Plexitis of the shoulder jointPlexitis of the shoulder joint develops as a result of complete or partial inflammation of the nerves of the brachial plexus. With prolonged flow can lead to loss of ability of the upper limb. It occurs more often in middle-aged people, but it is often found in newborns as a result of traumatization at obstetrics.
The brachial plexus is formed by the lower spinal nerves of the cervical segment and the upper thoracic plexus. Inflammation occurs due to:
- traumatic injuries - fractures, dislocations, sprains, bruises in the shoulder and collarbone;
- osteochondrosis of cervical or thoracic segments;
- prolonged irritation of the plexus nerves due to occupational activity( vibratory action), with compression of nerve endings when walking on crutches, with uncomfortable posture during sleep;
- birth injury;
- infectious and viral diseases;
- compression of nerve endings with a tumor, aneurysm, additional cervical ribs;
- metabolic diseases - gout, diabetes.
Depending on the type of lesions, plexitis is distinguished:
- upper - manifested by the defeat and spread of pain in the supraclavicular area;
- lower - manifested by the defeat and spread of pain in the area of the elbow joint, forearm, hand;
- total - is manifested by a combination of symptoms.
Plexitis of the shoulder joint proceeds in two stages:
- neuralgic - characterized by a sharp pain in the arm, which is amplified with load, wide-amplitude movements and at night;
- paralytic - manifested by a violation of sensitivity, numbness, a feeling of cold, trophic changes in the skin and nails. Violation of fine motor skills, decreased reflexes and muscle strength of the shoulder. In severe cases, paresis and paralysis of the hand with severe muscle hypotrophy.
In some cases, more often with viral damage, there may be a movement of the eyelid, a narrowing of the pupil, a deepening of the eyeball from the side of the affected limb.
To confirm brachial plexitis:
- X-ray examination;
- tomography is magnetic resonance or computerized.
Treatment of plexitis of the shoulder joint
In the period of acute manifestations of the disease, medicamental treatment is used, aimed at eliminating pain and improving nutrition, blood circulation of tissues. Necessarily, the rest of the affected limb is prescribed with the application of a fixative bandage and the maximum restriction of the load.
Drug treatment includes the appointment of:
- anesthetics for local blockades( with novocaine, analgin);
- non-steroidal anti-inflammatory drugs( diclofenac, ibuprofen);
- Neuroprotective agents( milgamma, vitamins "B" group);
- dehydration preparations with pronounced edema( urea, mannitol);
- antibiotics and antiviral drugs for infectious disease.
In the recovery period, physiotherapeutic procedures are used:
- curative gymnastics.
Surgical treatment is used in cases of compression of the brachial plexus tumor, aneurysm, bone fragments as a result of trauma.
Therapeutic exercises with plexitis of the shoulder joint
In position, sitting or standing:
- straightening the shoulders to reduce and dilate the shoulder blades;
- raise and lower your forearms up and down at a calm pace;
- bend your arms in the elbows, dilute to the sides, set brushes on the forearms. Perform a circular rotation in the shoulder joint forward and back;
- tilt the trunk in the direction of the injured arm. Perform a circular rotation in the shoulder joint forward and back;
- bend forward, perform flexion and slow extension of the arm in the elbow joint;
- straight arms to turn palms up, then down.
Each exercise is performed 8-12 times, gradually increasing the number of repetitions to 18-25 times.
Treatment with folk remedies
As an adjunct to pharmacological and physiotherapeutic treatment, you can use rubrics and ointments made according to the traditional medicine prescriptions:
- to mix a quarter of a glass of Vaseline with the crushed herbs of St. John's wort, sweet clover and hops. Obtained ointment rub off painful areas several times a day;
- for the preparation of anti-inflammatory rubbing it is necessary to mix half a cup of honey with a mixture of the root of horseradish, althea, Adam's root and aloe leaves. The resulting composition should be poured half a liter of vodka for 72 hours. Mix the mixture in the affected hand up to 3 times throughout the day;
- tincture of Angelica for grinding. Chopped angelica root pour boiling water, insist about 2 hours. Use for grinding;
- ointment for rubbing. Pork fat 50-100 g mixed with 3-6 g propolis, rub into the area of the shoulder and into the affected arm;
- anti-inflammatory turpentine based on turpentine. Mix 30 ml of turpentine with 30 ml of ammonia and 2 eggs, whipped into a foam. The received structure to rub in area of an arm or a shoulder and a scapula before a dream. For grinding, it is also possible to use an 8-10% alcohol solution of mummy;
- warming compress. Grind the bark of willow, cover with boiling water for 1-2 hours, drain. The obtained infusion is used for compresses on the shoulder joint area.
