Common Federal Employee Injuries

Nerve Injuries

Nerve Injury

The nervous system is divided between the central nervous system (spinal cord and brain – myelopathy) and the peripheral nervous system (various sensory neurons – neuropathy).

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Myelopathy pertains to the central nervous system and usually indicates that there is something wrong with the spinal cord itself. Spinal disc injury, bone spurs and other degenerative changes in the spine are pressed into the spinal cord and thus creates myelopathy. But myelopathy is most commonly caused by spinal stenosis, which is a progressive narrowing of the spinal canal caused by abnormal bone growth due to changes in joint mechanics brought on by back injury. In the later stages of spinal degeneration, bone spurs and arthritic changes make the space available for the spinal cord within the spinal canal much smaller.

The interfering developments press on the spinal cord and the nerve roots, and that pressure starts to interfere with how the nerves function normally. When the effects are not simply local but extend out into the parts of the body serviced by the nerve, this radiating effect is known as radiculopathy of the spinal nerve roots. If peripheral nerves are also involved the term radiculoneuropathy is used.

Myelopathy can be “graded” accorded to the severity of weakness caused or by decrease in function and sensation. It can be difficult to detect, because this disease usually develops gradually and also occurs at a time in life when people are beginning to slow down a little bit anyway.

Surgery is usually offered as an early option for people with myelopathy who have evidence of muscle weakness that is being caused by nerve root or spinal cord compression. This is because muscle weakness is a definite sign that the spinal cord and nerves are being injured (more seriously than when pain is the only symptom) and relieving the pressure on the nerves is more of an urgent priority.

However, the benefits of nerve and spinal cord decompression have to be weighed against the risks of surgery. Many people who have myelopathy due to degenerative cervical disorders are older and often a bit frail. Spine surgery can be a difficult stress for someone who is older or who has many different medical problems. However, your surgeon will be able to discuss the risks and benefits of surgery with you, and what the likely results are of operative versus non-operative treatment.

Neuropathy pertains any other nerve damage. The symptoms depend on the type of nerves affected; motor, sensory, or autonomic. They also depend upon where the nerves are located in the body. Neuropathy pertains to the peripheral nervous system, it is associated with more generalized pain, muscle weakness, cramps, spasms and loss of balance, particularly with diabetics.

Fibromyalgia is within the gambit of nerve damage because it is the presence of:

  • chronic widespread pain
  • a heightened and painful response to gentle touch
  • fatigue
  • loss of stage four sleep which is critical to nervous system “reset”

It is considered a controversial diagnosis due to an unfortunate lack of abnormalities;

  • on physical examination
  • in objective laboratory testing
  • in medical imaging studies

Initially thought to be either a musculoskeletal or neuropsychiatric condition, recent research indicates it is more likely to be due to abnormalities in the central nervous system and affecting brain regions. Although some evidence indicates it can be genetically related much more evidence indicates it is caused by stress.

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