Radial nerve neuropathy: causes, symptoms, treatment

The radial nerve is responsible for extension of the thumb and index finger, wrist and elbow joints, and rotation of the hand. Its trunk runs along the muscles, bones and ligaments. Damage to the radial nerve is caused by compression caused by compression of adjacent structures.

Neuropathy (neuritis, neuralgia), which occurs against the background of compression, disrupts the motor activity of the affected limb. Treatment tactics for inflammation of the radial nerve of the arm are selected taking into account the nature of the provoking factor.

Description of neuropathy

Compression-ischemic neuropathy of the radial nerve is one of the most common forms of this type of disorder. The occurrence of neuropathy is often associated with injuries to the upper extremities. The problem even occurs due to incorrect hand position during sleep.

The nature of the clinical picture of radial neuralgia is determined by the affected area. Disruption of the innervation of the fingers and the area on the palm side of the injured limb leads to the development of radial nerve palsy, in which a decrease or complete loss of sensitivity occurs. However, in this case, forearm extension is not impaired.

Carpal tunnel syndrome is diagnosed based on a comprehensive examination of the affected limb.

When selecting treatment methods, it is important to establish the presence of damage to the radial nerve, since a decrease in the sensitivity of the little finger and other fingers is often explained by impaired conduction of other nerve fibers.

Causes

The reason for the development of radial nerve neuropathy is pinching of the nerve root, which causes inflammation. This can occur against the background of various injuries and physical strain. An incorrectly administered injection can lead to illness.

There are other reasons for the development of pathology:

Infectious diseases that develop due to various bacteria: typhus, influenza, tuberculosis, pneumonia. Inflammation occurs and the nerve ending is affected. As a rule, viruses and bacteria can provoke radial neuritis.
Traumatic damage to the nerve ending. Fractures of the humerus and radius, bruises of the forearm, injuries to the joints of the upper limb and an incorrectly administered injection.
Intoxication of the body due to various toxic substances. Alcoholic drinks, drugs, mercury, arsenic, lead.
Compression of the nerve ending is the most common cause of the disease. This usually occurs due to an incorrect sleeping position, as well as due to the application of a tourniquet to stop bleeding. Compression may occur due to various tumors. If the patient uses crutches, compression of the nerve root in the armpit area also often occurs.
Severe physical muscle strain can cause pinching of the radial nerve.

It all depends on the cause of the disease and there are several types of hand neuritis. If the ulnar bundle is affected, there is a loss of sensation in several fingers. They stop working and the hand begins to look like an animal's paw. You will need to visit a doctor, otherwise there will be serious consequences.

Anatomy of the radial nerve of the arm

To understand the structural features of the radial nerve that it innervates, it is necessary to consider its anatomy. Understanding the structure allows us to establish the relationship between damage to the upper extremities and accompanying symptoms (consequences of impaired innervation).

The radial nerve begins on the shoulder, passes along the posterior muscle wall, entering the triceps area, and affecting the local tendons. It is in this area where the radial nerve canal is located that damage most often occurs. The nerve then passes to the humerus. Here the head of the triceps muscles, together with the groove of the radial nerve, form the spiral (brachioradial) canal. Damage to the latter ranks second in the frequency of causes of neuralgia.

The spiral canal runs along the projection line of the axillary artery.

At the end, the nerve enters the elbow joint, where it divides into two parts. This part of the hand is also one of the most vulnerable in terms of the likelihood of developing neuralgia.

The radial nerve is divided into several branches, each of which is located in different areas:

Articular. It runs in the upper part of the forearm, reaching almost to the shoulder joint.
Rear. Lies close to the surface of the skin. The posterior radial nerve is responsible for innervation of the dorsum of the shoulder.
Lower side. It lies next to the previous one, entering the lateral and lower parts of the forearm.
Proxial, lateral and medial branches. Depending on the type of nerve fibers, they innervate the radialis, ulnaris, triceps and brachialis muscles.
Posterior, running along the forearm. Affects areas along the brachial and axillary canals. Characterized by strong branching of nerve fibers.
Superficial. Responsible for innervation of the back of the hands and the first three fingers.
Deep. It runs through the instep bone and ends on the inside of the forearm. The job of the deep branch of the radial nerve is to transmit sensation to the extensor muscles.

