Shoulder plexitis. Symptoms of the disease - pain in the elbow joints Treatment of lesions of the brachial plexus

Plexopathy (plexitis) of the shoulder joint can disturb a person at any age. This disease is characterized by inflammatory damage to the nerve fibers of the brachial plexus and occurs after trauma, in the presence of concomitant pathologies and for other reasons. Plexitis is not a harmless disease. With the wrong approach to treatment, it can reduce a person's ability to work and lead to disability.

To avoid unwanted complications, the disease should be started to fight immediately after the appearance of its first signs. Medicines prescribed by a doctor, physiotherapy exercises and non-traditional remedies will help the patient in this.

Distinctive features of pathology, its types

The brachial plexus includes nerve fibers that extend from the cervical, spinal, and thoracic spine and connect the neck to the sternum. These fibers form bundles that surround the axillary artery and are responsible for the functioning of the upper limbs. that affect the brachial nerves, lead to the appearance of painful sensations in the hand located on the side of the development of the pathological process. This entails a decrease in the motor activity of the affected limb and the inability to perform simple actions (holding a pen, brushing teeth, inserting a key into the keyhole, etc.).

A severe form of plexopathy can lead to complete loss of sensation in the limb, muscle atrophy and even paralysis.

Depending on the localization of the inflammatory process, experts distinguish 3 types of plexitis:

• total (spreads throughout the brachial plexus);
• upper, or Duchenne-Erb paralysis (observed with inflammation of the upper trunk of the brachial plexus);
• lower, or Dejerine-Klumpke paralysis (changes in the lower branches of the brachial plexus).

Plexitis of the brachial plexus mainly affects one arm, however, with a severe course of the disease, the pathological process can spread to both upper limbs. Pathology does not belong to the category of age-related diseases; both adult patients and children suffer from it. Most people are diagnosed with plexitis between the ages of 20 and 60, and men suffer from it much more often than women.

Causes

Plexitis occurs for various reasons. The factors that can provoke it are:

• damage to the brachial or cervical nerve plexuses during sprains, dislocations and bruises of the shoulder joint, injuries;
• birth trauma in children caused by incorrect presentation of the fetus, prolonged presence of the child inside the birth canal, etc.;
• costoclavicular syndrome;
• long-term presence of a person in an uncomfortable position, leading to compression of the brachial nerves (observed in bedridden patients and people leading a sedentary lifestyle);
• osteochondrosis, localized in the neck or sternum;
• diseases arising from metabolic disorders (gout, diabetes mellitus);
• pathology of the lymphatic system;
• herpes, flu and other ailments of infectious etiology;
• benign or malignant tumors;
• prolonged hypothermia (hypothermia).

Symptoms

Shoulder plexopathy will help to recognize its characteristic symptoms. These include:

• pain of varying degrees of intensity, localized in the area of ​​the brachial plexus and on the inner surface of the hand;
• violation of fine motor skills of the affected part of the body;
• paresthesia of the inner side of the hand.

With plexitis of an infectious origin, the patient often has pathological changes in the organ of vision located on the side of the affected limb (narrowing of the pupil, dysfunction of the oculomotor muscles, enophthalmos of the eyeball).

Post-traumatic plexopathy is often accompanied by pain in the supraclavicular and subclavian regions, radiating to the arm. Also, the disease is characterized by swelling of the sore arm, blue discoloration of its skin, sweating of the palm, changes in the shape and color of the nail plates, atrophic paresis and paralysis, weak pulse on the radial artery.

Upper brachial plexopathy (Duchenne-Erb palsy) has its own characteristics. This type of pathology is accompanied by a decrease in the sensitivity of the outer surface of the shoulder and forearm and difficulties in moving the arm to the sides or bending it at the elbow joint.

Diagnostic methods

Diagnosis of plexitis today is not difficult. For many people, it is carried out by a specialist (traumatologist, neuropathologist or orthopedist) based on the patient's complaints and research results, including:

• x-ray;
• electromyography;
• ultrasound procedure;
• magnetic resonance imaging.

Traditional approaches to therapy

Treatment of plexitis of the shoulder joint is determined by the doctor based on the results of the patient's examination. If the disease is detected at the initial stage, it is really possible to get rid of it at home, observing the therapy prescribed by the doctor. The neglected form of plexopathy requires treatment in stationary conditions.

In the fight against the disease, specialists use an integrated approach, with the help of which not only its symptoms are stopped, but also the reasons that led to its development are eliminated. For people diagnosed with brachial plexus plexopathy, doctors recommend medication. Traditional therapy includes the use of drugs with analgesic and anti-inflammatory effects, agents to increase conduction in nerve fibers and increase blood circulation, cyanocobalamin and thiamine.

In parallel with taking medications, patients are prescribed physiotherapy. The methods of physiotherapy used for pathology include:

• massage;
• balneo and laser therapy;
• mud therapy;
• electrophoresis;
• UHF therapy;
• inductophoresis;
• the use of impulse currents;
• ultraphonotherapy with hydrocortisone, etc.

Physiotherapy increases the effectiveness of medicines and accelerates recovery.

An auxiliary method of treating brachial plexus plexopathy is physical therapy, which is recommended after the end of the acute period of the disease. Exercise therapy for plexitis helps to reduce painful manifestations in the hand and increase its sensitivity. It includes a set of exercises to strengthen the muscles of the shoulders, forearms and hands.

Exercises for plexitis should be performed 2-3 times a day, devoting at least 15 minutes to each exercise session. The treatment complex includes the following exercises:

• alternating lowering and raising of the shoulders;
• dilution and flattening of the shoulder blades;
• slow bending of the arms at the elbows and shoulder joints;
• circular and cross hand swings;
• raising straight arms above your head;
• exercises on the wall bars and simulators (they should be performed under the supervision of an instructor).

Exercise for patients with shoulder plexitis should be done while standing, performing each exercise 7-10 times. In addition to physiotherapy exercises, they are recommended to swim and moderate physical activity.

It is recommended to treat brachial plexopathy surgically in extreme cases, when the factors that provoked the disease are traumatic plexitis, costoclavicular syndrome and other pathologies, which cannot be eliminated by conservative methods.

Fighting the disease with folk methods

For people diagnosed with plexitis of the shoulder joint, in parallel with traditional methods of therapy, non-traditional means can be used. They help to alleviate the condition of the sick person and make the treatment of the disease more effective.

1. In the fight against pathology, representatives of alternative medicine recommend using the bark of white willow (willow). For medicinal purposes, 15 g of crushed plant materials are recommended to pour 200 ml of boiling water and leave for 40 minutes. Gauze folded in 4 layers should be moistened in the resulting infusion and applied to the sore spot for 1 hour. The compress helps to reduce pain and stop the progression of the disease.
2. Treatment with folk remedies is recommended using an alcoholic infusion of mummy (10%). To restore the sensitivity of the hand, the solution should be rubbed into the affected joint every day for 5 minutes.
3. With plexitis of the brachial plexus, the patient is advised to take warm baths with the addition of a decoction of mint every evening before going to bed. Such water procedures help to reduce the intensity of inflammation and pain in the problem area and accelerate recovery.

Acquaintance with shoulder plexitis can occur at night, suddenly. With excruciating, boring pain, he will drive away even the deepest sleep and force you to change position.

What happened?

The pain arose from squeezing (compression) of a bundle of nerves running deep in the shoulder joint.

The figure shows that this bundle leaves the spine and, passing under the collarbone, goes into the axillary region. During a long sleep on its side, it is squeezed between the arm and the chest, trying to free itself, the nerve sets in motion its main weapon - pain.

It is possible to create plexitis by measuring pressure, when the cuff of the tonometer strongly squeezes the arm in the upper part, pain and numbness of the arm immediately appear.

This pain is more likely plexalgia than plexitis, because there is still no inflammation, but artificially caused pain from a lack of blood supply to the nerve bundle.

The examples are described in order to get an idea of ​​the sensations that plexitis causes.

Plexitis of the shoulder joint (plexus-plexus) Is an inflammation of the bundle of nerves that run in the shoulder joint.

The term neuritis is applicable when it comes to inflammation of one of the nerves of the brachial plexus: ulnar nerve, median nerve, etc.

Anatomical features of the area

The brachial plexus, leaving the spinal column, is divided into the upper, middle and lower trunks.

Below the trunks are still divided and form secondary bundles that tightly envelop the axillary artery. The plexus ends far on the periphery with small branches of the nerves of the hand.

The bundles have two types of nerves, sensory and motor, therefore, with inflammation or damage to the brachial plexus, pain and decreased sensitivity (numbness) occur, and later muscle work is disrupted (paresis and paralysis).

Causes

There are many reasons, so it is better to divide them into the following types:

• Post-traumatic - occur after fractures, dislocations and sprains in the shoulder joint. Often after a collarbone fracture, because the bundle passes directly under the collarbone.

Shoulder bruises, birth trauma from the application of forceps, falling on an outstretched arm entails damage to the nerves in the plexus.

Harmful production associated with constant vibration, in this case, microtraumatization of the plexus nerves occurs. Gunshot and stab wounds to the shoulder region can snag the nerve bundle.

• Infectious and infectious-allergic - transferred flu, tuberculosis, tonsillitis, post-vaccination plexitis - these are the causes of bacterial or viral plexitis

Cytomegalovirus and herpes virus can affect the plexus, especially if we carry it on our feet and there is hypothermia.

• Compression-ischemic - occurs after prolonged compression of the plexus, for example, in a person in strong alcoholic intoxication, the plexus area may die off during sleep.

Constant trauma to the axillary region with crutches in case of leg fractures, forced long postures in bedridden patients, tumor-like growths - all these are causes of compression of the nerves and, as a result, a violation of their nutrition.

• Exchange-dystrophic - occurs against the background of existing common diseases: diabetes mellitus, gout, osteochondrosis.

In the plexus, secondary changes gradually occur, associated with a lack of its blood supply. Vegetative-trophic disorders develop in the form of cyanosis or pallor of the hand, swelling and stiffness of the hand, sweating, nutritional disorders of the nails, etc.

Often, plexitis occurs in women after 40 years of age against the background of cervical osteochondrosis. Nerves come out of the narrow bony openings of the spine, when salts are deposited in the spine, the opening narrows even more, the nerve is pinched, numbness and chilliness of the hand appears, especially at night. After a while, a spasm of the adjacent muscles occurs, in the thickness of which the vessels supplying the nerves pass, the nutrition of the nerve begins to suffer and plexitis progresses.

Shoulder plexitis symptoms

When a disease has symptoms inherent only to it, it facilitates the task of making a correct diagnosis and ensures 50% success in treatment.

For plexitis, such characteristic features are the nature of the pain and the symptoms accompanying the pain.

For inflammation of the nerve plexus, boring pain, reminiscent of a bite, is characteristic. I involuntarily want to shake my hand, stretch it. Simultaneously with the pain, there will be numbness, loss of sensitivity in the sore hand, especially in the fingers of the hand.

If we pass the hand with a tourniquet or belt, the pain intensifies to such an extent that it is impossible to endure - this is a sure sign of plexitis.

Another important thing when making a diagnosis is to find pain points. With plexitis, the pain points will be in the supraclavicular region (t. Erba), the subclavian and axillary hollows.

If plexitis is caused by cervical osteochondrosis, then the pain will be in the neck and adjacent muscles.

If the cervical and axillary lymph nodes are enlarged in combination with the above complaints, it is a sure sign of infectious plexitis of the shoulder joint.

In such cases, pain occurs acutely, has a connection with cooling, and is accompanied by general symptoms: weakness, malaise, fever.

The acute period lasts 7-10 days. In favorable cases, the pain gradually disappears, movements in the hand are restored, and complete recovery occurs.

The prognosis is often good.

With delayed or insufficiently correct treatment, the course of the disease is delayed, the consequences are observed: weakness in the muscles, they lose weight and dry out. This usually happens a year after the onset of the disease.

It is customary to say that plexitis has passed from the neuralgic stage to the paralytic one.

Shoulder plexitis treatment

The goal in treating plexitis is to eliminate the cause of the disease.

If the cause of plexitis is an injury, then the treatment will be limited to a fixing bandage for a while, then special exercises for the hands are shown, at first simple, then complex.

With infectious plexitis, antibacterial or antiviral therapy is carried out, without this there will be no success in treatment. It is advisable to establish the nature of the infection in order to choose the right antibiotic. Antibacterial treatment is accompanied by anesthetic and anti-inflammatory therapy, both general and local. A course of vitamin therapy is useful for the nervous tissue, especially the B vitamins.

For analgesic therapy, the usual analgesics are used paracetamol up to 4 grams per day, Diclofenac 150mg, with concomitant gastritis, Celecoxib, Etoricoxib are better.

The therapeutic effect is reinforced with local ointments and creams: Voltaren ointment, Fastum gel in combination with Lioton ointment to relieve edema.

You can make a compress with Vishnevsky ointment at night. We treat the shoulder area with ointment, wrap it with cling film, and a woolen scarf or fabric on top.

To improve blood circulation and reduce swelling of the nerve roots, diuretics are used, a solution is injected into a vein Pentoxifylline with Theophylline.

In case of severe pain, the narcotic analgesics Tramadol are used in combination with Paracetamol.

Persistent, difficult to treat pain is relieved by blockages of corticosteroids at painful points, such a procedure requires an obligatory visit to a neurologist who owns this technique.

With compression plexitis caused by a tumor, surgery is necessary.

For the treatment of such a common plexitis with cervical osteochondrosis, the emphasis is on massage, physiotherapy and therapeutic exercises.

Metabolic dystrophic and ischemic plexitis requires long-term step-by-step treatment. After the course of the main therapy, they switch to other types of therapy:

- Mud baths, paraffin and ozokerite

- Electrophoresis with novocaine or lidocaine

- Amplipulse therapy - electrical stimulation of the shoulder area

- Diadynamic therapy

- Healing shower

- Acupuncture, acupuncture

- Swimming

- Hirudotherapy

- Physiotherapy

Moreover, swimming and remedial gymnastics should become a way of life.

Persistent, poorly treatable pain in the shoulder requires examination, it is not worth delaying with this, because you can "heal" to a shrunken and hanging like a whip!

Sudden weakness in the hand, the inability to perform this or that movement, vague soreness, which does not have an exact localization - all these are symptoms of a formidable neurological disease. Shoulder plexitis can develop for various reasons. Usually, the disease is characterized as a chronic dystrophic process with a predominant lesion of the motor and sensory axons of the nerve fiber. If symptoms of brachial plexitis appear, then treatment with full restoration of all lost functions can be carried out only in the first 10-14 months. then the process of atrophy of the nerve fiber begins and it will be almost impossible to restore its working capacity.

This article describes in detail about the characteristic symptoms and treatment of plexitis of the shoulder joint using manual therapy techniques. if you notice such signs in yourself or your loved one, we recommend that you do not hesitate and immediately seek professional medical help from a neurologist. you can also sign up for a free consultation with a neurologist at our manual therapy clinic. During the first appointment, which is carried out completely free of charge, you will learn about the alleged diagnosis, prospects and possibilities of conservative treatment of pathology.

It is necessary to understand that plexitis of the shoulder joint is a dangerous condition that can lead to a complete loss of mobility of the upper limb. This is not a damage to one nerve, but to the whole plexus and bundle, which is responsible for the innervation of all tissues of the upper limb. the primary clinical sign is pain syndrome, which is further supplemented by symptoms of autonomic dysfunction. In particular, the patient may complain of lack of physical activity, decreased skin sensitivity, muscle weakness, feeling of coldness in the hand, the appearance of paresthesia, creeping, etc.

Basically, the clinical picture is formed due to the severity of the lesion that caused the cause of plexitis and the continuation of its negative impact. if it was an injury, then the increase in clinical symptoms will be extremely slow. But if the cause is cervical osteochondrosis and intervertebral disc herniation, then the clinical picture will form intensively with an increasing load on the radicular nerves.

Self-diagnosis is not effective, since only an experienced orthopedic surgeon can distinguish brachial plexitis from other degenerative diseases. To clarify the diagnosis, a number of laboratory examinations will be required. This can be X-ray, MRI, ultrasound, arthroscopy, electromyography, electroneigraphy, blood tests to exclude rheumatism, etc.

Causes of plexitis of the brachial plexus nerve

In the formation of the brachial plexus, axons are taken from the radicular nerves located in the intervals between the 5-8 cervical vertebrae and the first thoracic vertebrae. Accordingly, the development of osteochondrosis with protrusion of the intervertebral disc in this area may contribute to the development of brachial plexitis.

This plexus is responsible for the innervation, motor function and sensitivity of all tissues of the upper limb and directly of the shoulder. With the defeat of the entire brachial plexus, Kehrer's palsy is formed, in which motor and sensory functions may be completely absent. Differential diagnostics must be carried out without fail with acute cerebrovascular accident.

Plexitis of the brachial plexus of the upper part of the cervical spine with damage to the C5-C8 radicular nerves causes the development of proximal paralysis, bearing the names of Drs. Duchenne and Erb. And when diagnosing distal muscle paralysis of Dejerine-Klumpke, we can say that the patient's radicular nerves C8-Th1 have suffered.

Depending on the cause that provoked it, brachial nerve plexitis can be toxic or infectious, traumatic or compressive, ischemic or metabolic, tumor or autoimmune.

Consider the most common causes of the development of this neurological disease:

• traumatic effects, including on the shoulder joint, axillary area, collar region of the neck;
• fractures of the shoulder, clavicle, scapula, acromial process;
• stretching of the ligamentous apparatus with the formation of rough scars that disrupt the passage of the nerve fiber;
• tuberculous infection of soft tissues with foci of spread along the spinal column;
• work in conditions of increased harm (for example, miners, with constant contact with vibrating jackhammers, risk getting the brachial plexus of nerves damaged very quickly);
• prolonged walking on crutches (when squeezing the axillary region, there is a regular microscopic injury to the brachial plexus with a gradual formation of the clinical picture of plexitis);
• in children, birth trauma predominates due to a violation of the technique of providing obstetric care;
• compression effect on the radicular nerves by intervertebral hernias and protrusions;
• wearing tight clothing in the armpit and collar area;
• development of hematomas in the area of ​​passage of the brachial plexus;
• tumor growth, lymphadenopathy and metastasis of the neoplasm in the axillary group of lymph nodes;
• malnutrition due to deformation of the bloodstream, for example, in diabetic angiopathy;
• operative surgical interventions;
• transferred purulent tonsillitis, chronic tonsillitis, brucellosis, syphilis, etc.

All possible causes of the development of brachial plexitis should be excluded at the stage of differential diagnosis. A full-fledged successful treatment with the continuation of the cause of the disease is impossible. There will be a deterioration in the innervation process, as transforming pressure will continue to be exerted on the damaged brachial plexus.

Shoulder plexitis symptoms

The first symptom of brachial plexitis is plexalgia (pain syndrome). It can be shooting, stabbing, cutting, aching, or boring. The pain can be localized in the shoulder, forearm, neck area, etc. often pain syndrome is localized in the clavicle and then spreads along the outer and inner surfaces of the upper limb.

All symptoms of plexitis of the shoulder joint are aggravated in the evening and at night. the patient complains that he literally cannot find a suitable position for sleeping at night. any movement causes the strongest aggravation of pain in the upper limb.

As the clinical picture of brachial plexitis develops, the following symptoms appear:

1. constantly increasing muscle weakness;
2. decreased muscle strength - the patient cannot even hold a cup filled with tea in his hand;
3. violation of mobility in the shoulder, elbow and wrist joints;
4. inability to bend the arm completely;
5. the inability to take the hand away from you and return it to the opposite position without assistance;
6. with paralysis of Dejerine-Klumpke, while maintaining mobility in the shoulder and elbow joints, movements in the wrist joint and hand suffer.

When performing functional tests, a neurologist can determine a decrease in intensity or complete loss of some reflexes. Basically, the elbow reflex suffers. less often, the absence of the carporadial reflex is detected.

Hyperesthesia and hypersensitivity of the skin is defined by the patient as a condition when all the "nerves are exposed". At the initial stage of development of shoulder plexitis, creeping creeping sensations regularly occur. Then these sensations develop into constant itching of the skin. Then there is a decrease in skin sensitivity.

In the later stages of brachial plexitis, trophic disorders occur - ulcers appear, the skin becomes dry and pale. This is a consequence of a violation of the innervation of the bloodstream. Capillaries lose their tone and do not transport blood to all soft tissues in a timely manner. Pasticity of the skin may be accompanied by slight swelling that occurs with improper venous outflow. Increased sweating with marbling of the epidermis gradually passes in the absence of the process of sweating and complete pallor of the skin.

Many women suffer from permanent fragility of the nail plate. Various creams and restorative formulations have been used, but the problem persists. Because the real cause of brittle nails is brachial plexitis.

Most often, plexitis of the shoulder joint is a one-sided disease, i.e. nerve fibers are affected only on one side. Bilateral shoulder plexitis can be metabolic in the presence of diabetes mellitus or toxic.

How to treat post-traumatic plexitis of the shoulder joint

Post-traumatic brachial plexitis is a fairly common disease that can occur after sprains and tendons, collarbone fracture, shoulder dislocation, etc. it is not uncommon for post-traumatic plexitis to occur with constant use of crutches. Representatives of some professions are susceptible to microscopic injuries: builders, painters, finishers, hairdressers, etc.

Before treating brachial plexitis, you need to conduct a diagnostic examination. Then, after the diagnosis is made, it is necessary to exclude the continuation of the traumatic effect. If the patient reveals the presence of scar tissue in the area of ​​injury, then it is necessary to take measures to remove it. This can be done surgically. But it is safer to remove cicatricial changes using manual therapy techniques and laser exposure.

It is possible to effectively and safely treat plexitis of the shoulder joint by several methods: conservatively, surgically, pharmacologically. The most effective methods of influence are manual, physiotherapy and kinesiotherapy. The first stage of therapy is to restore nutrition and position of the brachial plexus. Then, measures are taken to restore the lost functionality of the soft tissues of the upper limb.

Complex treatment of plexitis of the nerve of the shoulder joint

Treatment for shoulder plexitis should be comprehensive. During the initial consultation in our manual therapy clinic, a neurologist gives each patient individual recommendations. They are aimed at eliminating negative factors. Then a treatment plan is developed individually.

It can include various techniques. For the treatment of plexitis of the shoulder joint, the following methods of therapeutic conservative effects can be used:

• traction traction of the spinal column, in the event that plexitis is provoked by osteochondrosis and its complications;
• osteopathy and massage to restore microcirculation of blood and lymphatic fluid;
• reflexology - by acting on biologically active points on the human body, it is possible to start the process of tissue regeneration;
• therapeutic gymnastics and kinesiotherapy restore muscle strength and the ability to perform any movements of the upper limbs;
• physiotherapy, laser treatment, electromyostimulation.

If you need an effective and safe treatment for brachial nerve plexitis, then you can sign up for an initial free consultation with a neurologist at our manual therapy clinic. Here you will be given a preliminary diagnosis, a special examination is recommended and information on treatment options is provided.

