[libribook.com] Traumatic Scar Tissue Management 1st Edition

Compression Syndromes
Although peripheral nerves are fairly robust and capable of withstanding a hefty
amount of distortion, under certain circumstances even a relatively small amount
of pressure may trigger a cascade of immune-inflammatory responses leading to
peripheral neuropathy. Certain neural parts are less protected and more
vulnerable to compression or pressure injury; for example, at nerve roots and
where a nerve travels through confined spaces such as structured tunnels
(Coppieters & Nee 2012, Schmid et al. 2013).
Additionally, peripheral nerves can become entrapped in dense, fibrosed tissue
or compressed by dense, fibrosed neurofascia. Peripheral neuropathies may exist
where there is altered nerve conduction in the absence of severe enough
compression to be graded as neuropraxia. Sunderland (1978) referred to such
presentations as irritative lesion. This suggests that a nerve irritated at a lowlevel
state, something other than observable squish or fullrage inflammation, can
be the source of neuropathic pain. Pathophysiological scars may constitute such
irritative lesions.