19Feb

Lesions of the brachial and lumbosacral nerve plexuses

Among the most common lesions of the brachial plexus, neuritis of the brachial nerve, ulnar nerve damage and injury or compression of the median nerve in the shoulder joint are distinguished. The most common lesions of the lumbosacral plexus include lesions of the femoral, peroneal and tibial nerve.

Neuritis of the brachial nerve: symptoms and treatment

The cause of neuritis of the brachial nerve is the inflammatory-allergic lesion of the brachial plexus after immunization. Suffering from this damage to the brachial nerve is the face of a young age. The beginning is acute, for no apparent reason.

The main symptom of the neuritis of the brachial nerve is a strong cutting pain in the region of the forehearth, beginning at night, sometimes giving to the shoulder. A few hours later, the weakness of individual muscles develops in the shoulder and shoulder regions. Because of the intense pain, you have to keep your hand still. The right brachial plexus suffers more often, sensitive infringements are observed very seldom.

Forecast is favorable. In most cases, pain ceases within a week, the rest persists for no more than 3 months. Motor disorders begin to regress sometimes only after 9-12 months. Having identified the symptoms of neuritis of the brachial nerve, the treatment is prescribed by the doctor.

Treatment. In the acute stage, anti-inflammatory drugs, corticosteroids, later local thermal and other physiotherapy procedures are used. Also, in the treatment of neuritis of the brachial nerve, therapeutic exercise is shown.

Damage of the median nerve in the shoulder joint: symptoms and treatment of lesions

The causes of damage to the median nerve in the shoulder joint are:

  • injury: shoulder injury in case of fracture of the middle part of the humerus, elbow;most often the palmar surface of the wrist with any incised wound, even superficial;
  • compression: head of a sleeping partner - "paralysis of lovers";overlapping of the bundle;after a long ride on a bicycle - "paralysis of cyclists".

Symptoms. When trying to pinch your fingers into a fist, the patient can only bend the fingers of the ulnar edge of the hand, the muscles of which are innervated by the ulnar nerve. With the defeat of the median nerve, the so-called "blessing brush" is formed, the thumb tap is broken, that is, if you try to take a wide glass or bottle in your hand, the brush snaps in against the object and a kind of "swimming membrane" forms between the thumb and forefinger( "bottle symptom").Also a symptom of damage to the median nerve is a limited atrophy involving only the outer part of the base of the thumb.

Treatment of the lesion of the median nerve is prescribed the same as with lesion of the radial nerve.

Median nerve compression( carpal tunnel syndrome)

Carpal tunnel syndrome compresses the median nerve.

Causes of compression of the median nerve: hypothyroidism( lowering of thyroid function), amyloidosis( violation of protein metabolism), gout, diabetes mellitus. Women often suffer during pregnancy and menopause. A sharp increase in body weight may contribute to the development of the syndrome.

Symptoms. A person wakes up at night after a brief sleep with a feeling of numbness and swelling of one or both brushes. The movements in the fingers are slow and awkward, and the pulling pain can cover the entire limb. If you shake or massage your brushes, there is relief, but after a short time the pain resumes. In the morning, the first movements are hampered by the embarrassment and numbness of the fingers.

Treatment. In the absence of objective signs of nerve damage, immobilization of the wrist joint during a night's sleep with a special tire applied to the palmar surface is sufficient. If this method is not effective - surgical treatment. The expressed atrophy of muscles usually is not restored, however disturbance of sensitivity and a pain disappear in most cases quickly enough. In more mild cases, a local injection of 1 ml of a suspension of corticosteroids into the carpal tunnel is recommended.

Symptoms of ulnar nerve injury, treatment and exercise therapy

The defeat of the ulnar nerve is the most common peripheral neuropathy.

It can be:

  • traumatic: with a blunt impact or a cut wound, sometimes a fracture in the elbow area or dislocation. Years after elbow injury, delayed neuropathy of the ulnar nerve may develop;
  • chronic compression of the ulnar sulcus: in people whose professional activity is associated with prolonged support of the elbow: work on the phone, fine processing of products;
  • in patients permanently bedridden;
  • anomaly of the ulnar groove: dislocation of the ulnar nerve, repetitive movements in the elbow joint, for example, in the working of stamping or drilling machines;
  • arthrosis ;
  • chronic compression at the wrist level: when using various working tools such as a knife, woodworking machine, sledge hammer, pneumatic tools.

