Radial neuralgia treatment. Symptoms of damage to the radial nerve and its branches

RADIAL NERVE [nervus radialis(PNA, JNA, BNA)] is a long nerve of the brachial plexus, innervating the dorsal muscles of the upper limb, the skin of the posterolateral surface of the lower half of the shoulder, forearm and hand.

Anatomy

RADIAL NERVE (color fig. 1-3) starts from the posterior bundle of the brachial plexus (fasc. post, plexus brachialis). Contains nerve fibers most often from segments C5-8, less often from C5-Th1 or C5-7, which are sent to the L. n. as part of all three trunks of the brachial plexus (trunci plexus brachialis), mainly as part of the upper trunk, to a lesser extent - the middle and lower. From the posterior fascicle of the brachial plexus of the L. n. usually departs within the axillary cavity (cavum axillare) at the level of the pectoralis minor muscle behind the axillary artery. In the axillary cavity L. n. is the thickest nerve of the brachial plexus (see). However, after the departure of the muscle branches already at the level of the middle of the shoulder, it becomes thinner and includes fibers mainly only for the forearm and hand. At the level of the upper third of the shoulder, the diameter of the left n. is 3.4-4.6 mm. The largest number of bundles (up to 52, on average 24-28 bundles) is contained in the nerve in the axillary cavity, the smallest (minimum 2, on average 8 bundles) is at the level of the middle of the shoulder. The initial part of the nerve contains up to 22 thousand pulpy nerve fibers and 6-8 thousand non-pulpate ones, in the middle third of the shoulder - 12-15 thousand and 2.5-5 thousand, respectively. Among the pulpy fibers, the diameter is 1 - 3 microns (small) make up 3-11%, 3.1-5 microns (medium) -8-12%, 5.1 - 10 microns (large) - 70-86%, St. 10 microns (very large) - up to 14%. On the shoulder of L. n. located next to the deep artery of the shoulder in the posterior osteofascial space in the brachiomuscular canal (canalis humeromuscularis). Then, perforating the lateral intermuscular septum, it passes into the lateral anterior ulnar groove, where it is located between the brachioradialis muscle - laterally and the brachialis - medially. In the upper part of the named groove in front of the head radius L.n. is divided into two terminal branches: superficial and deep.

L.n. gives off the following branches: 1) articular branch (g. articularis) - to the capsule shoulder joint; 2) posterior cutaneous nerve of the shoulder (n. cutaneus brachii post.) - to the skin of the back of the shoulder; this branch usually originates in the axillary cavity, passes over the long head of the triceps brachii muscle, penetrating the brachial fascia below the insertion of the deltoid muscle, and branches in the skin of the lateral posterior surface of the lower half of the shoulder; 3) lower lateral, cutaneous nerve of the shoulder (n. cutaneus brachii lat. inf.), formed below the previous one, running next to it and branching in the skin of the lateral surface of the lower third of the shoulder; 4) muscular branches (rr. musculares), among which the proximal ones are distinguished, separating from the L. ii. in the axillary cavity to the long, lateral and medial heads of the triceps muscle, to the olecranon muscle, and distal, extending from the L. n. in the depth of the groove between the brachioradialis and brachialis muscles to the lateral part of the brachialis muscle, to the brachioradialis muscle (this branch sends a thin branch to the capsule elbow joint), to the long and short extensor radialis of the hand; 5) posterior cutaneous nerve of the forearm (n. cutaneus antebrachii post.), formed within the brachiomuscular canal, piercing the brachial fascia in the interval between the lateral and medial heads of the triceps muscle, emerging accompanied by the radial collateral artery dorsally from the lateral epicondyle humerus on the dorsal surface of the forearm, giving multiple branches to the skin; 6) superficial branch (g. superficialis), which arises as a terminal branch on the flexor surface of the brachioradialis joint and spreads in the radial groove of the forearm under the brachioradialis muscle. In the lower third of the forearm it passes under the tendon of the brachioradialis muscle to the back of the hand, where it is divided into the dorsal digital nerves (nn. digitales dorsales) for the skin of the back of the hand, fingers I and II, the radial side of the third finger (proximal phalanges); 7) a deep branch (r. profundus), passing through the instep, surrounding the neck of the radius, emerging on the back of the forearm, where it is divided into numerous muscle branches (rr. musculares) to the extensor muscles. The continuation of the deep branch is the posterior interosseous nerve (n. interosseus post.), innervating the long muscle, abductor pollicis, short and long extensor thumb, extensor of the index finger; it gives off a branch to the capsule of the wrist joint.

L.n. forms connections with neighboring nerves. Among them, the most important are between the branches of the radial and axillary nerves, between the superficial branch of the L. n. and the lateral cutaneous nerve of the forearm, as well as the dorsal branch of the ulnar nerve (see). There are differences in the length of the zone of innervation of the cutaneous branches of the L. n. So, for example, on the back of the hand, in some cases the dorsal digital nerves innervate the skin of only the 1st and 2nd fingers, and in others - the 1st, 2nd, 3rd, 4th and radial surfaces of the 5th finger.

Pathology

L.n. is most often affected by wounds and fractures of the shoulder, less often the forearm, with intoxication (lead, alcohol), with compression of the nerve during sleep, especially during intoxication (sleep paralysis, drunken paralysis), when walking on crutches (crutch paralysis), with prolonged fixation hands to the operating table during anesthesia, as well as during prolonged compression with hooks during surgery. Pathology L. n. may also be caused by a tumor emanating from the surrounding tissues and compressing the nerve, or a neuroma (schwannoma, neurofibroma). Malignant tumors of L. n. are rarely observed. When L. is affected. in the shoulder area, the function of the extensors of the shoulder, forearm and hand is lost; the forearm is bent in relation to the shoulder, the hand droops, and the fingers are in a semi-bent state (Fig. 1). Sensitivity disorders with lesions of L. n. (Fig. 2) are noted on the dorsum of the shoulder, forearm, on the dorsum of the radial half of the hand, on the proximal and middle phalanges of the first, second and partially third fingers. Due to connections with other nerves, these disorders have a much smaller area of ​​cutaneous innervation.

