Carpal tunnel syndrome - symptoms and treatment

Radial neuritis - what is it?

The radial nerve runs along the back of the humerus, it is part of the posterior bundle of the brachial plexus. This nerve causes the triceps muscle, hand, elbow muscle, muscle responsible for supination of the forearm and finger extensors to move, and controls the sensitivity of the back of the hand (namely the area between the 2nd and 1st fingers). If the radial nerve is affected, the upper limb is almost completely immobilized: the person is unable to write normally, lift and lower objects, knit, or perform other actions associated not only with fine motor skills, but also with coarser ones (holding objects in the hand: a glass, knife, spoon, etc.).

Discussion

The recurrent radial arteries are branches of the radial artery passing between the trunk of the spinal nerve and having an anastomosis with the distal portion of the deep brachial artery [15]. The literature [16–20] provides a description of various neurovascular compression syndromes of the arms with different patient management tactics: compression of the anterior interosseous nerve by a branch of the anterior interosseous artery, compression of the ulnar nerve in Guyon’s canal due to thrombosis or aneurysm of the ulnar artery, compression of the ulnar nerve by the recurrent radial arteries, compression of the brachial plexus of the posterior scapular artery.

The ultrasound picture of compression neuropathy of the recurrent radial arteries is described only in one observation (2013), in which C. Rolla Bigliani et al. [19] presented a case of changes in the shape of the nerve with subsequent confirmation of the diagnosis intraoperatively.

DIAGNOSIS OF RADIAL NERVE NEURitis

The doctor will have to make sure that this lesion of the radial nerve is neuritis; for this, the Naran clinic performs a special pulse diagnosis: careful listening to the pulse allows an experienced specialist to determine the degree of functionality of a particular organ, the patient’s emotional state and even the presence of mental problems. Other diagnostic methods are also mandatory: questioning and examination. In addition, some functional tests are carried out, for example:

  • the patient stands with his arms down, the doctor asks him to turn his hand, palm up, and move his thumb to the side;
  • the patient places the hand on the table with the back side up, the doctor asks to press the fingers to the plane without lifting the hand from it;
  • the patient places the hand on the table, the doctor asks to place the middle finger on top of the index or ring finger;
  • the patient presses his palms together, the doctor asks to spread the fingers of both hands to the sides.

Who will treat you?

Bogdanov Vadim Yurievich

Chief traumatologist-orthopedist..
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Ronami Valery Guseinovich

neurologist, reflexologist, chiropractor, professor, doctor of medical sciences.
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Dremin Evgeniy Vitalievich

neurologist, reflexologist, chiropractor.
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Repeated appointments with a neurologist based on examination results in our clinic are free.

CAUSES OF RADIAL NERVE NEURITIS

Research by Tibetan healers has long revealed a direct connection between neuropathy and a disorder of the Wind constitution, which is responsible for the nervous system, mental activity, rhythm of the heart, intestinal motility, and muscle activity.
It is believed that neuritis is a “cold blood” disease: Wind is very sensitive to prolonged exposure to low temperatures. It is extremely important to start herbal medicine on time and act on the disturbance of this constitution with external methods of Tibetan medicine in order to prevent its spread throughout the body. However, other reasons cannot be excluded:

  • long-term, untreated osteochondrosis of the cervicothoracic spine
  • anatomical feature;
  • previous injury in the neck, shoulder, elbow;
  • compression of the nerve (for example, during sleep, when the head rests on the hand for a long time);
  • infection or intoxication.

Tunnel syndrome: where it’s narrow, it hurts

“Tennis elbow,” “lovers’ palsy,” “park bench” syndrome—metaphors add a romantic charm to the names of tunnel neuropathies. But those who experience their symptoms have no time for lyrical associations: pain from carpal tunnel syndrome not only significantly impairs the quality of life, but can even lead to disability.

What are the most common tunnel neuropathies, how do they manifest and, most importantly, what to do about it?

Bunch of nerves

To transmit signals from the brain, they “entangle” the entire body. Nerve fibers also pass through the so-called anatomical tunnels - narrow spaces, the walls of which are various bones, tendons and muscles.

Normally, there is enough space for nerves in such conditions. But under certain circumstances, the narrow canal can narrow, and then the nerve is compressed. This is how tunnel syndrome or tunnel neuropathy occurs.

Circumstances that predispose to the development of “conflict” may be different. First of all, these are congenital anomalies, for example, additional muscles, tendons, fibrous cords in the tunnel area.

A number of diseases and conditions can contribute to tunnel syndrome, for example, diabetes, osteoarthritis, gout, malignant tumors, edema, pregnancy.

Tunnel neuropathy also occurs in completely healthy people whose professional activities are associated with constant microtrauma.

Programmers who don’t let go of their mouse for days on end, woodcarvers whose hand is used to holding a tool in the same position, and also milkmaids, wrappers, stenographers—representatives of these and some other professions may one day experience “strange” symptoms.

If there is a conflict in the tunnel...

The first sign of pinched nerves passing through the tunnel is usually pain. It appears against the background of inflammatory changes occurring in the “conflict” zone, as well as as a result of damage to the nerve itself.