Plexitis of the shoulder joint symptoms treatment
Anatomy of the shoulder is quite complicated. The brachial plexus is formed by the first thoracic spinal cord and the four lower cervical nerves. Damage to the nerve plexus can cause considerable discomfort and disability.
Plexitis - what is it?
The inflammatory process, which grasps the nerves of the brachial plexus, is called the plexitis of the shoulder joint. This pathology can provoke strong pain and limited movements. If the patient neglects treatment, then he can completely break down the small motor skills and the chances to move his hand.
Plexitis can have a two-sided form of development, which is most painful, but is less common. More often plexitis is left- or right-sided.
Causes of plexitis disease
Causes of development of plexitis can be divided into groups:
- Traumatic injuries resulting from traumatic nerve plexus injury. This can occur as a result of sprains and dislocations of the shoulder joint, as well as bruises, fracture of the clavicle, injuries to the shoulder, when the nerve roots of the cervical region are damaged. Also, the causes may be microtrauma associated with professional activities;
- Infectious when the nerve plexus is affected by infections, such as herpes or cytomegalovirus;
- Dismetabolic, associated with metabolic disorders, for example, in diabetes mellitus or gout;
- Toxic due to poisoning;
- Compression-ischemic, provoked by a long pinched nerve due to being in an uncomfortable position, is often observed in bedridden patients. This kind of plexitis can provoke an incorrect posture or a disorder in the structure of the spine. Often, plexitis is caused by osteochondrosis of the thoracic or cervical spine;
- Infectious-allergic, arising as a reaction of the body to certain vaccines.
Plesititis can affect even newborn children as a result of infection or birth trauma. Provoke a seizure of plexitis may be hypothermia and weakened immunity.
The disease occurs in two stages. At the first stage - neuralgic, - the symptomatology connected with irritation of the nervous endings is strongly pronounced. In the second stage - paralytic, - the symptomatology is associated with dysfunction of nerve fibers. Symptoms become more pronounced as the disease develops.
The main signs of plexitis are:
- Painful sensations, especially strong when trying to move a hand, lift it or move it back. The pain concentrates in the shoulder and on the inside of the limb. Painful sensations of aching, shooting or boring character;
- Violations of fine motor skills;
- Disturbances in the functioning of the limb, for example, the inability to bend fingers, clench the fist;
- Numbness of the hand, impaired sensation on the inside of the hand;
- Hand paralysis, accompanied by circulatory disorders and muscular atrophy;
- Sometimes there is a deepening of the eyeball, a narrowing of the pupil on the affected side, and a disorder of the movement of the eyelid from the side of the plexitis.
Treatment of plexitis of the shoulder joint
Diagnosing plexitis is not so simple, therefore, a number of methods are used to diagnose: medical examination, radiography, electroneuromyography, MRI and CT, ultrasound, blood tests. The consultation of the neurosurgeon is required.
In the acute course of the disease, it is necessary to provide absolute immobility to the arm. The shoulder is fixed with gypsum and the administration of anti-inflammatory and anesthetic agents is prescribed.
After relieving the exacerbations, physiotherapy procedures are prescribed that help improve blood circulation and reduce pain. These include mud and paraffin applications, magnetotherapy, phonophoresis, electrophoresis, dynamic currents, cryotherapy, laser therapy.
Another method that can be used with success after relieving exacerbation is exercise therapy. Special exercises serve to stimulate blood circulation and develop shoulder joints. To prevent muscle atrophy appoint courses of therapeutic massage.
Not bad proved in the treatment of plexitis of the shoulder joint such methods as acupuncture and hirudotherapy.
Plexitis of the shoulder joint: symptoms and treatment with folk remedies
Plexitis of the shoulder joint is an inflammatory disease during which the nerve plexus is affected. Before treating shoulder plexitis, it is necessary to eliminate the root cause of the disease - cervical osteochondrosis. Along with physiotherapy in plexitis, exercises included in the complex of physiotherapy exercises, as well as massage and vitamin injections are recommended.