At defeat of L. n. in the middle and lower third of the shoulder and upper third of the forearm, the function of the triceps muscle is preserved, paralysis of the extensor digitorum of only the proximal phalanges is noted, and the extension of the middle and distal phalanges is partially preserved due to the function of the interosseous muscles. Depending on the location of the injury, the reflex from the triceps muscle may fall out. When the nerve in the area of ​​the wrist joint is damaged, its terminal branch, which contains many autonomic fibers, is affected, resulting in swelling, coldness and blue discoloration of the dorsum of the hand; pain is extremely rare.

With paralysis of the wrist extensors, the function of the flexors may also suffer, which often leads to incorrect diagnosis of simultaneous damage to the median and ulnar nerve, so the use of tests to help clarify the diagnosis is very important.

The main tests used to diagnose L. n. lesions: 1) both hands approach each other with their palms so that all fingers of the same name come into contact; when the fingers of the healthy hand move away from the fingers of the patient, palmar flexion of the fingers is noted on the side of the affected nerve; 2) when asked to shake the doctor’s hand or form a fist, the flexion position of the drooping hand increases.

Lesions of L. n. can be primary (as a result of injury, tumor) and secondary (when the nerve is involved in scars, compressed by tumors, a plaster cast due to swelling of soft tissues). There are isolated and combined injuries (together with blood vessels and bone).

The symptoms of the lesion are determined by the nature and level of the pathol, the process, depending on which motor and sensory disorders manifest themselves to a greater or lesser extent.

The order of sequential restoration of muscle function during L. n. regeneration. next: extensors of the hand, general extensors of the fingers, long muscle, abductor pollicis and supinator.

Treatment of lesions of L. n. determined by the nature of the patol, the impact (trauma, intoxication, ischemia, allergy). Conservative treatment is aimed at stimulating nerve regeneration and eliminating pain. Dehydrating, desensitizing agents, vitamins, calcium preparations, ATP, lidase, nicotinic acid, complamin, nikoshpan, analgesics (analgin, butadione, reopirin, brufen, etc.), and in some cases acupuncture are used. Physiotherapy (thermal procedures, novocaine electrophoresis, UV erythema therapy), exercise therapy, and massage are prescribed.

Operations are indicated for wedge, nerve rupture, tumors, nerve compression, pain syndrome. For wounds, there are primary (together with surgical treatment of the wound), delayed (in the first weeks) and late (3 months after the wound) operations. In case of combined damage to the nerve and bone, one-stage and two-stage operations are performed. The latter are indicated in cases of impossibility of qualified restoration of the anatomical integrity of the nerve during the first operation, in the presence of an infected bone fracture. The phasing of interventions for combined injuries consists of preparing the nerve for plastic surgery and osteosynthesis, followed by neurorrhaphy (see Nerve suture). Access to the nerve during operations is shown in Figure 3.

The operation is effective with early, atraumatic, radical intervention. They perform neurolysis (see), tumor removal, nerve neuroma, neurorrhaphy, nerve autoplasty. Nerve grafting with preserved nerves is ineffective. The condition for successful neurorrhaphy is that the intervention is atraumatic, the fibers of the central and peripheral ends of the nerve are accurately compared without tension, and individual bundles are sutured using micro-neurosurgical techniques. Benign tumors L.n. (neurinoma-schwannoma, neurofibroma) are subject to removal in case of pain and increasing symptoms of loss of nerve function. In case of malignancy of the tumor, the operation is aimed at its removal with resection of the nerve and extended excision of surrounding tissue to prevent metastasis. Subsequent radiation and chemotherapy complete the treatment. Sometimes radiation treatment is given before surgery.

Bibliography: Atlas of peripheral nervous and venous systems, ed. V. N. Shevkunenko, p. 47, L., 1949; Blinov B.V., Bystritsky M.I. and P about p about in I.F. Rehabilitation of patients with fractures of the diaphysis of the humerus and damage to the radial nerve, Vestn, hir., t. 115, No. 8, p. 96, 1975; Intra-barrel structure peripheral nerves, ed. A. N. Maksimenkova, L., 1963, bibliogr.; Voiculescu V. and Popescu F. Progressive non-traumatic palsy of the deep branch of the radial nerve, Romanian, med. review, no. 4, p. 55, 1969; Grigorovich K. A. Nerve surgery, L., 1969, bibliogr.; Kalnberz V.K., Lishnevsky S.M. and Filippova R.P. Muscle plasticity in radial nerve palsy, Proceedings of Rizhsk. scientific research, Institute of Traumatology, and Orthopedics, vol. 10, p. 189, 1971, bibliogr.; Karchi-k I N S.I. Traumatic lesions of peripheral nerves, L., 1962, bibliogr.; Kovanov V.V. and Travin A.A. Surgical anatomy of the upper extremities, M., 1965; The experience of Soviet medicine in the Great Patriotic War, 1941 - 1945, v. 20, p. 68, M., 1952; O s i n a M. I. Errors and complications in the treatment of injuries of the radial nerve combined with a fracture of the shoulder, in the book: Relevant. Issues, trauma, and orthotics, ed. M. V. Volkova, v. 3, p. 27, M., 1971; Khoroshko V.N. Injuries of peripheral limbs and their physiotherapy, M., 1946; C 1 a g a M. Das Nervensys-tem des Menschen, Lpz., 1959.