In the initial stages, pain occurs only after exercise. As it progresses, it begins to occur at rest, including at night.

In this case, pain often appears in response to irritants that usually do not affect pain receptors: light stroking, exposure to moderate temperatures can cause a new attack.

Often the pain has the character of an electric shooting, penetrating the area of ​​“conflict” with lightning speed and sharpness. Classic signs of carpal tunnel syndrome are also numbness and tingling (paresthesia) in the affected area.

Later, difficulties may arise when making “fine” movements, for example, when fastening buttons, as well as increased fatigue of the muscles in the affected area. By the way, this area can be located in a variety of places.

Weak spots

About 30 types of tunnel syndromes are known. They can occur in the neck, shoulder region, arms, legs, and pelvic girdle. The most common tunnel neuropathies include:

• Carpal tunnel syndrome, the most common form of neuropathy, occurs due to compression of the median nerve under the transverse carpal ligament and is accompanied by damage to the hand. Working at a computer, drawing, driving are leading risk factors.

• Radial nerve compression syndrome can occur at various levels. If compression occurs in the middle third of the shoulder, “park bench” syndrome develops. The name comes from the fact that compression occurs when sleeping on hard surfaces. When the deep posterior branch of the radial nerve is compressed, tennis elbow occurs. Compression is typical for athletes who experience regular muscle overload in the area where the nerve passes - tennis players, badminton players, etc.

• Pronator teres syndrome ("lover's palsy") occurs as a result of compression of the median nerve in the forearm. It can occur with prolonged compression of the tissue in the forearm area, for example, if the beloved’s head rests on the forearm of the happy groom all night.

• Scapular notch syndrome develops as a result of compression of the nerve in the gap formed by the scapular notch and is characterized by pain in the depths of the shoulder joint.

• Piriformis syndrome occurs when the sciatic nerve is compressed and manifests as pain along the back of the leg.

Health to the nerves!

Despite the wide “geography” of tunnel syndromes, their diagnosis and treatment have common principles. The diagnosis is most often made on the basis of “telling” clinical manifestations. In addition, there are a number of tests that can distinguish one carpal tunnel syndrome from another.

To carry them out, neither laboratories nor equipment are needed: the sickest and most qualified neurologist who knows how and where to press is enough.

The basic principle of treatment for all tunnel syndromes is to stop exposure to the factor causing the narrowing of the tunnel.

Programmers will have to leave the computer mouse alone, milkmaids will have to take a break from cow cows, and pianists will have to put off playing their favorite instrument until better times.

However, milking cows or playing the piano with a bandage, splint or orthosis is unlikely to work: another necessary therapeutic measure is fixation of the affected area. And, of course, to alleviate the course of neuropathy, pain therapy is prescribed.

The patient may experience the following symptoms of neuritis:

  • disorder of muscle tone of the hand and forearm;
  • paresis or paralysis of the muscles of the hand and other innervated muscles. After about a couple of weeks, the muscles begin to atrophy;
  • violation of individual reflexes: with mechanical impact (for example, a blow with a hammer) on the periosteum or tendon, the muscles do not contract;
  • loss (complete or partial) of sensitivity (it seems like “goosebumps are crawling” or numbness is felt);
  • “clawed paw” - the adequate ability to extend and bend the fingers is impaired, the middle phalanges are sharply straightened and the tips of the fingers are bent, the hand resembles the paw of an animal;
  • difficulty spreading your fingers to the sides;
  • involuntary drooping of the hand. It becomes especially noticeable when the arm is stretched forward: the hand hangs down, and it becomes impossible for the patient to straighten it or the fingers.

ABOUT TREATMENT OF RADIAL NERVE NEURitis

If you are faced with neuritis of any origin, give up the idea of ​​self-medicating.
Contacting an experienced doctor will protect you from unpleasant consequences and relapses, and will allow you to quickly restore the motor activity of the injured arm. Radial nerve neuropathy is a “cold” disease, so first of all, the doctor will probably recommend procedures that warm the body and force the qi energy to actively circulate:

  • stone therapy;
  • Mongolian moxibustion;
  • warming up with wormwood cigars.

Treatment methods that affect the bioactive
are almost 100% effective :

  • acupuncture;
  • Su-Jok therapy;
  • hirudotherapy;
  • acupressure.

Treatment of any disease must be comprehensive; the importance of methods such as:

  • lifestyle changes
    : a good night's sleep, positive thoughts;
  • nutrition correction
    . If there is an imbalance in the nervous system, foods with sour, sweet, spicy and salty tastes are recommended, preferably freshly prepared. You should limit drinking cool water, consuming fruits and vegetables, strong coffee and unsweetened tea;
  • herbal medicine
    . Herbs that are collected in places with ideal ecology remove toxins, fill the body with healing energy, and have a mild anti-inflammatory effect.

Home gymnastics will not be superfluous: the patient can perform alternate squeezing and straightening of the fingers, putting them into a “lock” and other simple exercises for the hands.

