Inflammation of the articular nerves of the shoulder is called plexitis of the shoulder joint. This disease can not only cause the patient a lot of unpleasant sensations, but also make him disabled, unable to even perform everyday household tasks. The fact is that plexitis affects the “main” hand, i.e. right - for right-handers and left - for left-handers.
In addition, the disease is accompanied by pain that worsens at night. Fine motor skills are sharply reduced. If the disease is advanced or severe, plexitis can lead to muscle atrophy, paresis
and even paralysis.
Treatment of shoulder plexitis
Conservative treatment for brachial plexitis is complex and includes:
- drug therapy;
- massage, osteopathy;
- physiotherapy;
- various types of electrotherapy;
- cryo- and laser therapy;
- balneological treatment
; - reflexology and hirudotherapy;
- physical therapy.
For drug therapy of the disease, doctors prescribe modern, highly effective drugs:
- analgesics;
- anti-inflammatory agents;
- drugs to improve blood circulation;
- agents that restore nerve conduction;
- vitamins (B1, B12).
If there is such a need, specific medications can be used.
Anti-inflammatory therapy is one of the main components of the treatment of plexitis of the shoulder joint. Non-steroidal medications are used as anti-inflammatory agents, which not only prevent the development of the inflammatory process in the nervous tissue, but also relieve pain. These drugs can be prescribed either in the form of tablets or injection solutions, or in the form of ointments and creams.
If the inflammatory process is severe, the use of hormonal medications may be prescribed that effectively fight inflammation and accelerate the process of tissue repair.
What is shoulder plexitis, how to recognize and treat it
Very often, along with the shoulder, plexitis also affects the cervical region, since it is located in close proximity to the shoulder. At the first noticeable problem in the shoulder and arm area, for example, pain when moving a limb, after waking up there is a prolonged feeling of numbness.
Plexitis occurs on the right or left side, but is often referred to as bilateral plexitis. The disease can be the result of a large list of reasons, including injuries, infections, allergies and others.
How does the disease progress?
The course of the disease is divided into two stages:
- Neuralgia
Here the symptoms manifest themselves as pain in the muscles and joints, aggravated by movement.
- Paralysis
Here the pain turns into muscle weakness, which ends in atrophy, which, in turn, ends in paralysis.
Symptoms of plexitis
- Shoulder pain that gets worse with the slightest movement of the arm. It can be of the nature of attacks, and radiate to the collarbone and arm.
- Atrophy is swelling and pallor of the skin at the site of the lesion, the nails of the affected hand become brittle, and the palms sweat profusely.
- The sensitivity of the hand decreases, which indicates paralysis.
- The muscles of the arm are so weakened that they do not allow performing basic tasks.
Additional symptoms
- Breathing problems.
- Intense hiccups.
- Constriction of the pupils.
- Recession of the eyeballs on the side affected by the disease.
The disease can be localized in various areas of the shoulder joint and can be divided into:
- Upper – pain is focused in the supraclavicular region.
- Lower – pain is concentrated in the area of the elbow, hand and forearm.
- Total - pain spreads throughout the shoulder and arm.
Methods for diagnosing plexitis
- Examination by a doctor and medical history.
- Neuromyography.
- Electromyography.
- Magnetic resonance imaging.
- Ultrasonography.
- X-ray.
- Laboratory blood tests.
Work with plexitis and its diagnosis is carried out by a neurologist, who often involves doctors from other fields of medicine, for example, a gynecologist, urologist, and traumatologist. An x-ray of the entire spinal column and an ultrasound of the internal organs may also be prescribed.
Treatment of brachial plexitis
Nowadays, only conservative therapy methods are used to treat the disease, and usually the injured arm is fixed with a splint in order to avoid its mobility.
To begin with, drug treatment of plexitis is prescribed in order to relieve nerve inflammation:
- Painkillers are of various types that will quickly and effectively relieve pain.
- Non-steroidal anti-inflammatory drugs - they act locally on the sore spot.
- Multivitamin complexes with a predominance of vitamins of groups B, A, E.
- Anticholinesterase drugs (improves the transmission of nerve impulses).
- Decongestants.
- Medicines that increase tissue nutrition.
- Products that improve blood microcirculation.
After the main pain has subsided, a course of rehabilitation therapy begins, among which much attention is paid to manual and physical therapy. The most common recovery methods are:
- Acupuncture.
- Therapy with leeches.
- Massage course.
- Various therapeutic and physical training complexes.
The most commonly used physiotherapeutic methods are: cryotherapy, magnetic therapy, dynamic currents, ozokerite, balneotherapy and other methods of physiotherapy.
Treatment of plexitis usually takes place in combination with the use of traditional medicine methods, since only a complex effect on the disease can bring tangible and significant results.
In the event that plexitis is a consequence of an injury received by the baby during childbirth, then treatment is usually started immediately. Typically, treatment methods include massage, exercise therapy, special nutrition, and medications that improve the level of immunity.
The main thing is to consult a doctor in time so that treatment of the disease can begin in a timely manner.
Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr
Causes of the disease
https://www.youtube.com/watch?v=qLaLuPJZD2E
Hello. My name is Inna. I am an obstetrician-gynecologist, director of the women's health center. After graduating from the university with a degree in General Medicine, there was a subordination in the profile of Obstetrics and Gynecology and after that an internship at a clinical maternity hospital.
Rate this article:
(0 votes, average: 0 out of 5)
The brachial plexus is formed by the lower cervical and upper thoracic spinal nerves.
The following factors can lead to their inflammation:
- Traumatic injuries – dislocations, fractures, wounds, sprains and bruises in the area of the collarbone and shoulder joint.
- Long-term irritating effects on the nerves that form the brachial plexus due to the characteristics of professional activity (the effect of vibration), compression of the nerve branches due to an uncomfortable posture during sleep, walking with crutches.
- Thoracic or cervical osteochondrosis.
- Hypothermia.
- Birth trauma in a child.
- Pathologies of lymph nodes.
- Viral or bacterial infection (cytomegalovirus, herpes, etc.).
- Compression of nerve fibers by malignant neoplasms, accessory cervical ribs or an aneurysm - a pathological protrusion of the wall of a nearby blood vessel.
- Metabolic disorders and related diseases - diabetes, gout, etc.
Massagers can help improve blood circulation and reduce pain at home. Details
Here
.
Lyapko applicators: needle mats, rollers, plates. What is the power of miracle applicators? Here is a description of popular and inexpensive boarding houses and sanatoriums in the Moscow region.
Plexites
As a rule, plexite is one-sided. There are several stages in its course. In the neuralgic stage, the leading symptom is plexalgia - pain that occurs in the nerve plexus and radiates to the periphery along its nerve trunks. Plexalgia is often spontaneous and worsens with pressure in the area of the nerve plexus, at night and during movement. Mild sensory disturbances may occur.
The appearance of signs of loss of function of the nerves of the affected plexus marks the transition of plexitis to the paralytic stage. Paresis or paralysis, hypotension and wasting of the muscles innervated by these nerves are observed; loss of corresponding tendon reflexes is noted. In the areas for which the affected plexus is responsible for innervation, all types of sensitivity suffer and trophic disorders appear - vasomotor reactions, pastosity, hyperhidrosis or anhidrosis, skin pallor. Plexitis can be complete or partial. In the latter case, the symptoms of the paralytic stage appear more narrowly - only in areas innervated by the affected part of the plexus.
Subsequently, plexitis goes into a recovery stage, which can last up to a year. The degree of restoration of lost nerve functions varies. With incomplete recovery, plexitis leads to irreversible residual effects in the form of persistent flaccid paresis, muscle atrophy, and joint contractures.