D. G. Shefer; S. S. Mikhailov (an.), V. S. Mikhailovsky (neurosurgeon).

radial nerve found in the upper human limbs. It runs along the entire bone of the shoulder, located near the brachial artery. Neuropathy (neuritis) of the radial nerve is often diagnosed in patients of different ages. This deviation occurs due to a malfunction of the nerve caused by prolonged compression. This pathology is considered the most common.

Definition of the concept: radial nerve neuropathy

Due to innervation, a person is able to perform many motor functions:

• Extension movements can be performed in the elbow joint;
• The impulses ensure mobility of the wrist joint;
• The innervation and special anatomy of the hand allows for rotational movement (supination of the hand);
• A person is able to straighten or bend the phalanges of the fingers.

Even with minor malfunctions in the functioning of this well-coordinated system, there is a danger of neuropathy. Any neuralgia can lead to serious pathological disorders.

Often the consequence of this condition is a violation of the extensor function of the upper limb (forearm or wrist). In addition, the patient loses sensitivity in some areas of the hand.

Causes of the disease: radial neuritis

It has been established that the main cause of the development of radial nerve neuritis is considered to be its pinching.

The cause of this condition may be the following factors:

• Unpleasant symptoms occur as a result of severe fatigue, as well as during sleep, when the limb is located under the body;
• Often inflammation is the result of a severe bruise that provokes the appearance of scars under the patient’s armpit;
• Sometimes neuritis appears if the hand has been subjected to prolonged compression (with a tourniquet);
• A similar condition is diagnosed if there is a fracture of the shoulder, or if there is a fracture of the elbow joint;
• Often neuralgia occurs due to improper location of the nerve, and the deviation appears after an injection into the shoulder.

In addition to the above reasons, neuropathy is often formed under the influence of intoxication caused by alcohol, due to lead poisoning, or due to hormonal imbalance. In some patients, neuropathy is a consequence of infectious diseases (pneumonia, influenza) or in the presence of a serious illness (diabetes mellitus).

Signs of three types of disease: radial neuralgia

There are three types of factors that provoke the development of neuritis. The first type (Crutch palsy), in which the forearm extensor muscles are paralyzed. This neuropathy is characterized by the appearance of muscle atrophy (triceps).

The patient can hardly straighten the hand, while the first and second fingers will fit tightly. The ulnar extensor reflex is disrupted, sensitivity deteriorates, causing the person to feel numbness.

The second type develops due to a pinched nerve in the middle third of the shoulder. Often, such compression occurs due to the hand being fixed with a tourniquet for a long time, or when a person has been in an uncomfortable position for a long period. It has been proven that the second type is diagnosed more often than others, because due to the spiral bending of the humerus, muscle limitation occurs.

Symptoms of the second type of neuropathy:

• The extensor reflex of the forearm is not impaired;
• Shoulder sensitivity is preserved;
• Damage to the radial nerve of this type provokes the inability to straighten the fingers;
• Sensitivity of the hand (back side) is lost.

As for the third type, the disease is characterized by damage to the elbow area (due to pinching of the posterior process of the nerve). The disease is often diagnosed in tennis players, the second name is “tennis elbow syndrome.” Manifested severe pain, and sometimes hypotrophy in the forearm extensor muscles, severe pain when rotating the hand.

By revising clinical picture neuropathy Special attention you should look at the place where the radial nerve is pinched; only by correctly determining the type of neuralgia will you be able to quickly cope with the disease.

Treatment of the disease: inflammation of the radial nerve

Before starting treatment for radial neuropathy, it is important to determine the cause. To combat infectious diseases you will need to take medications.

If the cause of this condition is believed to be a nerve rupture, surgery may be indicated.

If neuralgia is a consequence external factors(uncomfortable position during sleep, nerve compression with crutches) it is possible to cope with it without any problems at home or on an outpatient basis.

Conservative treatment with medications includes:

• Anti-inflammatory drugs that relieve pain relieve inflammation;
• Decongestants and vasodilators (nourish weakened muscles);
• Anticholinesterase drugs normalize the transmission of impulses along the radial nerve;
• Biostimulants and vitamins will help speed up the process of nerve regeneration.

The above conservative treatment must be supplemented with special physiotherapeutic procedures. The patient is prescribed massage, exercise therapy, magnetic therapy, as well as electromyostimulation and ozokerite.

Features of therapeutic exercises: radial nerve of the arm

In order for the restoration of the radial nerve to be successful and to restore the lost functioning of the arm, patients should not neglect therapeutic exercises, as well as massage. Exercise therapy is selected by the attending physician, and the characteristics of the disease must be taken into account. The increase in load must occur gradually.

Example effective complex exercises:

1. The arm bent at the elbow must be rested on the table; it is important that the person’s forearm is at a right angle. The thumb should be lowered down and the index finger should be raised up. The movements are performed alternately. Repeat 10 times.
2. The starting position is similar to the previous one. But here the index finger goes down and the middle finger goes up. Perform alternating movements 10 times.
3. The phalanges (main) of the four fingers of the affected hand must be grasped with the healthy fingers of the second hand. Carry out flexion and extension movements 10 times. Next, repeat the procedure with the second phalanges.

Massage for neuritis of the radial nerve (video)

Timely initiation of therapy will help quickly restore the functioning of the radial nerve. Often, recovery time depends on the degree of disease progression. Sometimes the disease becomes chronic, with periodic exacerbations. Conservative drug therapy and therapeutic exercises will help eliminate compression.

• if you raise your hand, the hand continues to hang;
• the first and second fingers are closed together;
• the first finger cannot be retracted;
• the hand and forearm do not straighten;
• flexion in the elbow joint is impaired;
• there is no possibility to make extension movements in the elbow joint;
• paresthesia of fingers.

If the radial nerve of the arm is affected in the middle part, then the function of forearm extension and elbow joint extension is preserved. Even with the presence of all the above symptoms, there is no sensory impairment.