Symptoms. The clinical picture is characterized, first of all, by the weakness of the interosseous muscles, as a result, the ring finger and little finger are in the position of overdistension in the metacarpal joints( "clawed foot") when two fingers from the ulnar edge of the hand are diverted from the rest. Another symptom of the defeat of the ulnar nerve is incomplete removal and reduction of the fingers. Because of the weakness of the muscle that leads to the thumb, when trying to hold a flat object between the thumb and forefinger, the patient has to strongly flex the thumb in the interphalangeal joint. The border of sensitivity disorders always passes through the middle of the ring finger and is clear. Muscular atrophy is most pronounced in the gap between the thumb and forefinger.

Treatment. Avoid damaging factors and repetitive movements, if necessary change work, wear a soft gasket from the elbow. With chronic compression at the wrist level, refrain from intensifying the squeezing factors, if necessary continue the professional activities of wearing solid support tires for the palmar surface. The need for surgical treatment of ulnar nerve damage is extremely rare.

LFK in the treatment of ulnar nerve injury includes the following exercises:

1. Starting position: sitting at the table;The arm bent at the elbow rests on the edge of the table, the forearm is perpendicular to the table.

2. Drop your thumb down, raise the index finger, then do the opposite. Repeat for 8-10 times.

3. With a healthy hand, grab the main phalanxes of 2-5 fingers of the injured arm so that the thumb of the healthy hand is located on the side of the palm and the other on the back of the hand. Bend and unbend the main phalanx of the fingers. Then, having moved a healthy arm, also bend and unbend the middle phalanges.

Symptoms and treatment of femoral nerve injury

Causes of femoral nerve injury: lumbar hematoma or surgical intervention, occasionally with sudden overextension in the hip joint, with hemorrhagic diathesis.

Symptoms. The weakness of the extensor of the lower leg develops( the patient has difficulty climbing the stairs), the knee reflex weakens. Also, the symptom of a femoral nerve lesion is a sensitivity disorder on the anterior surface of the femur and the anterior surface of the tibia.

Treatment. In some cases, treatment is not required, and you can recover at your own discretion. In this case, any treatment aimed at increasing mobility during recovery will be positive. Supportive therapy is usually used if the symptoms appear suddenly, if there are only minor sensations of change.

Lesion of the peroneal nerve: symptoms and treatment

The causes of lesion of the peroneal nerve are: trauma and paralysis. This may be a trauma( a fracture of the fibula head, a dislocation in the knee joint, in case of unsuccessful movement - the turn of the foot), paralysis from compression( compression of the head of the peroneal nerve when sitting on the leg

also the cause of a nerve lesion in the sacral-lumbar plexus are awkward posture in an unconscious state, the pressure of the cast, certain activities related to the long-term position of squatting and kneeling( risk group - persons asthenic physique), injection paralysis( the injection insciatic nerve or in the immediate vicinity of it).

Symptoms. characteristic symptom of a lesion of the peroneal nerve is a gait disorder - steppage gait( gait cock) extensor weakness of the foot and toes form a "hanging foot" at every step the patient is forced to lift his leg high to the subsequent throwing her forward foot sock does not drag on the ground. When injecting

paralysis develops clinical picture as follows: about half the detected paresis( weakness), which developed immediately, and only a quarter of patients it is accompanied by acute pain.

Treatment. Urgent surgical revision to remove residual injection solution. During the treatment of the defeat of the peroneal nerve, it is released from any adhesions.

symptoms and causes destruction of the tibial nerve

reasons lesion tibial nerve are: damage in the popliteal fossa( for gunshot wound), dislocation of the knee, tibial fracture offset fragments profession in which the need to constantly press and release pedal( potter).

Symptoms. Weakness of all flexors of foot and toes, difficulty in walking on toes, decrease of Achilles reflex. Also a symptom of affection of the tibial nerve is a decrease in sensitivity on the sole.

Treatment. When expressed symptoms of nerve lesion in the lumbosacral plexus performed promptly release nerve trunk under mild cases - the wearing of suitable shoes, insoles-instep supports, which support the arch of the foot, the unloading gymnastics.