There are no strictly specific reasons, there is a predisposition to the anatomy and physiology of the joint itself or factors leading to the inflammation itself:

• Diseases of the connective tissue of an autoimmune nature - psoriasis, rheumatism, systemic lupus erythematosus.
• Nutrient Metabolism - Diabetes Mellitus.
• Water-salt imbalance - gout.
• Diseases of a general nature in which the joint is affected secondarily - tuberculosis, syphilis, gonorrhea, sepsis.
• Occupational hazard due to the need for static stress on the elbow joint - accountants, chess players, scientists, writers, engineers, truck drivers, engravers and jewelers, dental technicians. Work related to manual labor - builders and agricultural workers.
• The consequences of amateur sports or professional activities, fraught with constant regular microtraumas - tennis, volleyball, basketball, hockey.
• Untreated or undiagnosed unnoticed joint trauma, which resulted in mini-scarring, but with a violation of tissue physiology.
• Infection from the body by contact, with open lesions; hematogenous - with blood, with a septic condition; lymphogenous - for chronic colds viral diseases of the genitourinary or respiratory systems.
• Intentional or household, acute or chronic trauma, ending with hemarthrosis and secondary inflammation - dislocations, subluxations, fractures, damage to muscles and tendons.
• Oncological diseases of a malignant or benign nature.

Causes

In each case, the causes of the inflammatory process in the elbow joint may be different, but the most common of all are the following:

• the consequences of professional activity. This disease is observed when a person's work duties are associated with excessive loads performed by the elbow joint or if the hands are constantly and for a long time in an uncomfortable position. Examples include, for example, professions such as musicians or drivers;
• injury. In most cases, the elbow area suffers from direct impact or bruising. The disease is also observed after sprains. The result of all unsuccessful falls and bruises often becomes fractures, blows, ligament ruptures, bruises, dislocations, etc.;
• excessive stress on the elbow region. In most cases, this cause of inflammation is observed in athletes who are constantly involved in weightlifting or intensive training on strength machines;
• infection. Most often, the infection spreads through the body from some kind of superficial damage to the muscles of the elbow.

Treatment

Only a qualified doctor can diagnose the disease. To establish an accurate diagnosis, a blood test is taken from the patient, X-rays are taken of the damaged area, if there is fluid in the elbow bag, then it is also taken for analysis.

In each case, the patient is assigned a mandatory rest, the injured hand must be completely immobilized. If necessary, various dressings, headscarves, tourniquets and dressings are used for this.

Medical treatment is always prescribed in each case only individually. To eliminate the infectious process, the patient is prescribed a course of anti-inflammatory drugs, antibiotics and special physiotherapy (electrophoresis, UHF, heat therapy). To relieve the painful and edematous process, non-steroidal anti-inflammatory drugs are prescribed - Ortofen, Movalis. But in difficult cases, the doctor can also prescribe a hormonal anti-inflammatory drug - Diprospan.

External treatment is carried out with ointments: Fastum, Relief, Vishnevsky ointment and others.

In that unpleasant case, if the patient has suppuration in the elbow joint, then he is assigned a surgical operation, during which the joint cavity is cleaned and washed. If necessary, a special drain is installed to drain excess fluid.

Alternative treatment of inflammation of the elbow joint is also allowed, but this therapy should be carefully discussed with the treating doctor.

Symptoms

In the case when the patient begins to have inflammation of the elbow joint, the symptoms of this disease can manifest themselves of a different nature. When internal inflammation or bursitis is observed, the symptoms are as follows:

• pain of a sharp nature in the elbow area;
• redness of the skin in the area of ​​pain;
• swelling and swelling of the elbow;
• the formation of a soft seal in the painful part, which is able to change its shape with light pressure.

With internal inflammation of the bag of the elbow joint, fluid is produced, which makes it difficult to move the arm. The person feels lack of movement and muscle resistance.

In the case when the patient suffers from external inflammation (epicondylitis), the symptoms are different:

• crunching sounds in the elbow area when moving;
• aching pain, which increases with the movement of the ligaments. As a rule, if the patient is at rest and does not move his hand, then pain is not present;
• swelling is observed in the area of ​​the sore elbow.

Together with all of the above signs, a person may feel nausea, weakness, headache, fever.

Cervical osteochondrosis

Degenerative-dystrophic changes in the cervical spine lead to pain in the elbow.

The reason is that the destroyed tissues of the intervertebral discs pinch the nerve, the pain radiates to the arm and elbow joint.

With cervical osteochondrosis, pain in the elbow is a concomitant symptom that gets worse at night. The pain syndrome is intense to bend the arm or take it behind the back is problematic. In addition, numbness of the limb occurs.

Treatment is aimed at eliminating the underlying disease - taking NSAIDs, chondroprotectors, muscle relaxants, vasodilators. Physiotherapy and exercise therapy are required.

Physiotherapy

Physiotherapy treatment is aimed at relieving pain and inflammation, as well as muscle tension. After the end of the acute period, apply:

• Paraffin-ozokerite applications;
• Ultraphonophoresis of hydrocortisone;
• Local cryotherapy;
• Extracorporeal shock wave therapy.

In the acute period of epocondylitis, doctors prescribe high-intensity pulsed magnetotherapy, infrared laser radiation and percutaneous electroanalgesia using the Eliman-401 apparatus to relieve pain and inflammation.

Disease tennis elbow or lateral (external) epicondylitis of the elbow joint is a common disease of the musculoskeletal system. The monotonous repetition of the same movements, during which the elbow joint is actively involved and a serious load on the forearm and hand, causes inflammation at the site of attachment of these muscles to the lateral (external) epicondyle. Tennis players do it all the time. As a rule, the leading hand suffers. Therefore, the name tennis elbow syndrome has stuck to the disease. However, it also occurs in ordinary people.

To prevent injuries of this kind, for prophylactic purposes, kinesiological taping of the tennis elbow is used.

In the area of ​​frequent damage:

• People whose professional activity involves repeated execution of monotonous hand movements (painters, artists, doctors, builders, drivers, musicians, cooks, etc.);
• People aged 40-60;
• Athletes (tennis players, weightlifters, wrestlers, boxers).

Causes of the disease:

• Excessive tension in the muscles of the arm, leading to regular microtrauma to muscles and tendons and, as a result, to the development of inflammation;
• Age-related dystrophic processes in muscle and tendon;
• Genetic weakness of the ligamentous apparatus;
• Other diseases of the musculoskeletal system;

Sometimes it happens that the disease appears for no apparent reason (sudden epicondylitis) or after a one-time intense overload of the forearm. The disease often becomes chronic, as it progresses quite easily and many people simply do not go to the hospital.

How is ulnar bursitis treated?

Bursitis is considered an occupational disease in athletes. With bursitis, the periarticular capsule becomes inflamed from injury or microdamage due to prolonged stress on the joint.

Bursitis develops as inflammation of the elbow joint in the presence of:

• sports or household injuries (bruises, sprains, fractures);
• prolonged stay of the elbow and hand in the same forced position (rocking a small child, playing musical instruments);
• mechanical stress on the hands;

This inflammation does not affect a joint such as the jaw-temporal joint. It is characteristic precisely for the elbow and shoulder. Bursitis may not always be immediately recognizable, as it may initially manifest as a common edema. The synovial fluid gradually accumulated inside begins to interfere with movement. Then there is pain, a local increase in temperature, redness of the skin around the site of inflammation.

According to the form of the course of the disease, serous bursitis and purulent bursitis are distinguished. To cure bursitis, you need to undergo a difficult diagnostic procedure in the form of a joint puncture. The opinion that bursitis can be cured by folk methods is erroneous. Traditional drugs will reduce swelling and inflammation, relieve pain in the affected area. But the disease can be completely cured not by folk, but only by therapeutic means or by surgery.

Forms of the disease and characteristic symptoms

The acute form of bursitis is characterized by a sudden onset of the inflammatory process, which manifests itself the next day after the injury. In the area of ​​the elbow tip, a slight edema occurs, with a soft to the touch consistency. The edema is painful, which manifests itself both on palpation of the affected area and at rest. Inflammation is accompanied by general ill health, weakness and fever. Day after day for one week, the edema grows, delivering tangible discomfort to the person and hindering movement in the joint. Such a patient must immediately seek medical help and undergo a course of treatment prescribed by a doctor in order to avoid the transition of the disease into a recurrent form, when even a minor factor leads to a new round of inflammation after an apparent recovery.

A feature of the chronic form is not a sharp, but a gradual development of small edema.

A person does not immediately pay attention to the unusual condition of the elbow, so the disease can last for years in a sluggish form. The prolonged course of the inflammatory process negatively affects the joint itself, causing pathological changes in it

Chronic bursitis is dangerous for joint health

If an infection has been brought into the bursa (most often from the outside as a result of a bite or cut), then the pathogen begins to multiply inside the periarticular pocket, causing first serous and later purulent inflammation. It is accompanied by a sharp rise in temperature, up to heat. The place of edema is hot to the touch. Septic, or infectious, bursitis is dangerous for the possible development of necrosis of the walls of the articular bag and the entry of infection into the general bloodstream.

Purulent bursitis - an advanced case of septic inflammation of the synovial bag

Thus, common symptoms of bursitis include:

1. Edema: This is usually the first sign that the patient notices. The skin on the back of the elbow may be loose, so swelling may not be noticed at first. In some cases, the edema grows rapidly and is visible immediately. The swelling can be the size of a golf ball at the tip of your elbow.
2. Pain: As the bursa stretches, elbow pain increases, especially when flexing. As a rule, with extension, pain is reduced or absent. But there is a category of people with ulnar bursitis who do not experience pain in principle, regardless of whether their arm is bent or straightened.
3. Redness or pronounced warmth on the back of the elbow: May indicate an infection.
4. Tenderness in and around the elbow.
5. Pus: In advanced cases of infectious inflammation, a yellow or white, thick, cloudy exudate in the infected elbow is characteristic.

Elbow joint inflammation treatment

Effective treatment of the elbow joint, possible with both traditional and folk remedies

But it is important to remember that self-medication can cause serious harm to your health. To avoid this, before treating the disease with classical or folk remedies, you should immediately consult a doctor at its first manifestations.

Treatment with traditional remedies for elbow disease largely depends on the course and cause of the disease.

The main traditional methods of treatment for bursitis and epicondylitis:

• alternating warm and cold compresses;
• tight bandage;
• antibiotic therapy (purulent inflammation of the joint capsule);
• pain relievers;
• non-steroidal anti-inflammatory drugs;
• compresses, ointments (for traumatic bursitis);
• physiotherapy treatment.

Also, if necessary, can be used: surgical treatment, or intra-articular hormonal injections. Most often, such methods are used for complicated bursitis, when suppuration occurs in the synovial bag.

Treatment of bursitis and epicondylitis with folk remedies include:

• potato or cabbage compresses;
• compresses with decoctions of anti-inflammatory herbs (calendula, plantain, etc.);
• vodka compresses with Vishnevsky ointment;
• lotions from propolis tincture;
• reception of infusion of celery.

Inflammation of the elbow joint, the treatment of which, perhaps, with folk remedies, should not be in an acute form or be infectious. Otherwise, complex therapy is used.

It should be remembered that treatment with traditional methods of bursitis, without consulting a doctor and thorough diagnosis, is unacceptable. Otherwise, the disease may become more complicated and turn into a form that requires surgical treatment and drainage.