If there is neuropathy of the radial nerve in the lower part, then sensitivity is only partially preserved, and it becomes impossible to straighten the hand and fingers.

In all these situations, muscle tissue atrophy develops, mainly affecting the extensor muscles located on the forearm, hand and phalanges of the fingers. In such patients, the hand simply hangs. General sensitivity also suffers, in particular, the front part of the forearm and the back of the hand. Any serious vegetative disorders nervous system not happening.

Course of the pathological process

There is a progressive increase in symptoms and severity of neurological abnormalities. Loss of sensation and motor activity on the side of the affected limb. The lesion is characterized by symmetry. The course itself can occur in two types: continuously progressive or wave-like attacks of exacerbation and rest.

Diagnostic criteria

The diagnosis can be made by a doctor after a full examination, assessment of motor activity, assessment of preserved sensitivity, and testing of reflexes. Specialists have a set of special tests in their arsenal, on the basis of which it is possible to make a diagnosis such as radial nerve neuropathy.

To determine the depth of the lesion, special devices are used.

Principles of disease treatment

Treatment is usually complex. It includes the following groups of drugs: antioxidants that improve microcirculation, anticholinesterase agents. Dehydration is also carried out, medications containing B vitamins are administered. Additionally, 2-3 weeks after the onset of the disease, physiotherapeutic treatment, exercise therapy, and acupuncture are prescribed. Psychotherapy, manual therapy, homeopathic medicines are included.

When a structure such as the radial nerve is damaged, treatment requires a long time, followed by a complex of restorative and rehabilitation measures.

Causes

This disease can develop due to various reasons. For example, one of the most common is compression of the nerve while a person is sleeping.

• All information on the site is for informational purposes and is NOT a guide to action!
• Can give you an ACCURATE DIAGNOSIS only DOCTOR!
• We kindly ask you NOT to self-medicate, but make an appointment with a specialist!
• Health to you and your loved ones!

Radial neuritis occurs due to excessive numbness of the patient’s arm while he takes a certain position and remains in it for a long time. Typically the upper limb is located either under the head or under the body.

Sleep should be very deep. This often happens when the sleeper is either very tired or intoxicated.

Neuritis of the radial nerve can develop due to its compression by a crutch. This is the so-called crutch paralysis.

The disease can occur if the crutches were not properly sized for height or they do not have a soft padding on the armpit. Excessive compression of the radial nerve leads to the development of the disease.

The third cause of the disease is trauma, for example, a serious injury to the humerus. It can also develop due to excessive compression with a tourniquet. In some cases, the disease occurs when a nerve suddenly contracts.

Traumatic cases of neuritis also include:

Quite rarely, the disease appears after infections: influenza, pneumonia, typhus, etc. Intoxication, for example, alcohol poisoning, can cause the development of radial nerve neuritis.

The main preventive measures include the need to avoid injury, hypothermia and infection.

Symptoms of radial neuritis

The manifestation of the disease will directly depend on the degree of damage and the area of ​​​​damage localization.

But any neuritis is characterized by the following symptoms:

• sensory disturbance (numbness, tingling sensation, etc.);
• paralysis or partial decrease in muscle strength, development of muscle atrophy;
• swelling, blue discoloration of the skin, dry skin and thinning, the appearance of ulcers, etc.

Other symptoms will depend on the location of the damage.

So, if the armpit or the upper third of the shoulder is affected, then the disease is characterized by the following manifestations:

• complete or partial loss of sensitivity;
• the patient is unable to straighten the arm at the radiocarpal joint;
• inability to make any movements with the index and middle fingers.
• violation of the flexion-extension function of joints.

When the middle third of the shoulder is affected, the patient exhibits similar symptoms. However, the patient is able to extend the forearm and sensitivity of the posterior surface of the shoulder is preserved.

In this case, a characteristic sign is a “falling” brush. In addition, the patient cannot straighten his fingers at the metacarpophalangeal joints.

Diagnostics

The doctor can make a preliminary diagnosis based on the patient's complaints and specific clinical picture. Diagnostic tests are required to help assess the level of damaged nerve and the degree of impairment.

The patient, at the doctor's request, performs several light exercises.

The doctor makes conclusions about the presence of the disease based on the following characteristic signs:

• when stretching out his arms, the patient is unable to keep his palms parallel to the floor, his hand simply hangs down;
• specific position of the fingers in relation to each other - the thumb is almost pressed to the index finger, which is not typical for healthy people;
• extension and flexion of joints is difficult;
• loss of sensitivity, numbness of the limbs;
• the patient cannot simultaneously touch the back of the hand with his fingers;
• with neuritis, the patient is unable to move his fingers to the side.

To confirm the diagnosis, the patient is sent for electroneuromyography. Using this procedure, a final diagnosis is made. To assess the degree of nerve recovery after completing a course of therapy, the patient is re-sent to electroneuromyography.

Treatment

Treatment of radial neuritis is determined in accordance with the cause that caused its development. So, if the disease appears due to infections, then the patient is prescribed antibacterial therapy, antiviral and vascular drugs.

For traumatic neuritis, the patient is prescribed anti-inflammatory drugs and analgesics. Treatment begins with immobilization of the limb, then decongestant therapy is prescribed.

In both cases, the patient is prescribed vitamins B, C and E. This is necessary in order to restore blood circulation.

Drug treatment of radial neuritis is used in combination with additional methods that make it possible to cope with the disease more quickly and effectively.

So, the patient is prescribed physiotherapy:

• electrophoresis;
• phonophoresis;
• etc.

Their main goal is to restore sensitivity, as well as increase muscle tone. Usually they are not prescribed immediately, but at the end of the first week of treatment.

