Radial nerve neuropathy
Neuropathy or neuritis of the radial nerve affects the upper limbs of a person. The radial nerve constitutes the posterior bundle of the brachial plexus nervous system, located behind the brachial artery, and runs along the humerus. The nerve is divided into superficial and deep branches. Each finger is supplied with two dorsal and two palmar nerves.
The deep branch (motor) runs between the extensors of the thumb, descends to the wrist joint, innervating all the extensors of the shoulder, forearm and the radial muscle group. Radial nerve neuropathy develops as a result of compression of the deep branch of the radial nerve. This phenomenon is extremely rare. The nerve can be damaged by:
· Chronic trauma to the nerve trunk, resulting from friction against the sharp edge of the tendons during prolonged brushwork;
· Point impact of the head on the elbow bend area, in this case the radial nerve is compressed between the bones of the forearm. The radial nerve is pressed by the soft tissues of the forearm and the human head, for example, when a person is sleeping and his head is on the table, and the forearm is under his head;
· The development of scars in the intermuscular space along the path of the radial nerve after blows, for example, during martial arts competitions.
Sometimes the radial nerve is damaged by compression with a tourniquet, crutches. This happens during injections and after infectious diseases. The disease reports itself with all kinds of disturbances and changes in sensitivity. In the case of severe damage to the radial nerve, muscle paralysis may develop. Patients with neuritis of the radial nerve show the absence of reflexes.
You can also observe when raising the arms in a horizontal position, the drooping of the hands and a strong convergence of the fingers. Patients lose the ability to extend the forearm or hand, flex the joint at the elbow, and the sensitivity of the first three fingers. Such a process often leads to numbness of the limbs, to the impossibility of abducting the thumb when the hand is lowered downward, touching the inner side of the palm with the fingers.
With neuritis of the ulnar nerve, the palm does not turn upward, due to the fact that the fingers cannot be extended and it is impossible to take and hold objects with the fingers. Atrophy of the interosseous muscles of the fingers and the muscles of the palm occurs. I can't place and connect my fingers. The muscles that extend the forearms are stretched, the muscles that flex the hand are tense, and this is accompanied by pain and a decrease in the quality of life.
As soon as these symptoms are found, it is advisable to apply a splint on the hand and forearm. Treatment of neuropathy of the radial nerve implies conservative methods; very rarely, patients with this pathology go to a surgeon for surgery. Usually, after confirming the diagnosis, the doctor prescribes a method of electrical stimulation, massage, paraffin applications, B vitamins.
A complex of therapeutic measures is not complete without exercise therapy. Surgical treatment is necessary if there are scars along the nerve trunk and if there is a need to dissect the sharp edge of the tendons and fascial septa. To stop the development of the disease, constant neurological examinations are necessary. With the help of electronystagmography, recovery can be predicted.
In the presence of radial nerve compression factors, treatment should be aimed at eliminating them. For this, therapy is used, which includes preparations of absorbable action, agents that soften scar tissue, growths, both bone and cartilaginous.
Sometimes, to release the nerve, it is enough to conduct a course of manual therapy and inject drugs into the area of nerve compression. After improvement of the condition and in order to heal the nerve, drugs are used that effectively restore the nerve.
The benefits of exercise therapy
Special exercises are recommended to fully restore function and lost muscle volume.
The first set of exercises:
· Place the arm bent at the elbow on the table, the forearm should be perpendicular to the table. Lowering the thumb down, raise the index finger up and vice versa. Repeat 10 times;
· Put an arm bent at the elbow on the table and lean on it, the forearm should be perpendicular to the table. Lower the index finger down, raise the middle finger up, 10 times;
With a healthy hand, grab the main phalanges of four fingers (place the thumb on the side of the palm), and the other fingers on the back of the injured hand, you need to bend and unbend these phalanges. The next step is to bend your fingers into a fist with your good hand and straighten them 10 times.
Perform the second set of exercises in a bath filled with water:
· Press 10 times with a healthy hand on the middle phalanges of the fingers until they are fully extended;
· Raise and lower each finger with a good hand 10 times;
• take each finger back 10 times with your good hand, starting with the thumb;
· Perform circular movements with each finger in both directions 10 times;
· Raise and lower four fingers 10 times, while straightening them in the area of the main phalanges;
· Raise the hand 10 times with your good hand and lower it to the edge of the palm from the side of the little finger. Then make circular movements in the wrist joint clockwise and counterclockwise, holding the brush by the tips of the index, middle and ring fingers;
· Put the hand vertically in relation to the water on the fingers bent in the main phalanges, bend the fingers in each phalanx with a good hand and straighten 10 times;
· Put the brush with fingers spread and bent, straighten them 10 times with springy movements;
· Try to grab the towel located at the bottom of the bathtub, squeeze it in your hands, 10 times;
· Grasp rubber objects of different sizes and squeeze them 10 times.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".