Diabetes and Nerve Compression
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Why are Diabetics Prone to Nerve Compression?

1. Metabolic neuropathy: Diabetic nerve compression is primarily a result of metabolic imbalances in the nerve, and the tightness of the surrounding anatomy produces symptoms secondary to the original neuropathy. Consequently, one of the main reason's why a diabetic's nerves are susceptible to compression is because the nerves in a diabetic are swollen.

Sugar from the blood enters the nerve, just like it enters other cells, to give it energy. This sugar, glucose, is converted to another sugar called sorbitol. Sorbitol’s chemical nature makes it highly attractive to water molecules, and so water is drawn into the nerve causing it to swell. If the nerve swells in a place that is already tight, like the anatomic regions described previously, then the nerve becomes pinched or compressed, resulting in symptoms of numbness and tingling.

2. Transport Mechanisms: The second reason for swelling is related to the transport systems within the diabetic nerve. The nerve is filled with a substance that allows important chemical messengers to move along it, enabling the one end of the nerve to know what is happening at the other end.
If the nerve becomes damaged, by compression, for example, its cell membranes need to be rebuilt. The building proteins are transported inside the nerve along tracks called tubulin. This mechanism, called the "slow anterograde component of axoplasmic transport" does not function normally in Diabetics. This means that the nerve is unable to repair itself properly, rendering it more likely to remain in trouble from compression.

What Benefits does Surgery have?

The surgery to decompress the nerve does not change the basic underlying metabolic (diabetic) neuropathy that makes the nerve susceptible to compression in the first place. When the surgical decompression is done early in the course of nerve compression, restoration of blood flow to the nerve will stop the numbness and tingling, and allow the nerve to recover. When decompression is done later in the course of nerve compression, and there have been extended periods of symptoms, then nerve fibers have begun to die; decompression will facilitate regrowth of the diabetic nerve.

While it is not fully understood as to how to prevent neuropathy from occurring, there are methods available to slow the natural course or history of diabetic neuropathy. This is done by removing the compression, or tight areas along the course of the nerve that are causing the symptoms of numbness and tingling you may feel in your hands and feet. For more specific information on the surgery relevant to the area in which you are experiencing discomfort, please go to the section on Treatment Options, also located in the navigation bar at left.