In addition, the following procedures apply:

In some cases, a neurosurgeon performs surgical treatment of radial neuritis. It is necessary if the patient continues to have pain and there is a risk of developing muscle atrophy.

The operation is performed when, with a long-term and adequate treatment package, there are no signs of recovery. When processes appear that indicate nerve degeneration, it is also indicated surgical treatment, which involves stitching.

In young patients, neuritis responds well to therapy. On the contrary, in elderly people with concomitant diseases, in the absence of adequate treatment, paralysis and the formation of contractures may occur. That is why you should not self-medicate, and when the first signs of illness appear, seek help from a doctor.

Exercises

Therapy for radial neuritis involves performing a certain set of exercises, which contributes to the rapid restoration of functions and lost muscle volume.

First set of exercises:

Bend your arm at the elbow and place it on a hard surface. To perform the exercise correctly, it is necessary that the forearm be placed perpendicular to the supporting surface. The thumb must be lowered down, while the index finger must be raised up. Then do the reverse exercise. Total – 10 repetitions; Same starting position as in the previous exercise. We try to move the index finger down and raise the middle finger up. Again 10 repetitions; With your healthy hand we hold the main phalanges of the 4 fingers. In this case, the thumb is located on the side of the palm, and the others on the back side. We begin to make flexion-extension movements with the phalanges. We perform these steps 10 times. Then you need to place your hand so that you can do the same, but with the second phalanges. As you recover, you should make this exercise more difficult by bending your fingers into a fist.

Water gymnastics complex (must be performed in the bathroom):

Press with your healthy hand on the middle phalanges of the fingers, trying to completely straighten them; Using your healthy left or right hand, move your fingers up and down; Pull your fingers back using your healthy hand. You need to start with your thumb; Circular rotations with your fingers in one direction and the other; Grab rubber items of unequal size and try to squeeze them with maximum force; Place the towel on the bottom of the bathtub and try to grab it and squeeze it in your hands; Move up and down with 4 fingers; We place the hand vertically to the water on bent fingers and bend it at each phalanx.

Each exercise must be performed at least 10 times. These complexes can be used after consultation with your doctor. They need to be done as carefully as possible, so as not to aggravate the course of the disease.

Folk remedies

There are a variety of traditional medicine that promote a speedy recovery of the patient. It should be remembered that these recipes cannot completely replace traditional healing methods. They can only be used after consultation with your doctor.

Let's consider the most popular recipes of traditional healers:

Propolis	It is necessary to grind 40 grams. propolis and fill it with 96 percent alcohol. This medicinal solution should be placed in a dark place for a week. The drug should be shaken every day. After 7 days, it must be strained and mixed with olive or corn oil. The resulting solution can be used as compresses. A total of 10 procedures are required.
Red clay	Red clay must be mixed with vinegar. The components must be taken in such quantities that the resulting mixture can be used to make a cake, which should be placed on the sore spot overnight. This procedure must be done for three days in a row.

There are other recipes that allow you to quickly recover from radial neuritis. For example, folk healers recommend rubbing the problem area with bear lard every day for a month.

Radial neuritis (ICD 10 code: G56.3) is a disease that can develop for various reasons. Specific symptoms make it easy to diagnose this disease.

One of the common neurological diseases of the upper extremities is radial neuritis.

This nerve runs through the entire arm, originating just above the shoulder joint and ending in the first three fingers of the hand.

He is responsible for turning the hand with the palm up (supination), extension of the elbow and hand, and abduction of the first finger from the rest.

Due to the proximity of the radial nerve to the skin and the peculiarities of its anatomical structure, almost all people are familiar with some of the signs of this disease. For example, everyone knows the condition “overlying the hand” - numbness of the hand after prolonged squeezing during sleep. In a healthy person, this unpleasant symptom goes away within a few minutes, but in a sick person it will bother him for a long time.

The neurological disease in question can appear for several reasons:

1. Infectious or inflammatory disease: influenza, typhus, pneumonia, measles, tuberculosis, herpes, rheumatoid arthritis. The basis of radial nerve neuritis is the inflammatory process that affects this nerve. In other words, bacteria and viruses act as causative agents of neuritis in this case.
2. Traumatic damage to the radial nerve: fracture of the humerus or radius, dislocation of the shoulder or forearm, injuries to the ligaments and tendons of the arm joints, unsuccessful injection.
3. Poisoning of the body with arsenic, lead, mercury, alcoholic beverages or other toxic substances.
4. Compression (squeezing the nerve) is the most common cause of neuritis. Occurs during sleep due to an uncomfortable position of the arm (sleep paralysis), as well as when a tourniquet is applied to the arm to stop bleeding. The radial nerve may be compressed by the tumor. When using crutches, “crutch paralysis” is sometimes observed - compression of the nerve in the armpit. Prisoners experience "prisoner's paralysis" - compression of the radial nerve in the wrist area.
5. Excessive overload of one of the muscles innervated by the radial nerve.

Some diseases can cause hearing problems. if prolonged and left untreated, it can lead to deafness.

Symptoms and treatment methods for facial neuritis are described.

Types of radial neuritis

According to the mechanism of traumatic effect on the radial nerve, all neuritis of the radial nerve can be divided into three types:

1. Axillary neuritis, or “crutch paralysis.” It is less common than other types and is characterized by weakness of the function of the forearm flexors and paralysis of its extensors.
2. Damage to the radial nerve in the area of ​​the middle third of the shoulder, on its outer posterior surface. It is quite common and is usually the result of a fracture, improper injection, or sleeping in an awkward position. Also, neuritis of this type can act as a complication of an infectious disease.
3. "Tennis Player Syndrome"– damage to the posterior branch of the radial nerve in the area of ​​the elbow; mainly occurs due to overload of the muscles of the elbow area, which can often be observed in tennis players. Dystrophic changes in the ligaments and tendons of the elbow joint lead to chronic disease of the radial nerve. It is manifested by pain and weakness in the muscles of the forearm, pain when rotating the hand and when moving the fingers.