Case from practice

A 38-year-old woman came to the Naran clinic with complaints of decreased sensitivity, limited flexion and extension of the fingers of her right hand. According to the patient, two weeks ago there was an injury to her right hand - the woman slipped and fell on her right hand. When contacting the trauma center, the fracture was not diagnosed. After a consultation at the Naran clinic, the doctor made a diagnosis: post-traumatic neuritis of the radial nerve.

A course of 11 sessions of complex treatment was carried out in combination with the use of Tibetan herbal remedies. The treatment complex included: deep acupressure of the whole body, acupuncture, vacuum therapy, stone therapy, moxotherapy. After completing the course of treatment, the woman’s condition improved significantly - sensitivity was restored and range of motion was restored. A repeat course of treatment was recommended to consolidate the effect after 6 months.

How is radial neuropathy of the radial nerve treated?

The main direction in healing from neuralgia of this type is the elimination of the factors that caused it. A number of measures are carried out to maintain the metabolism and blood vessels of the area that has been subjected to destructive effects, and the functionality and strength component of muscle tissue are restored. In any case, an integrated approach to solving the problem is necessary. The treatment program includes drug therapy: taking antibiotics, anti-inflammatory and decongestant drugs. If necessary, the body is detoxified. In the case of traumatic neuralgia, the dislocation is reduced, the position of broken bones is corrected, and the limb is fixed. Often such injuries are so complex that corrective surgery, including nerve grafting, is necessary to eliminate them.

Vitamins B1, B6, hemodialysate, thioctic acid, pentoxifylline, nicotine, neostigmine contribute to faster recovery. Massage, manual therapy, electrical myostimulation, and physical therapy are also recommended.

FAQ

Is it possible to cure a disease without drugs?

To choose the right treatment for radial neuritis, you need to know the cause of the disease, and it is better if a doctor does this. The Naran clinic does not use pharmaceuticals, but only prescribes natural Tibetan herbal medicines, which have a healing, harmonizing effect on the nervous system as a whole. Herbal medicine is used in combination with external procedures prescribed individually to each patient.

Bibliography

  1. Tibetan medicine: Big encyclopedia / Svetlana Choizhinimaeva. - Moscow: Eksmo, 2015. - 384 p. - (Russian Medical Library). ISBN 978-5-699-79532-1.
  2. “Choosing vitamins.” — Iozefovich O.V., Ruleva A.A., Kharit S.M. — Issues of modern pediatrics — 2010.
  3. Haglund MM, Moore AJ, Marsh H, Uttley D. Outcome after repeat lumbar microdiscectomy. // Br J Neurosurg. – 1995 – V. 9 – P.487–95.
  4. Delicious food. Tibetan medical science about the art of food / Svetlana Choizhinimaeva. — Moscow: Arguments of the Week, 2021. — 320 p. ISBN 978-5-9908777-0-2.
  5. Notes of a doctor of Tibetan medicine / Svetlana Choizhinimaeva. — Moscow: Arguments of the Week, 2021. — 160 p. — ISBN 978-5-6040607-2-8.
  6. McGirt MJ, Ambrossi GL, Datoo G, Sciubba DM et al. Recurrent disc herniation and long–term back pain after primary lumbar discectomy: review of outcomes reported for limited versus aggressive disc removal. // Neurosurgery. – 2009 – V.64 – P.338–45.
  7. "Physiological basis of nutrition." Zinchuk V.V. — Journal of Grodno State Medical University — 2014.

Facial neuritis: symptoms and treatment

In a multifactorial disease of the peripheral nervous system, 7 pairs of cranial nerves are affected. Often the provoking factor is hypothermia of the face. The patient has weakness of the facial muscles.

Signs of asymmetry:

  • lack of ability to wrinkle forehead;
  • the corner of the mouth is lowered;
  • failure to close the eyelids on the affected part;
  • failures when trying to smile or whistle;
  • speech ceases to be intelligible.

Depending on the level of damage, other symptoms are observed in the treatment of facial neuritis: dry eyes or tearfulness when eating, increased sensitivity to sounds, a pronounced nasolabial fold on the affected side.

To relieve inflammation, medications are used, physiotherapy and therapeutic massage, and acupuncture are performed. Physiotherapeutic procedures are prescribed from the 7th to 10th day of treatment to improve blood circulation and prevent the development of muscle contractures. Therapeutic massage for the treatment of facial neuritis is indicated from 2–6 weeks of the disease, depending on the course of the disease and the individual characteristics of the patient’s body.

Drug treatment of facial neuritis involves taking several groups of medications. The list may include:

  • anti-inflammatory drugs: glucocorticosteroids;
  • diuretics - to relieve swelling during an additionally prescribed diet;
  • B vitamins;
  • antispasmodics and analgesics;
  • means for symptomatic treatment: for dry eyes, antibacterial drugs, for herpes, acute respiratory viral infections - antiviral drugs.

If the treatment of facial nerve neuritis is carried out incorrectly or at the wrong time, a complication may occur in the form of contracture of the facial muscles. Spontaneous twitching of the facial muscles is observed; when eating, the palpebral fissure narrows. The cheek on the affected side is thicker. In this case, only plastic surgeons can eliminate the deformity.

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