- Nerve injuries are many and varied. The nerve can either be cut, pulled or compressed causing damage to the nerve fibres.
- You may experience pain, loss of sensation or loss of muscle control.
- If the nerve is cut, then the nerve following on from the injury site will die and need to regrow. The outside pathway is connected so the nerve knows where to grow, however, it needs sensory stimulation. The nerve takes approximately one month to get started and then grows at a rate of 1mm a day. This can be a lengthy process depending on where you were injuries. The nerve needs to be rested and protected for up to four weeks in a splint or cast. The sutures will be removed after ten days. It is important to look after the scar to stop it becoming too sensitive. You will be taught desensitisation exercises, massage and need to wear silicone while the scar heals. As the nerve recovers, it is important to keep the connections alive in the brain. To do this you need to practice nerve re-training exercises (e.g. laterality, imagery and mirror therapy exercises). These will be explained in detail to you by the therapist and you will be given a small booklet to read. Active exercises will be given around three to four weeks and a graded strengthening program commenced at approximately six weeks.
- It is important to keep all other joints moving through their range of movement, so when re-innervation occurs, full movement will follow. When a nerve is damaged you may experience sharp shooting or burning pains while it recovers – these are a good sign.
- If a nerve is compressed, by releasing the site of compression, the nerve signals can occur again. The information in a nerve is carried on the outside of the nerve. You may feel pins and needles or numbness when a nerve is compressed, which is a sign the nerve is having trouble communicating. The nerve can also have been pulled in a severe injury and remain in place but no longer transmit impulses. Neuropraxia is a term to indicate the nerve is damaged, irrespective if the damage is from compression or traction.
- Monitoring your nerve growth will be done via a series of tests. It is important that when you don’t have sensation, you use your eyes and common sence to watch you don’t burn or blister yourself. It is important not to grip things for long periods of time and not to touch anything that is hot.
Sensory Re-education After Nerve Repair