The brachial plexus is more often affected than the rest of the nerve plexus. This damage results from infections, intoxications, injuries, dislocations of the humerus, compression of pathological processes in the neck( aneurysms, tumors, enlarged lymph nodes, additional cervical rib).
Symptoms of shoulder plexitis
In this disease, both acute and slow arise diffuse pain, accompanied by a sensitivity disorder in the entire arm. Further signs of paralysis and atrophy of the next group of muscles: deltoid, biceps, inner brachial, and flexor muscles of the hand and fingers( because of all this, the hand on the affected side hangs like a whip).Symptoms of plexitis may include trophic changes: swelling of the hand and forearm, thinning or, conversely, thickening, as it were keratinization, of the skin, a change in its color.
Sympathetic tenderness in the supra- and subclavian areas, as well as subscapular points, pain along the nerve trunks on the arm, sharp soreness in the brachial plexus area with the outstretched hand extended.
Treatment of plexitis with folk remedies
When acute onset of the neuritis of the brachial nerve, fixation of the corresponding position of the hand and phalanges of the fingers is carried out: they are given a half-bent position and laid on a longi with a roller placed under the metacarpophalangeal articulation. The forearm and the hand are suspended on a scarf.Of course, this severe defeat requires urgent, urgent appropriate therapy under the supervision of an experienced neurologist.
In the treatment of plexitis of the shoulder joint, physiotherapy( UHF, etc.) is shown;anti-inflammatory, vasodilating, decongestant and analgesic drugs;injections of vitamins B1 and B12;easy, gentle massage;electrophoresis with novocaine, currents of Bernard;complex exercises exercise therapy.
For neuritis of the humeral nerve or brachial plexus, it is recommended to rub the 8-10% alcohol solution of mummy for 5-6 minutes in the affected area.
One of the folk remedies for treatment of plexitis is taking 5 g of mummy with milk( in proportion 1:20) or with honey( also 5 grams) or rubbing a mixture of mummies and honey into the affected areas.
Shoulder joint plexitis exercises
Shoulder joint plexitis exercises are performed in the initial sitting or standing position:
1. Raise the shoulders up, then lower them - repeat this 8-10 times.
2. Flatten the blades, then return to the starting position - 8-10 times.
3. Raise your hands, brush to your shoulders, dilate your elbows to the sides, then press it against your body again. Further, do circular movements bent at the elbow by hand( movements in the shoulder joint) clockwise and counter-clockwise. Repeat 6-8 times.
4. Bend the injured arm, then straighten, pull it aside( straight or bent at the elbow joint), then return to its original position. Repeat 6-8 times.
5. Bending to the side of the damaged arm, make circular motions with a straight hand clockwise and counterclockwise also 6-8 times.
6. Leaning forward, bend the arm in the elbow joint, and then straighten it, helping with a healthy hand - do this 5-6 times.
7. Turn the forearm and brush to yourself and from yourself - 6-8 times.
As for the symptomatic manifestations, they vary depending on the form of the course of the disease. So, neuralgic plexitis is accompanied by severe pains that occur unexpectedly and are greatly intensified when moving. In paralytic form, paralysis and paresis of muscles are added to the clinical picture, a violation of the natural sensitivity of the affected area.
Among the common symptoms for which the disease is diagnosed are:
- , the flexion of the fingers of the hand is impaired;
- pain occurs not only in the immediate inflammation, but also in the lower part of the hand;
- sensitivity of the inside of the affected arm is impaired.
Narrowing of the pupil of the eye from the side of the affected shoulder can indicate plexitis
Sometimes the plexitis of the shoulder joint can be determined by the behavior of the eye located on the side of the affected shoulder: there may be disruption of the muscles of the eyelid, deepening of the eyeball and narrowing of the pupil.
In plexitis, patients describe painful sensations as aching, drilling or bursting. When the cause of the disease is an active infectious process, then reflexes are lost, there is increased sweating, changes in the state of the nail plate and the flow of the brush.
Undoubtedly, the pain syndrome makes life much more difficult, but the main danger of the disease lies not in constant unpleasant sensations. Without proper treatment, nerve fibers are damaged more and more, which initially threatens with a violation of fine motor skills, and subsequently - the disabling of all functions and atrophy of muscle tissue.
