Causes, Symptoms of Inflamed Nerve & its Treatment, Prognosis

Inflamed nerve (also known neuritis) is a term used to describe inflammation of a nerve or generalized inflammation of the peripheral nervous system. It is often accompanied by degenerative changes in the nervous tissues. It is usually characterized by neuropathic pain, pins and needle sensation, paraesthesia, numbness, weakness, loss of function etc. in the affected area. It can be caused by a multiple reasons which include trauma or injury to a specified nerve, nutritional deficiencies, infectious diseases, genetic inheritance, and presence of underlying systemic diseases. The symptoms depend on the type of nerve that is affected, i.e. damage to sensory nerves causes symptoms that differ from the symptoms caused by damage to motor nerves.

Inflamed nerve caused by involvement of sensory nerves leads to tingling or burning sensations, pins and needle sensation, loss of sensation, paralysis and stabbing type of pain in the affected area. In case of motor nerve involvement, symptoms include weakness, loss of muscle tone and muscle wasting. Mixed nerve involvement, though rare, can lead to severe complexities.

The commonly encountered symptoms of inflamed nerve include:

• Tingling in extremities
• Sharp, stabbing pain
• Numbness in hands and legs
• Weakness in limbs with occasional feeling of heaviness
• Frequent episodes of dropping things
• Facial paralysis in case of facial nerve involvement
• Tightness over the affected area
• Fluctuation in blood pressure
• Thinning of skin
• Sexual dysfunction (more common in men)
• Constant buzzing or shocking sensation
• Digestive issues such as constipation and diarrhoea
• Profuse sweating.

Inflamed nerve can be caused by multiple reasons. It has been seen that 1 among 400 individuals develop some form of nerve inflammation in their lifetime.

Inflamed nerve generally have good prognosis and treatment yields good results. However, in certain severe cases, inflamed nerve can lead to permanent damage and the symptoms can last for life time. If left untreated inflammation of the nerve can lead to paralysis of the affected area, which may last for life time.

The most common causes of inflamed nerve are:

• Mechanical Trauma: This is usually caused by injury or pressure leading to nerve damage and inflammation.
• Vascular Issues: This is secondary to blockage or haemorrhage in the nerves.
• Infection: Presence of infectious conditions such as shingles, diphtheria, tetanus, leprosy, polio etc. can cause inflamed nerves.
• Chemical Trauma: Trauma to nerve due to exposure to toxins of heavy metals such as arsenic, mercury and lead; chemical poisoning from drugs, alcohol and organophosphate; and side effects of vaccination in cases of Guillain Barre syndrome can cause inflamed nerve.
• Underlying Systemic Conditions: Inflamed nerve can also be caused by systemic conditions such as metabolic acidosis, diabetes, vitamin deficiency etc.

Common medical conditions caused due to inflamed nerves are:

• Cranial neuritis or Bell’s palsy
• Optic neuritis
• Brachial neuritis
• Vestibular neuritis.

Inflamed nerve can either be a temporary condition or a permanent disorder. It can either affect only a single nerve or multiple nerves in the body. This is also known as polyneuritis.

Treatment of inflamed nerves depends on the underlying cause and severity of the disease. The treatment modality includes:

• Medications to Manage Inflamed Nerve: The medications are given based on the condition as follows:
  • Mild Pain: NSAIDs such as acetaminophen and aspirin, or codeine are generally prescribed for managing pain.
  • Moderate to Severe Pain Nerve Pain: This requires opioid analgesics such as tramadol, hydrocodone or oxycodone.
  • Acute Pain: In severe cases of nerve inflammation, corticosteroids may be considered.
  • Chronic Neuropathic Pain: Medications such as duloxetine, pregabalin, amitriptyline, carbamazepine, capsaicin, and lidocaine may be considered based on the severity of nerve inflammation.
• Physical Therapy: Physical manipulation may be needed by an experienced physical therapist. Physical therapy helps in improving muscle tone and range of motion. A physical therapist may use the following modalities based on the condition:
  • Cold therapy
  • Heat compresses
  • TENS/transcutaneous electrical nerve stimulation
  • Trigger point therapy and acupuncture
  • Massages
  • Home exercises are often recommended.
• Nutritional Supplements to Treat Inflamed Nerve: In cases if inflamed nerves are caused by nutritional deficiencies, dietary modifications with additional supplements are recommended. The following are recommended based on the underlying cause:
  • Vitamin B12: Helps in growth and regeneration of nerves.
  • Vitamin B1: Promotes healing of nerve injury.
  • Calcium and Magnesium: Helps in improving nerve conduction.
  • Lecithin: Protects and repairs damaged nerves.
  • Protein: Promotes nerve repair and improves function.
• Surgery for Inflamed Nerve: Surgical intervention is considered as the last resort in management of inflamed nerves. It is usually considered in cases of nerve compression and physical injury. In some cases, surgical denervation is considered.

Inflamed nerve is treated and diagnosed by a nerve specialist or a neurologist. The main goal is to identify the cause of nerve inflammation and plan a treatment accordingly. A detailed case history is obtained followed up clinical examination with detailed neurological examination. In some cases, a treatment may not be required and the symptoms improve on its own. In other cases, treatment modality may include symptomatic management of the condition. The following investigative studies are carried out for diagnosis of inflamed nerve:

• Blood Tests: Comprehensive blood works are carried out to detect presence of an infection or inflammation like Erythrocyte Sedimentation Rate (ESR), Complete Blood Count (CBC), antibodies etc.; diabetes (GTT, HbA1C); nutritional deficiencies such as vitamin B group deficiency; autoimmune diseases (ANA test).
• Eye Tests (in cases of Optic Neuritis): Eye tests for testing colour vision, visual acuity tests, eye examination by a fundoscope or ophthalmoscope; test for studying light reflex, visual response test etc.
• Lumbar Puncture: This is done for analysis of the cerebrospinal fluid. This test is generally carried out in patients suspected with meningitis or encephalitis.
• EMG (Electromyography) and Nerve Conduction Test: Nerve conduction test and EMG are carried out to study the electrical functioning of the affected nerves. It measures the speed and strength of the nerve signals being transmitted. It is also beneficial in localizing the affected nerve.
• Nerve Biopsy: It is a routine test to confirm the diagnosis. A small sample of the affected nerve is taken and sent to a pathologist for investigation.
• Radiological Studies for Inflamed Nerve: Radiological investigations include MRI, CT scan and x-ray based on the affected site. It helps in identification of nerve compression, tumours, granulomatous lesions, sarcoidosis etc.

Inflamed nerve or neuritis is a neurological condition characterized by inflammation of the nerves. It can affect only one nerve or can affect multiple nerves. The symptoms vary based on the type of nerve involved. The most symptoms of inflamed nerve include tingling, pins and needle sensation, pain, muscle weakness, loss of function, numbness, paraesthesia etc. The treatment modality depends on the causative factor. While in some cases, no active treatment is needed for nerve inflammation, in some cases symptomatic management of the symptoms may be needed. Treatment plan generally involves oral medications, physical therapy, nutritional supplementation and rarely surgery.