way to prevent an injury.

Frequently asked questions.

Can I fully recover from neuropraxia?

Yes, nerves typically recover fully from the less serious injuries associated with neuropraxia. However, recovery time differs from patient to patient based on their previous medical history, the severity of their injury, and other factors.

Is it safe to exercise if I have neuropraxia?

Gentle exercise may be beneficial, but it is very important to be careful and consult with your doctor to make sure the exercises you do are safe.

Can neuropraxia reoccur?

Yes, especially if the factors that led to the initial injury are not eliminated or mitigated. That’s why it’s very important to identify what caused the injury so it doesn’t happen again.

What if neuropraxia is left untreated?

Neuropraxia can resolve on its own, however, if left untreated, it can lead to muscle weakness and, in rare cases, muscle atrophy. It’s best to address neuropraxia early, to prevent long-term effects.

Why can both cold and heat therapy soothe pain in neuropraxia?

Heat helps to relax muscles and improves blood flow to the injured area. Alternatively, cold reduces inflammation and numbs the area, essentially acting to reduce pain.