Diagnosis of brachial plexitis
If the first symptoms occur, it is not necessary to postpone the visit to a specialist, the delay is fraught with difficulties in treatment and recovery. The following diagnostic tests can be prescribed by a doctor:
- X-ray of the shoulder;
- CT( computed tomography) of the affected area;
For diagnosis, magnetic resonance imaging(
MRI) can be assigned;
- surface neuromyography( with the help of a special device, the state of the nerves and the process of impulse transfer are studied with additional stimulation);
- blood test.
When diagnosing the shoulder plexitis, treatment should be started immediately.
Doctor's opinion: it is really necessary to hurry with treatment, as in most cases the defeat reaches the stage in which the damage is no longer possible.
How to cure the shoulder plexitis?
Treatment of plexitis of the shoulder joint is complex and is aimed at resolving several problems at once: first, removal of pain, secondly - improving the supply of tissues and blood circulation in the affected area, and thirdly - restoring the normal operation of the nerves and returning the functional abilities of the affected arm.
To relieve pain, a doctor prescribes pain medications( selected individually based on the patient's condition). The main therapy for plexitis is anti-inflammatory. Non-steroidal anti-inflammatory drugs are often prescribed, they perform two functions at once - and affect the reduction of the inflammatory process, and relieve pain. These drugs are available in the form of tablets or in the form of injectable liquids.
When the disease is at a neglected stage, more serious hormone-type preparations are needed to reduce inflammation. They effectively fight the inflammatory process and promote tissue regeneration.
The type of treatment depends on the root cause of the disease. So, if plexitis provoked an infectious process, then antibiotics will definitely be present in the appointment. Treatment is often supplemented with a course of vitamins to improve the processes occurring in the body.
During medical treatment to prevent or slow muscle atrophy, electrostimulation is prescribed - an electrical effect on soft tissues, which stimulates the muscles to contract and thus allows them to remain in tone.
Physiotherapy methods for plexitis of the shoulder joint are divided into several groups depending on the type of their influence:
- for the reduction of pain sensations appoint electroanalgesia with pulses of short type or drug electrophoresis;
UHF-therapy will help prevent the accumulation of fluid in the joint
to prevent the accumulation of fluid in the joint bag - UHF-therapy;
- acceleration of tissue repair will contribute to laser infrared therapy and ultrasound therapy;
- neurostimulation procedures - neuroelectrostimulation and stimulation of the bioregulated type;
- vascular expansion will contribute to irradiation with infrared rays and high-frequency magnetotherapy.
Treatment of chronic disease also implies the passage of a sanatorium treatment.
Plexitis of the shoulder joint: treatment with folk remedies
For plexitis of the shoulder joint it is also possible to resort to methods of alternative medicine:
- in the area affected by inflammation, is recommended to rub the mummy ( 10%);
- to reduce the intensity of pain sensations will help bath with mint .Grass can be taken as purchased, and dried by yourself. Before the procedure, you need to prepare a decoction from the leaves of the plant, then strain it and pour it into the bathroom, diluted with clean water. The water temperature should be moderate - about 40 degrees. After the procedure, it is recommended to wrap it up and rest;
- for grinding the shoulder can also be prepared with infusion of herbs: adam root, horseradish root and medicinal althea, aloe leaf ( in equal proportions - 15 grams).All ingredients are mixed, poured honey( about 100 grams) and half a liter of alcohol. Insist means for three days, then use as ointment for a diseased shoulder;
- leaves of the white willow will also help in the fight against the disease. They are used as follows: washed( fresh) and ground, after which the resulting gruel is applied for a quarter of an hour to the sore spot;
- compresses from oatmeal .30 grams of flakes are poured with 400 ml of pure water and all together cooked for 10 minutes. Compressor is ready;
- ointment from hop cones ( shredded cones must be mixed with petroleum jelly in proportion one to four);
- tincture for rubrassing from Ledum, burdock root and wheatgrass, thyme, sweet clover, hop cones and juniper berries .All ingredients in equal amounts are mixed, placed in a jar and poured into vodka. The tincture is prepared for 10 days in a place protected from light;
- decoction of wild strawberry .To prepare the preparation, the whole plant is taken.1 tablespoon chopped strawberries pour a glass of boiling water and cook a quarter of an hour on a small fire. You can drink this remedy instead of regular tea.
Plexitis is a disease in which large nerve plexus lesions occur.