All detailed manipulations of the hands are performed by the small but complex elbow joint. It consists of the articular heads of the three bones of the upper limb - the diaphysis of the humerus and the epiphyses of the ulnar and radial, which are surrounded by an articular capsule and lined with a synovial membrane. The cells of this tissue secrete a special fluid to smooth out movements in the joint, and cushion during sudden movements and lifting weights.

Inflammation is classified according to several parameters:

1. By the type of pathogen: specific (Koch's bacillus, gonococcus, treponema) and nonspecific (streptococcal and staphylococcal infections, viral lesions).
2. By the type of course: acute, which, in turn, is detailed by the type of exudate that accumulates in the focus of inflammation: serous, hemorrhagic and purulent; subacute and chronic - fibrous.
3. By localization:
   • arthritis - affecting all elements of the joint without irreversible changes;
   • arthrosis - degeneration, partial or complete destruction of the articular complex;
   • the defeat of the capsule is called bursitis, from the Latin word "bursa" - a bag;
   • a pathological process in the muscles and tendons surrounding the elbow joint is called epicondylitis.

Causes of bursitis and its treatment video

Most patients recover safely from bursitis. The best prevention is to maintain a healthy lifestyle with moderate exercise and use protective elbow pads as needed.

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Diseases and their symptoms.

Symptoms are usually precisely localized in the joint area: pain of a different nature, swelling, induration (infiltration), redness, dysfunction in a different range, redness of the skin of the elbow.

Bursitis.

Bursitis manifests itself in various symptoms, depending on the aggression and severity of the inflammation. From subtle swelling and mild pain during extension, to a significant increase in the joint, redness, sharp pulsating and bursting pain, suffering of joint function. With suppuration or a sharp exacerbation, a violation of the general condition is possible - low-grade fever, chills, weakness, headaches and loss of appetite. In the case of purulent inflammation, there is a danger of the transition of the articular abscess into the phlegmon of the hand, and damage to the muscles and bones directly - myositis and osteomyelitis, with the appearance of fistulas and necrotic fusion of tissues. Chronic bursitis is characterized by thickening of tissues, the formation of nodules and limitation of function during exercise.

Epicondylitis.

Epicondylitis is external and internal, and the symptoms will correspond to the localization: disturbance and pain during extension and flexion. Often, the lesion is asymmetric - in accordance with the working hand, which is in constant continuous load. Also distinguish: lateral and medial forms. Lateral - called the "tennis player's hand", characteristic of the age after 30 years, occurs with certain complex-directed movements, inherent in tennis players, lumberjacks and painters. The medial is called the "golfer's elbow", with the active use of movements that strain the forearm.

Arthritis.

Arthritis is characterized by early dysfunction, all signs of inflammation. Depending on the stage, the whole palette of pain is sharp, cutting, dull and aching. Severe stiffness and stiffness of the joint, to complete immobility and inability to move the arm at the elbow. Inflammatory painful contracture of the musculo-ligamentous apparatus. With suppuration, fluctuation and cyanosis of the tissues surrounding the joint are observed.

Complications of bursitis

Complications of bursitis include:

• a secondary infection that can develop after aspiration or steroid injection;
• secondary septic (infectious) arthritis;
• sepsis (blood poisoning) and osteomyelitis (purulent-necrotic process in the bones) sometimes occur due to severe septic bursitis, especially with late diagnosis;
• fistulas (abnormal opening in the body) can develop after spontaneous rupture or surgical drainage of the periarticular sac;
• recurrence of bursitis - more likely with a recurrence of the injury that caused the inflammation.

Chronic pain in the joint and the associated decrease in its functionality can be caused by the inflammatory process in the persistent course of bursitis.

Causes and symptoms of development

Elbow problems can be caused by many reasons. This disease occurs in people of different age groups, regardless of gender. Anyone can be at risk.

Causes of occurrence

The causes of the disease of the elbow structure can be:

• untreated injuries;
• sprain;
• excessive loads of a constant nature;
• long-term support on the elbow;
• hypothermia;
• transferred infectious diseases;
• heredity.

The main symptoms

Symptoms vary depending on the type of disease. Whereas bursitis is inflammation of the internal elements of the elbow structure (bursa), epicondylitis is inflammation of the external structures of the elbow joint.

The main symptoms of inflammation of the joint capsule:

• swelling of the joint capsule (soft elastic swelling of a round shape);
• difficulty in movement;
• soreness when flexing and extending the arm;
• crunch when moving;
• local and sometimes general temperature rise.

The main symptoms of epicondylitis are:

• pain when turning the forearm, as well as rotational movements;
• sharp intense pain on palpation;
• the pain is localized in the affected area.

Treatment how to act correctly

Immobilization and drugs

The treatment regimen is determined by the doctor. Self-medication is dangerous. For complex injuries, it is recommended to immobilize the limb by applying a retainer. If there is inflammation in the elbow joint, the arm should also be kept at rest. With inflammation provoked by bacteria, antibiotic therapy is prescribed. An injection of Novocaine can relieve severe pain. It is also recommended to use the following anti-inflammatory and pain relieving pills and liniment:

The drug will relieve pain and inflammation.

• Voltaren;
• Diclofenac;
• Dolobene;
• "Dolgit";
• "Nimedar";
• "Fastum";
• "Indovazin";
• Ibuprofen;
• "Analgin".

Physiotherapy

Physiotherapy treatments for the ulnar muscle and other tissues include procedures such as:

• magnetotherapy;
• laser therapy;
• infrared irradiation;
• electrophoresis;
• diadynamic therapy;
• thermal wraps with ozokerite or paraffin;
• phonophoresis;
• shock wave therapy of the elbow joint;
• cryotherapy.

Treatment with folk methods

The product has anti-inflammatory properties.

1. Take 50 g of propolis and vegetable oil.
2. Darken the ingredients in a water bath to a uniform consistency.
3. Refrigerate.
4. Lubricate the elbow joint, tie on top with polyethylene and a warm cloth.