Radial nerve location

Symptoms

The pathology expressed by radial nerve neuritis disrupts the normal motor functions of the hand, changes the microstructure of its nerve fibers and reduces sensitivity.

Most often, the disease manifests itself in the form of a symptom of a "hanging brush" on the arm raised forward or up. Pain is felt along the affected nerve trunk.

The symptoms of this disease are varied and depend on the location and type of the pathological process:

1. Wrist and lower forearm area: characterized by burning pain on the back of the first finger, radiating to the forearm and above - to the shoulder, as well as loss of sensation in the skin of the fingers and the back of the hand. Impaired abduction of the thumb. The patient cannot clench his fist painlessly.
2. Elbow, upper forearm or lower third of the shoulder: the sensitivity on the back of the hand decreases, it becomes impossible to straighten the fingers and hand. Pain on the back of the hand intensifies during activities in which the arm is bent at the elbow. The sensitivity of the skin of the forearm is practically not impaired.
3. Upper or middle third of the shoulder and armpit: impossibility of abducting the thumb; only with great difficulty can one bend the arm at the elbow. Weakness and decreased sensitivity of the thumb, index and half of the middle finger, as well as the back of the shoulder. If the patient stretches both hands in front of him, then he cannot turn the sore hand with the palm up, the thumb is pulled towards the index finger, and the hand on the sore side hangs down. If the middle third of the shoulder is affected, the extension of the forearm is not impaired, the sensitivity of the skin of the back of the shoulder is preserved.

In any case of the disease, radial neuritis will be manifested by pain along the nerve, muscle weakness and decreased sensitivity (numbness) in the hand.

Diagnostics

To verify the presence of this pathology, when neurological examination Several functional tests are carried out to identify violations of the motor function of the hand. The following signs clearly indicate radial nerve neuritis:

• if the patient presses both palms to each other and tries to spread his fingers, then on the sore hand the fingers will bend and slide along the palm of the healthy hand;
• with the sore hand lying on the table, palm down, a person will not be able to place its middle finger on the ring or index finger;
• in a standing position with arms down along the body, the patient will not be able to turn the hand forward with the palm on the affected side and move the thumb up;
• When the hands are positioned with the back of the hands lying on the table, the person is unable to abduct the thumb.

Treatment of neuritis of the radial nerve of the hand

When treating this neuritis, the cause of the disease must be taken into account. So, for neuritis caused by bacteria and viruses, drug treatment should be prescribed with the active use of antibiotics and decongestants.

If the disease arose under the influence of external factors, such as sleeping in an uncomfortable position, intense tennis or using crutches, then these factors must be eliminated during treatment.

Neuritis caused by muscle atrophy is treated simultaneously with the underlying disease.

If the disease is a consequence of injury, then in addition to anti-inflammatory drugs, immobility of the injured limb is ensured. If conservative therapy is ineffective, surgical intervention is used, which consists in restoring the injured radial nerve.

To eliminate painful sensations, restore sensitivity and increase muscle tone, physiotherapeutic procedures are prescribed:

• electrophoresis with drugs;
• electromyostimulation;
• ultrasound with hydrocortisone;
• acupuncture;
• magnetic therapy;
• ozokerite.

Vascular preparations are widely used together with vitamin complexes; they help restore normal blood circulation in the sore arm.

Treatment of radial neuritis cannot be complete without physical therapy and massage.

Most rehabilitation exercises are performed using spring and rubber machines to work the joints. Exercises in water are also effective and beneficial.

Therapeutic measures are selected for each patient individually, depending on the symptoms and cause of the disease. Treatment is usually long and requires persistence and patience from the patient.

Leg cramps can occur due to heavy loads, as well as insufficient intake of minerals from food. - review of traditional and folk methods.

At a young age, neuritis responds well to treatment and ends with complete recovery. However, in older people, especially in the presence of concomitant diseases and lack of treatment, limb paralysis and the formation of contractures may occur.

In this regard, in order to avoid irreparable consequences, it is necessary to seek medical help at the first signs of the disease.

Radial nerve neuropathy is a common pathology, well known to neurologists, the main cause of which is compression of the nerve under the influence of various factors with the appearance of characteristic symptoms.

A pathological condition of a nerve or several nerves resulting from compression, trauma, infection or other causes and resulting in functional disorders in the area of ​​nerve innervation, ischemic processes and trophic disorders in the surrounding tissues is called radial nerve neuropathy.

The basis of the neuropathic process is the destruction of nerve structures due to malnutrition and exposure to toxic substances coming from the zone of inflammation of surrounding tissues, pain and swelling occurs in the innervation zone and sensory, motor, autonomic and trophic disorders appear.

Why does it occur?

While sleeping in an uncomfortable position, the radial nerve is compressed by surrounding tissues - neuropathy develops.

Damage to the radial nerve is more common among other nerves of the upper limb: median or. The reason for this may be the following factors:

• Compression-pinching (squeezing) of a nerve: a) during sleep, when a person is in an uncomfortable position on a hard surface for a long time, the hand is pressed by the head or torso, for example, during the deep sleep phase due to alcohol intoxication or severe fatigue; b) “crutch” paralysis—compression of a nerve by a crutch; c) there may be cases of compression by a pacemaker; d) tumor of the axillary fossa.
• Nerve injury resulting from a fracture of the humerus, dislocation of the shoulder or forearm;
• Iatrogenic factors are associated with medical error: a) compression by a tourniquet when performing manipulations to stop bleeding, when it is on the arm for a long time; b) violation of the technique of intramuscular or subcutaneous injections into the shoulder area, when there are peculiarities of the anatomical location of the nerve and a high risk of damage;
• Infectious nerve lesions. Bacterial: for typhus, pneumonia, tuberculosis; Viral: influenza, pneumonia, ;
• Intoxication (in rare cases) with lead, arsenic.

