No abstract

In nerve compression syndromes restricted nerve sliding may lead to increased strain, possibly contributing to symptoms. Ultrasound was used to examine longitudinal median nerve sliding in 17 carpal tunnel syndrome patients and 19 controls during metacarpophalangeal joint movement. Longitudinal movement in the forearm averaged 2.62 mm in controls and was not significantly reduced in carpal tunnel syndrome (CTS) patients (mean=2.20 mm). In contrast, CTS patients had a 40% reduction in transverse nerve movement at the wrist on the most, compared to least, affected side and nerve areas were enlarged by 34%. Normal longitudinal sliding in the patients indicates that nerve strain is not increased and will not contribute to symptoms.

No abstract

Patients with non-specific limb pain often show signs of nerve mechanosensitivity, i.e. local tenderness over nerve trunks and pain in response to limb movements that cause nerve stretch. In such patients a nerve lesion is not apparent, and it has been suggested that local neural inflammation may be a key factor. The present study examines the extent to which nerve fibres in regions of local inflammation respond to small stretches, and whether functional changes occur throughout the primary afferent neurone. A local neuritis was induced in adult rats by wrapping oxidised cellulose saturated in complete Freund's adjuvant (CFA) around the peroneal or sciatic nerves. A small cut was made in the perineurium of some of the peroneal lesioned animals. A- and C-fibre recordings were made 2-10 days post-surgery from filaments dissected proximal to the lesion. Local mechanosensitivity was assessed using a glass probe and by small stretches. Responses to stretch and local pressure were recorded in 7% of C- and 8% of A-fibres from the peroneal nerve following CFA treatment with the sheath opened. A smaller proportion of stretch sensitive fibres were seen in sciatic and peroneal nerves after CFA treatment alone (2% of C- and 3% of A-fibres), but such fibres were not seen in control preparations. The most responsive fibres fired to 3% stretch, which is within the range of nerve stretch seen during normal limb movements. Less than 1% of stretch sensitive fibres had peripheral fields, indicating that most had probably degenerated distally.