Pinched radial nerve or compression-ischemic neuropathy is one of the most common diseases of the peripheral nervous system. This phenomenon has a number of characteristic symptoms and causes. In milder cases, with timely medical attention, the disease lends itself well to conservative treatment, while surgical treatment is often required to treat severe forms of the disease.
Injury - the main cause of compression
The most common cause of compression-ischemic neuropathy is injury. In this case, a bruise or injury means not only mechanical damage, but also damage to the radial nerve as a result of prolonged compression. Surely many of us are familiar with the habit of sleeping, putting our hands under our heads instead of pillows. In medicine, such a pathology is called "garden bench paralysis." In this case, numbness and drooping of the hand with impossibility to perform extensor movements are observed.
In some patients, this kind of neuropathy occurs due to improper use of support. No matter how paradoxical this may sound, people with fractures of the lower extremities are often prone to pinching the radial nerve in the arm when the injured person does not use crutches correctly. Due to improper posture and the use of inappropriate support, the radial nerve is squeezed.
In addition, a banal bruise from a fall or careless movement can lead to nerve injury.
Other common causes of compression
As a rule, they are also associated with mechanical damage. Among the causes of pinching of the radial nerve in the hand, the following are distinguished:
- scarring between muscles in the immediate vicinity of the radial nerve after an impact;
- humerus fracture;
- prolonged compression of the upper extremities with a tourniquet;
- the consequences of injections made to the outer part of the shoulder when the patient’s nerve is located in a place different from the conventional one (abnormal location).
Intoxication
The next cause of pathology is the toxic effect of infections and alcohol on the radial nerve. For example, intoxication of the body, as a complication after the flu or another infectious disease (pneumonia or typhus). And if complications after the flu are a rare occurrence, then poisoning of the body due to excessive alcohol consumption is observed much more often. Usually, patients who are addicted to alcohol are not very concerned about the fact that in the morning after waking up, the body is not working properly. At such moments, they are more concerned with something else, and when intoxicated, a person feels better. That is why an appeal to a doctor is postponed until later, which only exacerbates the situation of the patient.
In exceptional cases, severe lead poisoning becomes the cause of nerve damage.
Rare reasons
Injuries and poisonings are considered the most common causes of pinching of the radial nerve, however, in medical practice there are also such as diabetes mellitus, an imbalance of hormones in the female body, and the state of pregnancy.
Typical symptoms of pinching of the radial nerve
The main signs of this disease, depending on the degree of its defeat, are reduced to pain and limited mobility, accompanied by impaired sensitivity of certain parts of the upper limbs. Such pathologies are often accompanied by violations of extensor movements of the hands.
The easiest way to self-diagnose neuropathy is as follows: try folding your hands in a position of the type of “offering prayers”, then spread them apart without opening the wrists in the place of contact. In this position, it will be problematic to remove the affected brush.
If pinching is located in the armpit, a violation of the extensor function of the hand is observed in the forearm. It’s not possible to hold the hand in a horizontal position when you hold your hands in front of you. With such pathologies, the brush hangs.
Since the radial nerve is responsible for the movements of the wrist and elbow joints, the first, third and thumb, numbness and pain are often observed in these parts of the hand. Sometimes patients complain of severe burning pain in the thumb, extending to the upper limbs, for example, to the shoulder.
Types of Compression Nerve Damage
Depending on the location of the lesion (compression) of the nerve, the symptomatology of the pathology varies. Each type of nerve damage has its own distinctive features. Here are the most common symptoms of the disease for each case.
First type compression
With the first type of pathology, compression of the nerve occurs at the level of the axilla. This phenomenon is not so common and is called "crutches of paralysis", largely due to the cause of the pathology. In this case, there is a violation in the extensor muscles of the forearm, the appearance of weakness in the shoulder up to the development of atrophy of the triceps muscle.
Compressions of the first type have the following distinctive features:
- in a straightened state of the upper extremities, difficulty in extensor movements of the hand is observed, as well as a stable fit of the first and second fingers of the hand;
- weakness of the hand when trying to raise a hand (the patient cannot bring the brush to a horizontal position);
- violation of extensor reflexes in the elbow joint;
- decreased sensitivity in the fingers;
- feeling of numbness and tingling in the hand.
