Traumatic neuralgia from pressure-point strikes in the martial arts: results from a retrospective online survey.

CONTEXT Many techniques in Asian martial arts hand-to-hand combat systems emphasize hitting or striking specific sites on the body that correlate with exposed portions of peripheral nerves. OBJECTIVE To evaluate the prevalence and clinical effects of this unique sports-related injury. METHODS An anonymous self-administered retrospective 20-question electronic survey was posted on a high-traffic martial arts Web site. Primary outcome measures were demographic and medical history data, including martial arts experience and neuropathic symptoms associated with injury from this form of combat. Risk of symptoms was calculated by dividing the number of individuals with symptoms in each pressure-point area by the number of individuals who were struck in these areas during martial arts training. RESULTS Of the 651 survey responses received, 605 met inclusion criteria. Neuropathic symptoms were reported by 291 subjects. Most symptoms occurred in individuals aged between 20 and 30 years as well as in individuals with less than 1 year of martial arts training. The majority of respondents with neuropathic symptoms reported a symptom duration of less than 1 year (207 [71%]). Individuals with more than 5 years of combat training experience had a greater risk of chronic symptoms than individuals with less experience. Strikes to pressure points on the back had the greatest risk of inducing neuropathic symptoms. CONCLUSION Symptoms of neurapraxia can occur in individuals as a result of practicing martial arts involving strikes on pressure points. Although the majority of symptoms resolve within 1 year, individuals with prolonged exposure to pressure-point strikes may be more likely to have chronic symptoms.