The maximum accumulation of nerve fibers is observed in the area of the armpit, the minimum number in the region of the third of the shoulder.

Carpal tunnel syndrome: what is it?

Tunnel syndrome (tunnel neuropathy) is the general name for a group of neuropathic conditions in which compression of the nerve trunk occurs. The syndrome gets its name from the shape of the osteo-fibrous structure - a canal (tunnel) of joints, tendons and bones surrounding the nerve.

Causes of the disease Risk factors Types of carpal tunnel syndrome Symptoms of the disease Possible complications Diagnosis of carpal tunnel syndrome Treatment of the disease Lifestyle correction

The nerve, which runs in a canal made of hard tissue, is reliably protected from external influences. But at the same time, it can suffer from deformations of the canal, the walls of which surround it. Deformations are caused by overstrain of ligaments and tendons, causing a temporary deterioration in the blood supply to the tissues and a deficiency of nutrients in them. With constant loads on this area, the changes are consolidated and become permanent: the tissues of the tunnel thicken, loosen or swell. As a result, there is no free space left in the tunnel and the pressure on the nerve trunk increases, after which disturbances in its functions begin to develop - the conduction of motor signals.

Much less commonly, tunnel syndrome can be caused by swelling of the nerve itself. This condition can develop due to general intoxication of the body with salts of heavy metals, derivatives of arsenic and mercury and other toxic substances. The prolonged course of someone's disease requiring the use of antibiotics, diuretics and vasodilators can also lead to the development of tunnel neuropathy.

Carpal tunnel syndrome usually develops in areas exposed to constant or regular stress in the form of monotonous, repetitive movements. But besides mechanical irritation of the nerve and surrounding tissues, other factors can lead to the disease.

The risk group for carpal tunnel syndrome includes the following categories of the population:

people whose professional or everyday activities include the same type of flexion-extension movements (hairdressers, typists, tennis players, sign language interpreters, musicians - most often violinists, guitarists, painters, etc.);
people over 50 years of age (age-related changes that occur throughout the body invariably affect bone tissue);
people suffering from endocrine diseases (diabetes mellitus, dysfunction of the thyroid gland, pituitary gland), which significantly impair the ability of tissues to recover;
people who have a family history of musculoskeletal diseases or suffer from these diseases (arthritis, osteochondrosis, etc.);
people who are often exposed to microtrauma of joints and ligaments (loaders, bodybuilders, masons, etc.);
people with autoimmune diseases (systemic lupus erythematosus, HIV, etc.)

Carpal tunnel syndrome is the most common type of tunnel neuropathy and is very often mistaken for the only form of the disease.

But this condition can develop when the following nerve trunks are infringed:

Compression of any of the listed nerves falls into the category of tunnel syndromes and has similar symptoms.

Compression of the nerve trunk develops gradually and the intensity of symptoms increases at the same pace. In the initial stage, the syndrome practically does not manifest itself: a person may only experience a feeling of discomfort with prolonged stress on the area of the body in which the nerve is pinched. As the canal narrows, more and more significant dysfunctions of the nerve occur, which are manifested by the following symptoms:

One of the distinctive signs of tunnel neuropathy is that when a nerve is pinched in a large joint (scapula, elbow, thigh), pain can manifest itself at a considerable distance from the affected area, which makes diagnosis difficult. For example, if you have shoulder pain accompanied by numbness in the shoulder, forearm, or upper back, the nerve may be compressed in both the elbow joint and the scapula.

Most often, tunnel neuropathy becomes a chronic state, when exacerbations of the disease alternate with periods of remission (asymptomatic course of the disease).

The good news for people suffering from carpal tunnel syndrome is that the pathology rarely extends beyond the affected area and the worst that can happen is an increase in symptoms and pain.

Therefore, this condition is not life-threatening. But it can greatly disrupt its quality. The pain, which becomes longer and stronger over time, can cause disturbances in sleep, appetite, extreme irritability and ultimately lead to other diseases of the nervous system, such as chronic insomnia, anorexia, bulimia, etc.

First of all, the doctor examining the patient excludes other diseases that have symptoms similar to the clinical picture of tunnel neuropathy. Among such diseases are arthritis, arthrosis, neuralgia, myalgia, etc.

Treatment of tunnel neuropathy is aimed at relieving the inflammatory process and eliminating swelling in the affected area, relieving the patient of pain and preventing more severe nerve entrapment.

Among medications, the following groups have confirmed their effectiveness:

nonsteroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen, Ketorolac, Indomethacin, Nimesulide, etc., in addition to relieving inflammation, provide an analgesic effect;
hormonal drugs (Hydrocortisone, Prednisolone) are introduced into the affected area by injection and/or applied to this area in the form of an ointment;
calcium chloride is injected intravenously to relieve inflammation and stabilize the immune system response;
vitamin preparations are prescribed to improve the conduction of nerve signals and normalize blood circulation in the area of nerve compression.

When treating tunnel neuropathy, a course of thermal physiotherapeutic procedures is recommended, using anti-inflammatory and hormonal drugs (electrophoresis, phonophoresis) and reflexology, which normalizes the functions of the nervous system.

Physical therapy is prescribed on an individual basis, depending on the results of the examination and the degree of compression of the nerve - in some cases, with tunnel neuropathy, it is recommended to exclude any stress on the affected joint.

In cases where conservative treatment of carpal tunnel syndrome is ineffective, the doctor may recommend surgical treatment. During the operation, which is performed under general anesthesia and lasts about an hour, the surgeon excises the thickening in the tissue that is compressing the nerve, which allows its function to be restored.

Our readers successfully use SustaLife to treat joints. Seeing how popular this product is, we decided to bring it to your attention. Read more here...

Causes of pinching

Neuralgia occurs due to:

prolonged lying (particularly during sleep) on your arm in an uncomfortable position;
applying a tourniquet to the arm to stop bleeding;
repeated and prolonged flexion of a limb (while running, conducting or when performing other actions);
wearing crutches or handcuffs.

incorrect posture while sleeping

conducting
Compression occurs in the presence of fibroids and other neoplasms growing along the course of the radial nerve canal. Post-traumatic neuritis is caused by fractures of the right humerus, head of the radius, dislocations and other injuries. The following diseases also lead to damage to the radial nerve:

alcohol intoxication;
bursitis;
synovitis;
arthrosis;
rheumatoid arthritis;
infectious pathologies;
diabetes.

Those at risk for developing neuralgia include pregnant women and people with hormonal imbalances. Less commonly, neuropathy occurs due to improper administration of a subcutaneous injection.

Symptoms

In case of radial nerve neuritis, symptoms are determined by the localization of compression or inflammatory process caused by infectious or other pathologies. In case of damage to the fibers located in the armpit, the following disorders are noted:

the forearm, hand and partially the phalanges of the fingers do not fully extend;
the thumb is not moved to the side;
when extending the left or right limb, the hand falls down, the thumb is pressed against the index finger;
the elbow extensor reflex disappears;
there is a decrease in the mobility of the forearm and hand when they are turned outward.

Inflammation of the radial nerve in the armpit area causes a decrease in the sensitivity of the first three fingers.

This part of the hand also experiences pins and needles, tingling, and burning sensations (a condition known as paresthesia). In advanced cases, muscle hypertrophy is detected in the affected area.

If the damage to the radial nerve is localized in the middle third of the forearm (in the area of the spiral canal), the patient is concerned about the following symptoms:

weakening of the extensor function of the forearm (the reflex remains);
a slight decrease in sensitivity in the shoulder area and complete loss of it on the back of the hand.

In case of damage to the radial nerve in the lower third of the shoulder and upper third of the forearm, as well as in the elbow, intense pain and paresthesia occur on the back of the hand. These symptoms bother you mainly when making movements of the limb. At the same time, there is a decrease in muscle tone in the forearm area while maintaining sensitivity in this area.

When the wrist is damaged, causing radial nerve neuropathy, symptoms manifest in the form of two syndromes: tunnel and Sudeck (Turner). The first develops due to compression of local fibers. The appearance of Sudeck's syndrome after a fracture of the radius of the arm provokes various symptoms, determined depending on the time period that has passed since the injury.

Initially, this condition is characterized by the following symptoms:

redness of the skin in the hand area;
edema;
burning or sharp pain in the hand.

Over time, the skin color in the affected area acquires a bluish tint. Due to impaired blood supply, the hand becomes cold. Sudeck syndrome causes numbness in the fingers (mostly the thumb). Uncontrollable twitching of the muscles in the affected hand is also possible.