Second type of compression
It occurs when a nerve is squeezed in the middle third of the shoulder during sleep, or as a result of prolonged fixation of the arm, damage to the limb with a tourniquet, or prolonged presence of a person in an uncomfortable position.
In addition, the second type of compression neuropathy occurs in patients with complications after infectious diseases, as well as with lead poisoning.
This type is considered more common and is characterized by such signs:
- with full preservation of the extensor reflexes of the forearm and good sensitivity of the shoulder, disturbances in the movement of the fingers are noted;
- loss of sensitivity on the inner surface of the brush.
Third type of compression
It is characterized by compression of the nerve in the elbow joint. This phenomenon is often found in people who are fond of tennis, and is called "tennis elbow syndrome." Often, the pathology flows into a chronic disease due to persistent disorders in the area of attachment of the ligaments of the elbow joint and extensor reflexes of the hands and fingers.
The following symptoms are characteristic of this type of compression:
- strong pain in the forearm, with extension of the fingers and rotational movements of the brush;
- pronounced pain in the shoulder and elbow;
- weakness and malnutrition (one form of dystrophy, accompanied by a decrease in muscle mass) of the muscles of the forearm.
Pathology diagnostics
The diagnosis of pinching of the radial nerve is clarified through several consecutive medical measures, including:
- a preliminary examination of a therapist with a subsequent referral to a specialist - a neurologist;
- conducting neurologist diagnostic tests for violations in the work of peripheral nerves;
- a comprehensive study of the general state of nerve conduction and the functional state of the muscles of the upper extremities (electroneuromyography);
- blood and urine tests of the patient (general tests, analysis for blood sugar, blood biochemical composition).
Neuropathy treatment
Methods of treating neuropathy are selected individually for each patient, depending on the degree of compression, the localization of the pathological process and the causes of its occurrence. For example, treatment of pinching of the radial nerve caused by intoxication of the body is carried out through medication. Disease associated with fractures of the bones of the hands - by immobilizing the limb for the duration of the fusion of the fracture with subsequent rehabilitation measures. To eliminate the compressions caused by rupture of the radial nerve, surgery is required.
Treatment of pinching of the radial nerve in the hand, provoked by mechanical stress (uncomfortable posture during sleep, improper use of crutches), is carried out by traditional methods with the obligatory elimination of the causes of compression.
The vast majority of patients undergo outpatient treatment, and only in the presence of severe pathologies the patient is hospitalized in a hospital (for example, when the administration of potent drugs is required).
Conservative methods of treating compression neuropathies include prescribing medications such as:
- medicines to eliminate pain and relieve inflammation (non-steroidal anti-inflammatory drugs);
- funds for relieving swelling in the affected limb;
- medicines to improve blood supply to the affected areas (vasodilator drugs);
- drugs to enhance nerve conduction in the upper limbs;
- Group B vitamin supplements and stimulants to accelerate the regeneration of nerve fibers.
To achieve the desired effect, as well as accelerate the recovery processes, it is recommended that drug treatment be combined with physiotherapy prescribed by a physiotherapist. Additional physiotherapeutic methods for the treatment of pinching of the radial nerve include the following:
- a set of special exercises (physiotherapy exercises, including gymnastics in the aquatic environment);
- massage with pinching of the radial nerve;
- acupuncture (acupuncture);
- drug electrophoresis;
- magnetotherapy and electromyostimulation;
- ozokerite (waxing of the extremities);
- local application of therapeutic mud (mud applications).
The best restorative effect has massage and physiotherapy exercises. A set of exercises are prescribed individually for each patient, taking into account the severity of his condition.
In exceptional cases, when conservative methods of treating pinching of the radial nerve in the hand do not contribute to the elimination of compression, surgical intervention is used.
The overall recovery period varies within a two-month period, however, it can vary depending on the severity of the pathology and increase in cases where treatment is carried out by surgery. In the postoperative period, a patient with pinching of the radial nerve in the hand requires special rehabilitation measures for complete recovery.