A little anatomy

Before moving on to the symptoms of radial nerve pathology, let us remember it anatomical features. So, the radial nerve is peripheral, that is, located outside the head or spinal cord and is part of the brachial plexus. It is formed by the fibers of the root of the 5th and part of the 8th cervical and partially by the root of the 1st thoracic spinal nerves, descends into the armpit (the first place of possible compression of the radial nerve as a result of external influence) from the brachial plexus in the form of its posterior secondary bundle. Further, the nerve descends down the humerus, passes in the so-called groove of the radial nerve (bone spiral groove), tightly pressed against it, bending around it in the form of a spiral, from behind in its middle third (the second place of probable compression of the nerve).

In the area of ​​the capsule of the elbow joint, the radial nerve gives off two branches, superficial and deep. The first one goes through outer surface of the forearm and passes to the dorsal (posterior) surface of the lower end of the forearm, is divided into small branches that innervate the radial half of the rear of the hand from the nail phalanx of the 1st finger, the middle phalanx of the 2nd, and the radial side of the 3rd finger.

The radial nerve contains motor and sensory fibers, which is why it is called mixed. The motor portion of the fibers innervates the extensor muscles of the shoulder (triceps muscle), wrist, fingers, the supinator (performs the function of abduction) of the forearm, and the muscle that abducts the thumb. The sensitive part of the nerve fibers of the radial nerve branches in the skin of the shoulder, forearm on the dorsal (back) side, the back of the hand and the first three fingers of the hand.

Clinic of the lesion

The presence of certain clinical manifestations will depend on the level of nerve damage:

• motor;
• sensitive;
• trophic and vegetative.

1. If this is the area of ​​the armpit and shoulder in the middle third, then the following disorders occur: a) motor: decreased strength (paresis) of the muscles innervated by this nerve, in this case, when the patient tries to raise his arms and stretch them in front of him, the hand with a pathological the nerve will hang down (“dangling hand”). It is impossible to move the first finger away from the second, to straighten the forearm and hand due to damage to the extensor muscles. The third finger is superimposed on the adjacent one. Supination (outward rotation) of the forearm when extending the arm is difficult. There is no ulnar (extensor) reflex (when struck with a neurological hammer from the outside of the elbow joint, the forearm is extended) and the carporadial reflex is reduced (tapping with a hammer in the wrist area at the styloid process of the radius leads to flexion of the forearm at the elbow joint and phalanges of the fingers. b) Sensitive: burning pain and a feeling of tingling, numbness in the fingers and forearm, hypoesthesia (decreased sensitivity) of the outer side of the forearm, skin in the area of ​​the middle phalanges of the thumb and index fingers in the radial half of the hand.
2. If the nerve in the middle third of the shoulder is damaged, the extension of the forearm is not impaired, the ulnar extensor reflex remains intact, the sensitivity in the shoulder does not change, but all the other symptoms described above are present.
3. In the case of compression of the nerve at the level of the lower third of the shoulder and the upper third of the forearm (one of the most common options), the extensor function of the muscles of the hand and fingers may be impaired, and hypoesthesia of the fingers and the back of the hand may appear.

Autonomic disorders in the innervation zone occur in the form of cold temperatures, “blue discoloration,” paleness of the fingers, and impaired sweating of the skin.

Trophic - muscle nutrition is disrupted due to nerve damage - the muscle loses weight, becomes flabby, the skin on the sore arm is dry, thin, trophic ulcers may appear.

Arch support syndrome

In the most common cases, the radial nerve can be affected in the canal of the supinator fascia of the forearm by compression of the supinator muscle bundles (supinator syndrome). It manifests itself as pain, usually in the elbow, lateral surface of the forearm and dorsum of the hand, which intensifies more often at night. During the day, pain may occur when doing manual work. Pain syndrome also provoked by rotational movements of the forearm (pronation, supination). Complaints of weakness in the hand may often appear, primarily weakness in extension of the little finger, which appears during work, this leads to disruption of the coordinated movement of the fingers and hand, but wrist extension remains - a cardinal symptom that distinguishes nerve compression in the supinator canal from damage to it on the shoulder .

Radial tunnel syndrome

Neuropathy of the branches of the radial nerve can be at the level of the elbow and wrist joint.

Damage to the branches of the nerve at the elbow level is a consequence of severe compression of its bone or connective tissue fibers of the triceps brachii muscle, inflammation of the capsule of the elbow joint, at the level of the wrist - the result of injuries to the radius or ulna, bone tumors, pressure from a bracelet, watch strap or handcuffs, which can cause numbness and acute burning pain in the upper forearm, back of the hand and fingers (or only the 1st finger), increasing during straightening of the fingers. Hypesthesia (decreased sensitivity) of the radial side of the 1st finger and muscle paresis may occur, but they are caused less frequently than with cubital tunnel syndrome.

Diagnostics

Electroneuromyography will help determine the location of nerve damage.

It is advisable to carry out some diagnostic tests to make a correct diagnosis:

• the patient presses his palms tightly against each other with straightened fingers so that the wrists touch and when the hands are extended, the fingers of the affected hand do not move away, but bend and make sliding movements along the healthy palm, and it will also be difficult to spread the fingers;
• the back of the hand and the patient’s fingers cannot simultaneously touch a flat surface;
• if you lower your hands, then on the affected hand it is impossible to abduct the thumb or turn the hand outward;
• with the hand on the palmar surface, it is difficult to place the third finger on the adjacent one.

More complete information about the location of the nerve lesion is obtained using ENMG.