The peripheral nervous system consists of a great many different nerve fibers that create nerves and nerve branches. Intertwining with each other, they form a neural plexus. There are three large plexuses: cervical, brachial and lumbosacral. Plexus serves many important functions: motor, sensory, trophic( nutrition of tissues).Inflammatory lesion of these plexuses is called plexitis. The lesion pattern consists of motor disorders, sensitivity disorders and vegetative disorders. With the development of this disease, the pain sensations gradually increase;pain intensifies mainly at night, and can also spread to the neck, elbow joint, scapula or leg. In addition to these symptoms, this disease is accompanied by a decrease in sensitivity in the affected plexus, swelling and cyanosis of the skin.
Causes of plexitis
Neural plexuses are extremely vulnerable to damaging factors, among which:
- any trauma( professional, athletic, due to increased physical exertion),
- certain infections,
- compression by neoplasia or deformation of any tissues,
- such diseases as osteochondrosis, gout, diabetes mellitus.
Coldness, infectious lesion, compression of nerve fibers in fractures and traumas lead to swelling of the fibers forming the nerve plexuses, and to the violation of all their functions.
Types, stages and symptoms of plexitis
The course and symptoms of this disease depend on the localization of the affected nerve plexus. Depending on this, the following are distinguished:
- Cervical plexitis, which is manifested by pain in the occiput. In later stages, paresis or paralysis of the neck muscles can occur. Sometimes this form of plexitis can be accompanied by hiccups, as irritation of the diaphragmatic nerve occurs.
- Shoulder plexitis, which is accompanied by pain in the area of the clavicle, irradiating in the hand, a violation of skin sensitivity. Decreased reflexes and muscle strength in the area of the shoulder girdle and on the upper limb. Trophic symptoms are manifested in the form of cyanosis of the hand on the affected side, sweating of the palms increases.
- Lumbosacral plexitis. When the lumbosacral plexus of the nerves is affected, all of the above symptoms are manifested in the lower extremities. Gradually develop paresis and paralysis of certain groups of muscles of the lower extremities, and also trophic disorders.
Inflammation can be total, that is, affect the entire plexus, including branches and nodes, or partial, affecting individual branches or trunks. In addition, one-sided and two-sided plexus lesions are distinguished.
In the development of plexitis, two stages are distinguished. In the first or neurological stage of this disease, spontaneous pains occur in the area of the affected plexus, which increase during movement and do not pass at rest, disturb the tingling, cold skin, lethargy, or painful muscle tension in the affected area.
In the absence of treatment, this disease passes into the second stage: paresis and paralysis develop in the region innervated by the branches of the affected plexus. Also in this area, the sensitivity decreases, and trophic changes develop in the form of swelling of the tissues and changes in color and turgor of the skin.
Treatment and prevention of plexitis
Methods of treatment of plexitis depend on the stage of the disease and the nature of the course. In most cases, treatment is done on an outpatient basis, but hospital treatment is not ruled out.
In traumatic plexitis surgery is required to eliminate the causes of compression of the plexus. In those cases where the cause of the development of the disease is an infection, special therapy is carried out. In addition, medications are prescribed to facilitate the patient's condition. Depending on the stage of the disease, physiotherapy is also selected. All this can be done only by a qualified specialist. Self-medication is unacceptable.
It should be noted that a special situation occurs in patients who are forced to move with crutches: brachial plexuses suffer from nonphysiological loading of the upper part of the crutch into axillary areas where the brachial plexus is very close. Therefore, it is necessary to choose and use crutches safely.
An important component of prophylaxis of plexitis is the normalization of metabolic processes. This reduces the risk of blood flow disorders in the peripheral nervous system. In the presence of chronic diseases, which can be the cause of plexitis, it is necessary to undergo periodic preventive treatment and general sanitation, including sanatorium and resort.
To improve the protective properties of the body it is recommended that physical culture, and especially swimming, be practiced. Equally important is balanced nutrition, proper rest and maintaining a healthy lifestyle. To prevent infection of the nerve plexus, it is necessary to apply adequate treatment of the primary focus of infection in a timely manner and prevent the spread of the process to surrounding tissues.
During the transition of the plexitis to the stage of remission( that is, to the stage of improvement after exacerbation with the absence of complaints and symptoms) at its chronic form, as well as during rehabilitation after acute plexitis, complex sanatorium treatment and prevention in health resorts specializing in diseases of the peripheral nervous system.
In the sanatoriums of Belarus and the Caucasian Mineral Waters for the treatment of plexitis in remission or rehabilitation the following procedures are used: