What is neurapraxia?

Neurapraxia is the mildest type of nerve injury.¹ It is a common disorder of the peripheral nervous system – the system of nerves that function to relay information between the brain, spinal cord, and the rest of the body.

A person with neurapraxia will experience a loss of motor and sensory function. These functions are either partially lost, or in severe cases, totally lost.

• A loss of motor function refers to body parts, usually limbs, not working as they normally would. This may result in poor stamina and muscle weakness.² With limited control over their muscles, someone with neurapraxia may struggle to coordinate their movement.
• A loss of sensory function refers to a loss of touch, smell, sight, taste, and hearing. Typically, losing your sense of touch due to neurapraxia may result in the affected area feeling numb.

Fortunately, the rate of complete recovery from neurapraxia is generally very high.¹ In addition, the healing process is said to occur within a matter of days or weeks.¹

What are the causes of neurapraxia?

In order for neurapraxia to occur, nerve impulses must be blocked. It is usually the case that nerve impulses get blocked in an injured area of the body.³ Although nerves are temporarily blocked from sending signals throughout the body, the nerves themselves are not expected to break down or degenerate as a result of neurapraxia. Being a mild disorder, the damage is mostly reversible.

Common injuries that can lead to neurapraxia include car accidents, falls, and other sport-related injuries or trauma.³

In particular, recent data has shown that players of American football are at a considerable risk for neurapraxia in their upper spinal cord.⁴ This is due to football being a high-contact sport. At the professional level, 9.4% of neurapraxic injuries cause athletes to lose their season.⁵

Neurapraxia can also occur in a medical setting: during molar extractions, anesthetic injections, and other procedures that involve surgery.⁶

The shared criteria for these causes of neurapraxia is that they stretch or compress your nerves, to the point that the myelin sheath gets damaged. The myelin sheath is a layer of insulating material that wraps around your nerves. Due to its design, the myelin sheath allows for nerves to quickly send impulses throughout the body. When this becomes physically damaged, nerves are no longer able to effectively transmit their signals.¹ From there, symptoms of neurapraxia may begin.

In many cases of mild neurapraxia, the myelin sheath is able to repair itself, causing the symptoms of neurapraxia to fade away.

Common symptoms of neurapraxia

Along with the loss of motor and sensory function, there are many common symptoms that a person with neurapraxia may experience. For example, a universal symptom is tingling.⁶ This tingling can be mild, or at times feel like a burning sensation. Another sign of neurapraxia may be that you have a difficult and painful time moving your neck.

Should I get treatment for neurapraxia?

For the most part, neurapraxia is known to not require any specific form of treatment.⁶ However, it is still recommended that patients report any symptoms or concerns to a physician so that their case of neurapraxia can be closely monitored.⁶ Follow-ups on the disorder may also be beneficial.

During the healing period, your healthcare practitioner may suggest avoiding high-contact sports and circumstances that could put you at any physical risk.

Depending on how severe and recurring the neurapraxia is, it may be necessary to use imaging to see if there are any other underlying conditions.⁶

• Ultrasounds have been useful for investigating the nerves of patients.³
• Computed tomographic (CT) scans have been used to scan areas affected by neurapraxia and identify other fractures.³
• Magnetic resonance imaging (MRI) of the lower spine and pelvis has been essential in traumatic cases of neurapraxia.³MRI and x-rays are also effective at taking pictures of damages to the spinal cord.

If the stamina of the patient is considerably low and they lack control over their muscles, more measures can be taken to manage the neurapraxia. Your doctor may provide you with some of the following options:

• As a conservative treatment, splints and limb supports can be offered to a patient in need.³
• Neuropathic pain medications may be prescribed if the patient is experiencing a nerve pain that is stronger than what is expected of mild neurapraxia.³
• Patients can be encouraged to attend physical therapy and rehabilitation sessions until their nerves have recovered and symptoms go away.³ This type of therapy helps a lot with regaining strength and putting your muscles in motion.

With the disorder having accessible treatment, neurapraxia is associated with a high patient recovery rate. Most people with neurapraxia will recover within 2-3 months of being diagnosed.⁷ A good sign that you have recovered is when you no longer have any of the common symptoms, and you have regained control over your muscles .

Typically, young people have smoother recoveries from neurapraxia than older people.⁸ Still, it is important to note that up to 30% of neurapraxia cases can result in some form of permanent disability.⁸

References

1. Benzon, H. T., Wu, C. L., & Argoff, C. E. (2013). Practical management of pain. Practical Management of Pain: Fifth Edition, 1–1115. https://doi.org/10.1016/C2009-0-64063-0
2. Henderson, J. M. (2012, April 2). Motor Impairment. International Neuromodulation Society. https://www.neuromodulation.com/motor-impairment
3. Cuello, C. M. C., & Jesus, O. de. (2021). Neurapraxia. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK560501/
4. Rihn, J. A., Anderson, D. T., Lamb, K., Deluca, P. F., Bata, A., Marchetto, P. A., Neves, N., & Vaccaro, A. R. (2012). Cervical Spine Injuries in American Football. Sports Medicine 2009 39:9, 39(9), 697–708. https://doi.org/10.2165/11315190-000000000-00000
5. Zuckerman, S. L., Kerr, Z. Y., Pierpoint, L., Kirby, P., Than, K. D., & Wilson, T. J. (2018). An 11-year analysis of peripheral nerve injuries in high school sports. The Physician and Sportsmedicine, 47(2), 167–173. https://doi.org/10.1080/00913847.2018.1544453
6. Neurapraxia – ICOI. (2019). International Congress of Oral Implantologists. https://www.icoi.org/glossary/neurapraxia/
7. Sunderland, S. S. (1990). The anatomy and physiology of nerve injury. Muscle & Nerve, 13(9), 771–784. https://doi.org/10.1002/MUS.880130903
8. Bergmeister, K. D., Große-Hartlage, L., Daeschler, S. C., Rhodius, P., Böcker, A., Beyersdorff, M., Kern, A. O., Kneser, U., & Harhaus, L. (2020). Acute and long-term costs of 268 peripheral nerve injuries in the upper extremity. PLoS ONE, 15(4). https://doi.org/10.1371/JOURNAL.PONE.0229530
9. Image by Colin Behrens from Pixabay