In the program “Live Healthy!” with Elena Malysheva about damage to the radial nerve (see from 34:00 min.):

Hand neuritis is a disease resulting from pinching nerve endings. The first symptom is pain, which has a different area of ​​localization depending on the lesion and intensity. Treatment is carried out using medicines and physiotherapeutic procedures.

The main cause of neuritis of the hand is pinched nerve endings, against which the inflammatory process begins. Occurs as a result of limb injuries, heavy physical exertion, incorrect technique injections. The following factors can also trigger the development of hand neuritis:

1. Hormonal imbalances.
2. Infectious diseases.
3. Disorders of the cardiovascular system.
4. Tuberculosis.
5. Pneumonia.
6. Exposure to toxic substances.
7. Intoxication alcoholic drinks.
8. Disorders of the thyroid gland.

Depending on the cause, there are several types of hand neuritis. This is due to the fact that it is the work of the median nerve, ulnar and radial bundles that provide not only motor activity, but also sensitivity.

When the ulnar bundle is damaged, the sensitivity of some fingers is lost. The phalanges stop extending, and the hands look more like an animal’s paw.

How the disease develops

Neuritis is an inflammatory process that develops in the peripheral nervous system. Hand involvement most often means radial neuropathy. The disease develops against the background of compression of nerve endings, which is accompanied by pain, loss of sensitivity and some other symptoms. In some cases, severe pinching may cause paralysis of the arms.

The arms are connected to the central nervous system by the bundles of the radial, ulnar and median nerves. Illness when pathological process spreads to several bundles of nerve endings at once; in medicine it is called polyneuritis.

Pathology causes dysfunction muscle tissue, and the inflammatory process is accompanied by loss of tendon reflexes. Depending on which nerve is damaged, the functioning of a certain area of ​​the hand or arm is impaired.

Types of radial neuritis

All neuritis of the radial nerve of the hand is usually divided into three types depending on the traumatic effect. These include:

1. Axillary. Also called crutch palsy. Diagnosed in rare cases. A distinctive feature is the weakness of the flexion function of the forearm. In addition, there is a loss of extensor mobility.
2. "Tennis Player Syndrome" It is characterized by injury to the posterior branch of the nerve in the elbow area. The reasons for development are large physical exercise when the pressure was on the elbow. This is exactly what can be observed when playing tennis, for which this type got its name. All changes that occur with radial nerve neuritis lead to chronic disease nerve bundle. It manifests itself as painful sensations when moving the arm or moving the fingers.
3. Nerve damage in the middle third of the shoulder, as well as on the outer back surface. Happens quite often. The causes include fractures, sleeping in an awkward position and incorrectly administered injections.

Radial neuritis in some cases may be the result of previous infectious diseases, when a person received insufficient or no treatment. Most often, due to infection, damage to the middle third of the shoulder develops.

Symptoms of hand neuritis

Symptoms of the disease directly depend on the degree and area of ​​damage. Common features include:

1. Loss of sensitivity. Patients often complain of numbness and tingling in the upper extremities.
2. Partial decrease in strength or paralysis of muscle tissue. Atrophy may develop.
3. Swelling of the skin.
4. Blue discoloration of the upper layer of the epidermis.
5. Thinning skin and dryness.
6. The appearance of ulcers on the surface of the skin.

In cases of injury to the armpit or upper third of the shoulder, the pathology is characterized by the following symptoms:

1. Partial or complete loss of sensation.
2. Inability to move the index and middle fingers.
3. Violation of flexion and extension functions.
4. Inability to straighten the arm in the wrist area.

When the middle third of the shoulder is affected, the same symptoms are observed. At the same time, motor activity and sensitivity of the shoulder are preserved. A distinctive feature is the “falling” brush. The patient is unable to straighten his fingers at the metacarpophalangeal joints.

Diagnostics

The neurologist first establishes the symptoms and conducts an examination. Also, to determine the degree of impairment of motor activity, it is necessary to perform several tests:

1. The patient should press his palms together and spread his fingers apart. With neuritis of the radial nerve, the fingers of the damaged limb will slide over the palm of the healthy one.
2. The patient's injured hand should be placed on the table, palm down. As the disease progresses, he will not be able to place his middle finger on his index or ring finger.
3. The patient should stand up and lower his arms along the body. With neuritis, it will be impossible to turn the injured hand forward with the palm and raise the thumb up.

Radial neuritis is diagnosed based on test results. After establishing the degree and area of ​​localization of inflammation, the doctor determines treatment regimens.

Treatment of hand neuritis

The course of therapy depends on the cause of the disease. Antibiotics are used in cases where neuritis is a complication of an infectious or bacterial disease.

The goal of treatment is to restore blood circulation in the limb. For this purpose they are appointed medicines And vitamin complexes, which help normalize the functioning of the peripheral nervous system. Taking anti-inflammatory drugs such as Ibuprofen is also indicated. It helps not only stop the pathological process, but also relieve pain.

After symptoms are eliminated, patients are prescribed a course of therapeutic massage and physiotherapy. Treatment methods allow you to restore hand function. Electrophoresis and magnetic therapy are indicated.

In severe cases, when suturing of injured nerve fibers is required, surgical intervention is performed.

Treatment folk remedies is strictly prohibited, as this can lead to irreversible processes, and it will be impossible to restore motor activity and sensitivity.

Prevention

As preventive measures Various hand injuries and hypothermia should be avoided. It is also recommended to promptly treat all infectious diseases and carry out vaccinations. In order to maintain immunity, you need to eat right, exercise, follow a work and rest schedule, and also healthy image life.

Neuritis of the hand manifests itself with pronounced symptoms, but can be treated without difficulty. The main goal of therapy is to restore impaired blood circulation. If you consult a specialist in a timely manner, the disease goes away without a trace and there are no consequences. But you should remember that self-medication is strictly prohibited.