Common disorders of a COMPRESSIVE nature include:

• CARPAL TUNNEL SYNDROME (CTS): CTS is a median nerve compression at the level of the wrist. This compression is usually caused by excessive use or repetative wrist movements. ie. typing, heavy labor.... Ganglion cysts may also contribute to this disorder. CTS is common among peripheral polyneuropathy patients. ie. diabetics. The patient may present with numbness, tingling, or pain in the wrist area or first three digits. Some patients have difficulty grasping objects or more commonly find themselves dropping things. Patients often complain of hand numbness at night that awakens them from sleep. This symptom generally goes unreported since patients believe that they 'slept on their hand wrong'.

• ULNAR NEUROPATHY: Ulnar neuropathy is an ulnar nerve compression most commonly found at the level of the elbow. The patient usually presents with numbness or tingling in the fourth and fifth digits. Weakness of the ulnar innervated hand muscles may also occur. Ganglions are often the cause for an ulnar nerve compression at the level of the wrist.

• PERONEAL NEUROPATHY: (Foot Drop) Peroneal neuropathy is a compression of the peroneal nerve at the level of the fibular head. These patients present with an irregular gait caused by a foot drop or loss of extensor control of the digits. This injury can be traumatic in nature or is seen in patients who sit with their legs crossed or squat for long periods of time. This is commonly seen in patients who are bedridden for long periods of time or have had their leg immobilized during a surgery.

• TARSAL TUNNEL SYNDROME (TTS): TTS is a compression of the tibial nerve at the level of the ankle. This lesion can be caused by ankle trauma, ganglion cysts, or tenosynovitis. This syndrome is difficult to diagnose in peripheral polyneuropathy patients. Patients usually present with numbness and or pain in the sole or digits of the foot. Some patients experience weakness in the intrinsic foot muscles.

• RADICULOPATHY: Cervical or Lumbosacral Radiculopathies are compressions of one or more nerve roots at the spinal level. Radiculopathies can be caused by bulged or herniated discs, arthritic changes of the spine, tumors, or traumatic root avulsion. Patients usually present with pain radiating from the spine into the extremities and/or numbness and tingling in dermatomal patterns.

GENERALIZED DISORDERS:

• POLYNEUROPATHY: The most common polyneuropathy is an aquired peripheral polyneuropathy. The most common is caused by diabetes, but renal disease, alcoholism, toxic insults, nutritional disorders, and malignancies are also common. The patient presents usually with sensory changes in a 'glove and stocking' distribution. Weakness in distal muscles is common as well as hypoflexia. It is important to note that patients with polyneuropathies are very susceptable to entrapment or compressive neuropathies. Many of these superimposed compressive neuropathies are overlooked due to the underlying nerve damage caused by their peripheral polyneuropathy. Some polyneuropathies are inherited.