In the absence of adequate treatment, Sudeck syndrome causes irreversible changes. Insufficient blood supply and damage to the radial nerve lead to muscle atrophy, which is externally manifested as a decrease in the size of the hand.

Functions

The radial nerve, innervating the above muscles, carries out motor functions, such as:

Finished works on a similar topic

Course work Radial nerve 490 rub.
Abstract Radial nerve 220 rub.
Test work Radial nerve 240 rub.

Receive completed work or specialist advice on your educational project Find out the cost

supination of the hand,
extension of the main phalanges of the fingers,
extension in the wrist and elbow joints,
abduction of the thumb.

The sensory fibers of the radial nerve are part of the nerves:

posterior cutaneous nerve of the shoulder,
posterior cutaneous nerve of the forearm,
inferior lateral cutaneous nerve of the shoulder.

Sensitive fibers of the radial nerve innervate the skin on the radial side of the hand, the back surface of the shoulder and forearm, the dorsum of the first, second and part of the third finger of the hand.

Diagnostics

To make a diagnosis of “neuropathy of the right radial nerve”, a comprehensive examination of the patient is necessary to identify the disorder and the causes of the pathology.

Neuritis is determined using special tests that evaluate functional changes that affect muscle performance. This will require knowledge of the topography of the radial nerve.

To assess the condition of the injured limb, the patient is asked to:

Stretch both upper limbs forward, keeping the hands in a horizontal position: the hand hangs down with neuritis.
Extend your arms along your body, turning your hands outward. With neuropathy this cannot be done.
Move your thumb to the side.
Bring your palms together and move your fingers away (fingers bend on the side of the problem area).

These tests make it possible to differentiate radial nerve neuropathy from other neurological disorders.

Help to determine the causes of the disorder:

general and biochemical blood test;
Analysis of urine;
hormonal tests.

Electroneuromyography (ENMG) is considered an important diagnostic procedure. Carrying out electrical stimulation for neuritis allows you to assess the degree of damage to the fibers. The results of the procedure show the speed at which the impulse travels through the nerves. To assess changes in the functional abilities of muscles, electromyography is prescribed.

CT, MRI and ultrasound of the radial nerves are performed to diagnose the causes of neuritis. If necessary, the patient is sent for consultation to an endocrinologist, traumatologist and other highly specialized doctors.

Treatment of neuralgia

After diagnosing a pinched radial nerve in the arm, treatment is carried out taking into account the nature of the lesion. Priority problems come to the fore when selecting a treatment regimen. In particular, drugs are first used to stop the inflammatory process and complications of toxic damage to the body, or other procedures are used to eliminate the consequences of a fracture or other severe injuries. In the latter case, limb immobilization and surgical intervention are more often used.

If neuralgia is caused by external factors, such as the use of crutches, you must stop using them for the duration of treatment. Treatment of neuropathy is usually carried out on an outpatient basis. More often, patients are admitted to the clinic if they require the administration of strong drugs or surgery for a fracture.

Drug therapy

Various medications are used to treat radial neuropathy. The basis of therapy is non-steroidal anti-inflammatory drugs: Ibuprofen, Diclofenac and others. Treatment of the radial nerve of the hand is complemented by antibiotics, which suppress the activity of the bacterial microflora that causes inflammation. At the same time, taking decongestant drugs such as Hydrocortisone or Diprospan is indicated.

Regardless of the cause, radial nerve palsy is treated with:

vasodilators that increase blood flow to the affected area;
anticholinesterase drugs that restore radial nerve conduction;
B vitamins that stimulate the regeneration of damaged tissues;
vasoactive drugs (nicotinic acid, Pentoxifylline) that normalize metabolism.

In case of acute poisoning of the body, detoxification is indicated, which is carried out using intravenous injections of glucose and sodium chloride solutions.

For endocrine disorders, hormonal drugs are prescribed.

In case of post-traumatic neuritis of the radial nerve of the hand, recovery after a fracture involves repositioning the bones and other procedures through which the previous skeletal structure is restored. Also, for such disorders, physiotherapeutic procedures are used: acupuncture, magnetic therapy, massage and others.

