Healing time of a nerve damage

The healing time of a nerve damage depends primarily on the extent of the damage. Minor damage, which only resulted in damage to the nerve sheath, usually heals within a few days. If the nerve is not completely severed, it can also take only a few weeks before the nerve is fully restored to its neurological function.

The situation is more complicated with complete nerve severance. The basic prerequisite for nerve generation here is that the nerve cell body is unharmed, which is usually the case. 2-3 days after damage, axons begin to regenerate and grow at an amazing speed of 0.5-2 millimeters per day.

Regeneration begins at the severed end of the axon. However, independent regeneration of the nerve does not take place by the two ends growing together again, but rather by a complete new formation of the nerve behind the lesion. In the case of nerve damage in the forearm, for example, it can take 3-6 months for the nerve fibres to grow back completely and resume their function.

For such a re-growth, however, intact connective tissue nerve sheaths are necessary as a guiding structure. There are various causes that can damage such a sensitive structure as the nerve tissue and thus lead to permanent damage. These include:

Mechanical damage or trauma
Vibration damage
Ischemia (circulatory disorder)
Toxic effects
Damage by the immune system (autoimmune disease)
Lesions caused by pathogens (infection)
Radiotherapy
Genetically caused injuries of the nerve (DNA damage)
Electrotrauma and
Nerve injuries of unclear cause
Piercing the tongue (tongue piercing)

Depending on the area of surgery, there is a low risk of nerve damage during surgery.

Major orthopaedic operations of the extremities are particularly affected, but also in the upper neck area. However, smaller operations, such as those for carpal tunnel syndrome, can also lead to nerve damage. It is assumed that approximately 15% of all known nerve damage occurs during an operation.

If it has been recognized that a nerve has been damaged during surgery, the further procedure initially depends largely on the extent of the damage. Thus, minor damage to the outer sheath of a nerve does not require further treatment. However, if a nerve is completely severed, it is usually treated directly by surgery or in a follow-up operation.

For all moderate nerve damage where no complete severing has taken place, a wait-and-see approach is recommended in order to give the nerve the chance to regenerate itself. If this is unsuccessful, surgical repair of the nerve damage is usually performed. Legal claims from the patient’s point of view do not usually arise in the case of nerve damage, as this complication is often part of the clarification.

As a result of some chemotherapeutics, a so-called neuropathy can occur. This disease, which mostly occurs on the hands and feet, is usually perceived by those affected as an unpleasant tingling sensation. However, it can also lead to numbness or muscle weakness.

If several areas of the body are affected by this phenomenon, it is called polyneuropathy. In most cases, however, this is only temporary and subsides within a few weeks after the end of chemotherapy. In total, approximately one third of all patients undergoing chemotherapy are affected by polyneuropathy.

In some cases, however, this clinical picture can be chronic and the nerve damage can be permanent. This is particularly true for patients who already showed a very strong manifestation under chemotherapy.If, as a result of a herniated disc, there is a longer lasting pressure load on spinal nerves, the result can be damage to the nerves. In addition to pain, such damage is usually accompanied by a variable loss of neurological functions.

How this loss presents itself depends on the extent of the damage and, above all, on the extent of the nerve damage. For example, in the case of herniated discs in the neck and chest area, the sensitivity and musculature of the arms and trunk may be affected, whereas the legs may show a loss of function when they are lower. To what extent the damaged nerve regenerates depends on the exact pattern of damage and the duration of the pressure load.

In the area of the spinal nerves, however, a slow regeneration process must be assumed. Find out more about the topics here:

Herniated disc in the cervical spine
Herniated disc in the thoracic spine

There are various surgical procedures in which regional anesthesia is used, such as that of the arm and shoulder through an injection of local anesthetics in the armpit. Most frequently, nerve damage after regional anesthesia affects the ulnar nerve or the entire brachial plexus, a nerve plexus for neurological care of the arm.

Damage to the nerves is caused here on the one hand by contact of the needle tip with the nerve itself. However, this risk has now been significantly reduced by performing the procedure on the awake patient. Severe nerve damage can occur especially when the local anesthetic is injected directly into the nerves.

However, this risk is also significantly reduced nowadays, as the position of the nerves can be determined well by electrical stimulation. However, should nerve damage occur despite these measures when regional anesthetics are administered, they usually have a good prognosis. Find out more about the topics here:

Side effects of local anesthesia
Peripheral nerve blockage

The clinical picture of carpal tunnel syndrome is relatively common in the population.

It affects mainly women who have to perform repetitive activities with their hands at work. Carpal tunnel syndrome involves permanent pressure on the median nerve in the area of the wrist. The increased pressure is due to the area in the wrist through which vessels, nerves and muscle tendons run being too narrowly defined.

The upper limit relevant for therapy is called the Ligamentum carpi volare. Symptoms of carpal tunnel syndrome are pain and sensitivity disorders of the thumb, index finger and, above all, the middle finger. They usually begin at night, only to appear during the day as the disease progresses.

The sensitivity disorder usually leads to a loss of “fingertip sensitivity” and smaller precise activities are significantly more difficult. The therapy of carpal tunnel syndrome initially consists of immobilization of the wrist and possibly the local application of steroids or local anesthetics. If there is no improvement, the ligament described above is surgically split.

It is possible to treat nerve damage conservatively or surgically. However, it depends on the type of damage. For example, in cases of diabetes mellitus or other metabolic diseases and vascular disease patterns, conservative measures can lead to healing.

In the case of pressure-induced damage to the nerve, surgical relief should be provided. In the case of chronic nerve compression such as carpal tunnel syndrome, the area should be immobilised by means of splinting. In addition, anti-inflammatory drugs are prescribed and physiotherapy is recommended.

If further deterioration occurs, carpal tunnel syndrome must be treated surgically. This is followed by further immobilization for about three weeks and additional physiotherapy. In the case of toxic nerve damage, the noxious agent should be avoided, i.e. no alcohol in alcoholically induced polyneuropathy.

Depending on the cause of the nerve damage, medication can also be used for intervention. In diabetes mellitus, blood sugar should be well adjusted. In case of vitamin deficiency, vitamin preparations can remedy the deficiency.

The chances of recovery are again related to the type of lesion.So it seems quite logical that a neuropraxia (where the axon and its envelope are preserved) or an axonotmesis (where the axon is disrupted but its envelope remains intact) have a better prognosis than a neurotmesis. If the nerve is completely or partially interrupted, permanent functional impairment must be expected. The longer the nerve lesion lasts and the closer it is to the central nervous system, the worse the prognosis regarding a complete cure.

If the nerve damage is rather long, the danger of a false nerve increases, i.e. that the nerve no longer grows together with its own nerve, but grows into another supply area. The longer the nerve lesion lasts and the closer it is to the central nervous system, the worse is the prognosis regarding a complete cure. If the nerve damage is rather long, the danger of a false nerve increases, i.e. that the nerve no longer grows together with the own nerve, but grows into another supply area.

Through a detailed clinical examination, the doctor can find out whether it is a nerve lesion and where it is located. Those of the nerve in the area of its supply are checked. The Hoffmann-Tinel sign can also be checked.

Here, one taps on the nerve and waits to see if paresthesias such as tingling occur in the innervation area of the nerve. Furthermore, clinical tests such as neurography and electromyography can be performed.

Sensitive
Motor and
Vegetative functions