Can nerves regenerate?

02 December 2007

Question

Three months ago I underwent surgery to fix a broken collar bone and since then an area just under the surgery site in the skin has become numb. My doctor’s told me that it’s normal and I’ll regain sensation there in a few months. Indeed it is coming back slowly but surely. I thought that nerve damage was permanent and it wasn’t possible to regenerate nerves and therefore get sensation back.

Answer

The nervous system is divided into two camps. There is the central nervous system (CNS) which is your brain and your spinal cord. Then there is the peripheral nervous system (PNS), which is everything else.

In the central nervous system (the brain and spinal cord), if you injure that - as far as we know - it's permanent. The nerve cells may die; or they may not die but they certainly don't reconnect with where they should connect. That stops signals getting through which is why you get problems of paralysis or loss of sensation, depending on where the damage is. That's why a stroke is so disabling.

In the skin the nerve cells there seem to be able to survive injury. They also seem to be able to re-grow to their targets so they go back to where they connected to in the first place. So if it was a muscle they were supposed to be supplying, they'll reconnect with the muscle. If it was a patch of skin they can branch out and re-supply the skin so you do get sensation back.

But nerves grow quite slowly, probably a couple of millimetres a day. So if you've got a big injury the length of your arm it can take a few weeks before the nerves can get back to your arm. The sensation may not be absolutely perfect because some nerve cells might die but you should get coverage of the skin back afterwards.

What happens when you break or interrupt a nerve is that the actual cell inside is just one massive long cell. The distal bit (the bit downstream of the cut site) will degenerate. It retracts and forms this little lump bulb. This then grows back along the original path of the nerve so it uses the original pathway of the nerve as a guide, rather like a motorway cone. It uses the cones and lays down a new road surface, which is the nerve, and it gets back to where it was supposed to attach. The distal site it was supposed to attach to switches on various markers so it can recognise it and off it goes!

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