Peripheral neuropathy

Peripheral neuropathy is when a nerve is damaged, injured or diseased (eg. Carpal tunnel syndrome, cervical radiculopathy, trauma, etc.). Clinically, this is assessed by a history, symptoms, and diagnostic tests, all consistent with the nerve suspected of being pathologic. 

In practice, the Upper Limb Neurodynamic Tests (ULNT) can be used to test the Median, Radial or Ulnar nerves, by detecting the increased nerve sensitivity to mechanical strain (mechanosensitivity), often seen in peripheral neuropathies.
- ULNT work by positioning the neck, shoulder, elbow, wrist and hand to mechanically tension the entire neural tissue of the tested nerve (and thus test its mechanosensitivity). Judiciously positioning these joints to increase or reduce the strain on the nerve is called "structural differentiation".
- A test is considered positive when it reproduces (at least partially) the patient's symptoms, and when these symptoms respond to "structural differentiation".
- ULNT are reliable and can be used in practice.
- However, the result of these tests may vary depending on the pathology itself, so they should be interpreted wisely.

In conclusion, even though more research is required to continue investigating their diagnostic accuracy, the Upper Limb Neurodynamic Tests are very useful in practice to assess peripheral neuropathies > from Nee et al.; J Orthop Sports Phys Ther 42 (2012) 413-424. All rights reserved to JOSPT.