Cervical plexitis manifests itself as diffuse pain along the anterolateral surface of the neck, radiating to the ear and back of the head. When the nerves of the cervical plexus are irritated, muscular-dystonic syndrome may develop in the form of spastic torticollis. Possible irritation of the phrenic nerve, accompanied by hiccups. In the paralytic stage, cervical plexitis is manifested by paresis of the diaphragm, atrophy of the posterior cervical and suboccipital muscles.
Brachial plexitis can be upper, lower and total. Total brachial plexitis is characterized by pain in the entire upper limb, bearing individual signs of sympathalgia; flaccid paresis of the arm; atrophy of the muscles of the arm and shoulder girdle; loss of tendon reflexes and signs of autonomic-trophic dysfunction in the tissues of the upper limb. Due to muscle atrophy, habitual shoulder dislocation may occur. In the stage of residual effects, contracture of the elbow joint is possible.
Lumbar plexitis is accompanied by plexalgia with irradiation of pain along the anterior surface of the thigh and into the buttock. The adduction and flexion of the hip and the extension of the knee joint are impaired. For this reason, the patient finds it difficult to walk and stand. There is no knee reflex and sensory perception of the gluteal region of the thigh and the medial surface of the lower leg. Atrophic changes are noted in the muscles of the buttocks and the front of the thigh. Contracture of the knee joint may develop.
Sacral plexitis is often combined with lumbar plexitis. It is characterized by pain radiating down the leg in the sacral area, the presence of trigger points along the gluteal and sciatic nerve trunks, hypoesthesia and muscle atrophy along the back of the thigh, foot and lower leg. Plexitis of the coccygeal plexus is characterized by the absence of the anal reflex, disorders of defecation, urination and sexual function.
Birth injury to the brachial plexus
Birth injury to the brachial plexus, or “obstetric palsy” as it is often called, is paralysis of the upper limb resulting from birth injury to the brachial plexus or the nerve roots that form it. Often this is facilitated by difficult and difficult childbirth, discrepancy between the size of the fetus and the birth canal, pathological presentation of the fetus, and the use of various methods of obstetric intervention. It should be noted that the cause is not always the incorrect provision of medical care, since some factors cannot be corrected in advance.
Currently, there are three forms of obstetric paralysis and paresis. This division is necessary to determine treatment tactics and make a prognosis for the future, since the clinical picture, depending on the form, will be different:
- lesions of the upper part of the brachial plexus - the Erb-Duchenne form - are most common (from 60% of cases). In this case, the muscles in the area of the scapula and shoulder joint suffer, and flexion of the arm at the elbow joint is difficult or completely absent. The arm hangs passively, movements are maintained only in the hand, the arm is usually pressed to the body and turned inward;
- damage to the lower part of the brachial plexus - Dejerine-Klumpke form - a rather rare form of paralysis (up to 10% of cases), with this form of movement in the shoulder joint is preserved, and movements in the hand and fingers are significantly difficult or completely absent;
- damage to the upper and lower parts of the brachial plexus - a mixed form of obstetric paralysis - (about 30% of cases), the most severe form, in which movement along the entire limb - from the hand to the shoulder - is significantly limited or completely absent.
In the first days and even weeks of life, it is not always possible to determine the severity of the damaged brachial plexus, since the entire arm is completely immobile. Only by 3-4 weeks of age does it become clear which part of the brachial plexus is most affected.
The course of paresis depends on the severity of the lesion. In mild cases, motor functions of the hand are restored within 1-3 months. If complete recovery does not occur during this period, the impairment of motor function will remain forever, but the severity of this impairment, the degree of limitation in everyday life, the degree of visibility of the problem to others can be completely different, and this already depends on the treatment.
For lesions of mild to moderate severity, early, comprehensive and regular complex treatment helps to achieve good compensation.
With severe lesions , the limitation of movements in the hand will be pronounced, but the range of movements and muscle strength can be increased quite noticeably.