Treatment with folk remedies

In case of a violation of the innervation of the radial nerve with damage to the arm or hand, the use of traditional medicine is justified if drug treatment is carried out. Herbal preparations relieve only the symptoms, but do not eliminate either the cause of the development of neuropathy or the disorder itself.

Treatment of the radial nerve with folk remedies is carried out using:

Propolis. The product is used in the form of compresses. To prepare the medicinal composition you will need 40 grams of propolis and 100 ml of 96 percent alcohol. After mixing, the solution is infused in a dark place for a week. During this period, it is necessary to shake the composition regularly. At the end you need to add corn or olive oil in a 5:1 ratio. A compress with this remedy is applied for 10 days.
Red (pottery) clay. It must first be mixed with vinegar and rolled into a flat cake. The clay should then be applied to the problem area overnight for three days.
Raspberries. You will need a tablespoon of chopped stems and 250 ml of boiling water. The mixture is simmered over low heat for 5 minutes. Next, the product is infused for half an hour. It is recommended to drink the resulting composition three times a day half an hour before meals.

Damage to the radial nerve of the arm is treated with bear lard, which must be rubbed into the problem area for four weeks. A good effect is achieved by applying horseradish leaves to the hand. Also, treatment of the radial nerve can be supplemented with an infusion of fireweed tea (a tablespoon of the plant per 250 ml of boiling water, infused for 8 hours in a thermos).

Physiotherapy

For neuropathy of the radial nerve, a set of physical exercises is indicated, with the help of which the lost functions of the limb are restored. Exercise therapy is selected individually. Damage to the radial nerve can be eliminated using the following exercises:

Bend your arm at the elbow and rest your limb on a hard surface, maintaining a right angle between the support and your forearm. Thumb down, index finger up. Repeat the exercise 10 times.
Hand position as in exercise No. 1. Index finger down, middle finger up. Repeat the exercise 10 times.
Grasp the lower phalanges of four fingers with your healthy palm, leaving the thumb aside. Bend and straighten your palm 10 times. Grab the upper phalanges and repeat the steps. Finally, with your healthy hand, clench the fingers of the affected limb into a fist 10 times.

Treatment of a pinched nerve in the hand has a good effect if the patient performs the following exercises in water:

Press with healthy fingers on the phalanges of the patients, straightening them completely.
Extend the sore fingers or spread them to the sides with the healthy hand.
Raise and lower the sore fingers (except for the thumb), straightening the phalanges.
Make circular movements with each finger.
Place a towel on the bottom of the bathtub and squeeze it into a fist with your sore hand.

It is highly not recommended to perform the described exercises without consulting a doctor. Failure to comply with this rule can lead to serious consequences. Of particular danger are cases when the patient refuses to follow medical recommendations after nerve repair.

Massage for radial neuropathy

Neuropathy of the radial nerve of the hand is often accompanied by an inflammatory process in the problem area. To stop the latter, it is necessary to speed up blood circulation and restore metabolism. This can be achieved by performing massage for radial nerve neuritis.

The procedure is carried out no more than 15 times. It is forbidden to perform massage actions on your own, as this can cause serious injuries.

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.

If there is no good effect from the drug treatment, then radiotherapy is prescribed. If the cause of neuritis is a traumatic lesion, a suture may be necessary.

The main goal of treatment is the maximum possible stimulation of restoration of the structure and function of the nerve fiber. The complex of drugs used also depends on the cause that caused the development of the pathological process. If there is an inflammatory process, then antibacterial drugs are prescribed.

Forecast and recovery

The recovery time for the radial nerve of the arm takes on average 1 – 2 months. The duration of rehabilitation is determined by the patient’s age, the nature of the lesion and the characteristics of concomitant diseases. Post-traumatic neuropathy requires a longer recovery.

The prognosis for neuritis is mostly favorable. It is important to promptly begin treatment for a neurological disorder and follow medical recommendations.

To prevent neuropathy, you need to sleep in a comfortable position and give up bad habits. Persons whose profession involves frequent repetitive movements should regularly exercise and massage the upper extremities. It is also recommended to undergo a complete body examination every 6 months.

How to prevent hand neuritis and its prevention

As a preventative measure, various hand injuries and hypothermia should be avoided. It is also recommended to promptly treat all infectious diseases and vaccinate. In order to maintain immunity, you need to eat right, exercise, follow a work and rest schedule, and lead a healthy lifestyle.

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.