Painful nerve conditions such as neuritis and neuromas

A neuroma is an abnormal growth of nerve tissue (usually benign), while neuritis is the inflammation of a particular nerve or the nervous system in general. These conditions can affect the hand and upper limb. Both of these nerve conditions cause nerve pain, numbness, the 'pins and needles' sensation and weakness.

Brachial neuritis is a rare type of neuritis seen at the Garden Route Hand Unit. It affects the chest, shoulder, arm and hand, particularly the lower nerves of the brachial plexus. It is also known as brachial neuropathy. Brachial neuritis is characterised by sharp, severe pain, numbness and weakness in the lower arm and hand, or even the entire arm and shoulder.

Ulnar neuritis is another type of neuritis that affects the upper limbs and hands. It affects the arm from the elbow down, causing difficulty with finger coordination and the muscles of the forearm. Ulnar neuritis causes pain and tenderness in the forearm as well as weakness and numbness in the hand, and grip. While it usually only occurs on one side of the body, neuritis can affect other nerves as well.

What causes them?

The cause of neuritis is still unknown, but it is believed to be related to another illness or injury. Neuromas, on the other hand, are usually caused by a lacerated nerve, which, when injured, causes a ball of scar tissue and axon sprouts to develop.

How are these neuropathies treated?

If your hand surgeon suspects you may have a neuroma or neuritis, he may do a physical examination and diagnostic tests to make a comprehensive diagnosis. Diagnostic tests may include a nerve conduction test, electromyography, ultrasound or an MRI.

A neuroma of the hand may be treated with non-surgical methods such as medication and hand therapy. In cases where these methods fail to treat weakness and pain, surgical treatment may involve the resection of the neuroma. With the surgery, there is a risk that the neuroma will be replaced with a new one. In some cases your hand surgeon may advise burying the neuroma within a bone or muscle, to reduce its effects.

If diagnosed with neuritis, treatment may involve splints and medication. Nerve gliding exercises may also be recommended and guided by your hand therapist. For more severe cases, surgery may be needed to release scar tissue around nerves and in certain cases nerve transfer surgery may be done.