Active early treatment must begin in the first weeks of life with orthopedic correction in the form of special hand placements, as well as therapeutic massage, physical therapy and physiotherapeutic procedures.
The most effective work with a child is in the first year of life, especially in the first 3-6 months, since the most active restoration of functions occurs during this period.
It should be noted that in the absence of treatment, radiographic changes in the form of osteoporosis are revealed in the affected limb, and ossification processes slow down already at 5-7 months of life. By the age of one, the process of lag in the development of the humerus, forearm and hand bones on the affected side becomes more obvious and sometimes irreversible, the development of the elbow joint is disrupted, and persistent contractures are formed. The severity of these changes depends on the severity of damage to the neuromuscular system, activity and adequacy of treatment.
Therefore, courses of massage and physical therapy must be repeated every 1.5 - 2 months. Physiotherapeutic procedures include laser therapy on the area of projection of the brachial plexus. Very early, from 3 to 4 months of age, electrical stimulation of muscles is used. At the same age, reflexology is also performed. This comprehensive approach brings tangible results.
Closer to one year of life, more active work with contractures is often necessary. Even mild contractures in the shoulder and elbow joints can be very persistent, significantly limit movement, fix the arm in a pathological position and are difficult to treat. During this period, thermal procedures are prescribed, the massage therapist and kinesiotherapist pay a lot of attention to the development of joints.
To summarize, we note that complex treatment of birth injury to the shoulder joint necessarily includes, along with drug treatment, therapeutic massage, physical therapy, electrical muscle stimulation, and reflexology.
Complex treatment in the form of regular courses should continue throughout the child’s growth period. Most often in early childhood and preschool period. In the future, depending on growth activity, i.e. During the period of growth spurts (stretching), rehabilitation courses are carried out more often.
Even with severe lesions of the brachial plexus, with timely and ongoing treatment, it is possible to increase the range of movements, “raise” the arm to a horizontal level and higher, reduce or even completely prevent the development of contractures in the joints, slow down or stop the growth retardation of the affected arm. This requires patience and regular hard work of parents and children.
Unfortunately, with irregular, insufficient treatment, there will inevitably be an increase in the severity of contractures, a decrease in muscle strength, a decrease in the active range of movements, and the deformation of the skeletal system will be more severe: shortening of the limb, scoliotic deformity of the spine.
I would like to emphasize once again that the basis for successful treatment is the earliest possible start of therapy (in the first 2 weeks of life) and regular, comprehensive, highly professional and consistent treatment in the future.
At the Pain Treatment Center of RAM Clinics, we, using the extensive experience of our specialists in treating children with birth injuries of the brachial plexus, will consult your child, draw up a treatment plan for the near future, issue detailed recommendations, and also offer the services of our Treatment and Rehabilitation Center.
Pathogenesis
This disease has two stages:
- Neuralgic. This form is characterized by the severity of symptoms that are associated with irritation of nerve endings. This may include, for example, pain in muscles and skin, which increases significantly if you perform even the simplest movements;
- Paralytic. Symptoms associated with impaired functioning of nerve fibers predominate. This is characterized by the manifestation of muscle weakness, the presence of edema, as well as a significant decrease in the function of tissue nutrition.
https://www.youtube.com/watch?v=5lgiPAtaJKw
Symptoms of the disease
After the development of plexitis of the shoulder joint begins, its symptoms become more and more noticeable.
As a rule, it has the following characteristics:
Plexitis of the shoulder joint differs in the nature of its course (chronic or acute), the extent of damage to the nerve bundles and the stages of the process.
It is customary to distinguish the following stages of pathology:
- neuralgic, when the patient is bothered by a sharp pain that worsens when trying to move the arm in the shoulder joint;
- paralytic, which manifests itself in a decrease in strength in the hand on the side of the affected brachial plexus (monoparesis), or in the complete absence of voluntary movements of the limb (paralysis).