Understanding Nerves: Expert Clarifies Differences Between Nerves, Ligaments, and Blood Vessels

• What are Nerves?

Nerves are the structures that transmit signals from the brain and spinal cord to various parts of the body. They are present throughout the body. The tingling sensation felt in the fingers when one hits the elbow is actually a nerve. Commonly, blood-carrying tubes are also referred to as nerves. However, the tube carrying impure blood is called a Vein, while the one carrying pure blood is called an Artery. Similarly, the strands of flesh attached to the bone are called Ligaments, which are commonly referred to as nerves as well.

• What Problems Occur in Nerves?

Various problems can occur in the nerves due to different reasons. Problems arise from nerve compression, injuries, swelling in the limbs (tendonitis), and similar issues. In cases where the disc in the spine protrudes, the spinal nerve gets compressed. Nerves can also be compressed by a 'fibrous band' in the hand. Compression of a hand nerve can lead to the inability to move the fingers. Furthermore, nerve compression can occur if an injury causes a bone fracture. If a blood vessel is compressed, blood flow to any part of the body can stop.

The ligament in the hand can swell, and the fingers might become immobile; this is what we call 'numbness' in the nerve. Deformity in the fingers might also be visible.

• What Symptoms Appear When a Nerve is Compressed?

Tingling in the body parts is a primary symptom when a Nerve is compressed. When a spinal nerve is compressed, pain radiates from the back of the thigh down to the foot, accompanied by tingling. It feels like being pricked by a needle or a thorn. If a hand nerve is pinched, the little finger, ring finger, and middle finger will tingle.

If the area near the elbow is hit, the little finger and ring finger will tingle. For such nerve compression issues, we determine whether surgery is needed through an MRI. If surgery is not required, treatment is administered with medication. Nerve surgery is performed by a Neuro or Orthopedic Surgeon.

Tendon surgery is performed by Orthopedic Surgeons, and no one else. Compression of a blood vessel also causes similar pain and tingling, but its symptoms are slightly different from nerve compression. When a blood vessel is compressed, pain occurs while walking, but it subsides after resting for a short while, allowing one to walk again. However, if a nerve is compressed, recovery takes some time. It is very important to distinguish between these two. Color Doppler (Ultrasound) is used to detect compressed blood vessels. Surgery for this is performed by a vascular specialist.

• How Do Problems Arise in Ligaments?

Ligaments can tear or swell due to injuries from various causes. Torn ligaments need to be stitched. When a ligament tears, joints, toes, or the elbow may become immobile. When the red flesh attaches to the bone, it is called a tendon; if injured, it can tear or rupture, which can also cause joints to become immobile.

• In What Condition Can It Be Cured with Medication?

Even if a disc protrudes near a nerve but does not affect mobility, surgery might not be necessary. Such problems can be managed with physiotherapy for relief and medication. If the nerve is completely compressed, surgery is the only option. If no improvement is seen after about a month and a half of physiotherapy, surgery becomes necessary. If improvement is occurring, it can heal without surgery.

However, if there is an inability to control urination or awareness of bowel movements, emergency surgery is required. In such situations, do not waste time waiting. Once a nerve is damaged, recovery is difficult. If delayed, blood circulation to the nerve can stop, leading to complete dysfunction, so surgery should be performed as soon as possible.

We generally use the term 'nerve' to refer to everything. However, one must understand that there are three different things referred to as nerves—the nerve that causes tingling in the fingers when the elbow is hit, the ligament used to move bones in the limbs, and the blood vessels (Arteries and Veins).

(Dr. Nepal is a Senior Orthopedic Surgeon at HAMS Hospital)