For oral administration, a tincture of cinquefoil is used, prepared as follows:

1. Take a few crushed plant roots.
2. Add 0.5 l of vodka.
3. Insist 21 days.
4. Take 10 ml 3 r. per day.

And also useful are decoctions and infusions of elecampane, oak or willow bark, birch leaves and buds. Warm baths with pine needles decoction or the addition of essential oils with lavender extract are recommended. It should be remembered that the folk method can be treated as an adjuvant, but not a substitute for traditional treatment.

Plexitis is an inflammatory process of large nerve plexuses, in particular cervical, brachial, lumbosacral. The disease affects people of absolutely any age category, which is why it is often diagnosed in babies in the first months of life. If you do not seek help from a specialist or improper treatment, an ailment can cause loss of performance and disability. In the international classification of diseases (ICD 10), this disorder has its own code, depending on the nature of development - G 54, G 55, M 50 and M 51.

The cause of the progression of this disease can be trauma to the nerve plexus with fractures, a history of such disorders as tuberculosis, diabetes mellitus or syphilis, allergies or drug overdose. In a newborn, the disease develops against the background of birth trauma. The severity of symptoms depends on the type, location and severity of the disease. The first sign is soreness, which is expressed constantly and increases with movement or minor physical exertion.

Confirmation of the diagnosis is carried out by examination by a specialist, as well as on the basis of laboratory blood tests and apparatus examination of the patient. Treatment tactics are determined depending on the nature of the disease. Without timely treatment of any form of the disease, complete loss of performance and disability can occur - these are the main complications of plexitis of the shoulder joint, cervical and lumbosacral regions.

Etiology

The main factor in the formation of plexitis is a violation of the transmission of a nerve impulse through the nerve plexuses. The predisposing circumstances are:

• oxygen deficiency of the nervous tissue due to prolonged compression by neoplasms, immobility of the limbs;
• complications after severe surgical interventions;
• diabetes mellitus, syphilis, tuberculosis and other infectious processes;
• allergies to food, medicines, or vaccines;
• drug overdose;
• adverse environmental conditions;
• harmful working conditions;
• violation of metabolic processes;
• poisoning of the body with chemicals;
• a wide range of injuries - fall, dislocation, cut or stab wound;
• birth injury.

Varieties

There are several classifications of plexitis, differing in many factors. At the place of occurrence of the inflammatory process, they are distinguished:

• shoulder plexitis - the disease process can spread to the entire arm, significantly reducing or completely eliminating the possibility of movement;
• pathology of the cervical spine;
• inflammation of the lumbar and sacral plexus - the lower limb is involved in the disease process;
• coccygeal plexitis is an extremely rare form of the disorder.

By the way the pathological process spreads, the disease is divided into:

• unilateral - with damage to the left or right limb;
• bilateral.

According to the severity of the course, the disorder of the nerve plexus is divided into:

• partial - individual nerve trunks are exposed to pathology;
• total - the defeat extends to the entire structure of the plexus.

Symptoms

The clinical picture of the disease differs depending on the place of manifestation of the disease. Thus, plexitis of the shoulder joint is expressed by such signs as:

• paroxysmal pain spreading throughout the injured limb;
• decreased sensitivity in the shoulder and hand;
• muscle weakness;
• limitation of motor functions;
• swelling of the affected area;
• pallor of the skin;
• increased fragility of the nail plates;
• significant sweating of the palms.

Symptoms of plexitis of the cervical spine:

• manifestation of soreness in the front and side of the neck, which increases with bending and turning;
• spread of pain to the back of the head, shoulder blades and ears;
• difficulty moving your head;
• constant hiccups, causing discomfort;
• violation of sensitivity.

Manifestations of plexitis of the lumbosacral region:

• localization of back pain with spread to the lower limb from the affected side;
• involvement in the pathological process of the internal organs of the small pelvis;
• a significant decrease in the susceptibility of the legs to external stimuli;
• decrease in physical activity;
• sweating feet;
• the skin on the affected area is cold to the touch, pale, sometimes with spots of a bluish tint;
• change in gait - severe lameness is observed.

Symptoms of coccygeal plexus plexitis are - a violation of the emission of urine and feces, a disorder of sexual function.

Diagnostics

A preliminary diagnosis of plexitis of the shoulder joint, cervical spine or lumbosacral plexus can be made by a specialist by examining the history, finding out the possible causes of the formation of the disorder, the first time and the severity of the symptoms of the disease. Additional information will allow you to get a thorough examination of the patient, as well as an assessment of the strength of the muscles of the limbs and neck, the condition of the skin and nail plates.

Laboratory studies of a blood test are aimed at detecting additional signs of the disease - an increase in the concentration of leukocytes. Hardware examination of the patient consists in carrying out:

• Ultrasound of the pelvic organs;
• electroneurography - measuring the speed of transmission of a nerve impulse;
• electromyography - a technique that allows you to assess muscle activity;
• radiography of the affected area;
• CT scan of the joints;
• Whole body MRI.

To differentiate plexitis from other disorders with similar symptoms, consultations of specialists from other areas of medicine, in particular - gynecology, urology, oncology, neurosurgery, traumatology, orthopedics, will be needed.

Treatment

Treatment of plexitis is aimed at the complete elimination of the factors that cause the disorder. With the infectious nature of the disease, patients are prescribed antiviral and antibacterial medicines. Plexitis of a metabolic nature is eliminated by normalizing sugar levels. Medical intervention is necessary for post-traumatic and compressive type of ailment. Therapy involves removing tumors and blood clots that can compress the plexus. For any etiology of plexitis, the following are prescribed:

• pain relievers and hormonal medications;
• vitamin complex;
• physiotherapy - treatment with electric current and magnetic field, acupuncture and hydrotherapy is carried out;
• a course of physiotherapy exercises both in the rehabilitation room and at home.

Plexitis of the shoulder joint - characteristic

Painful sensations, whatever localization they may have, negatively affect the human condition in all aspects. Poor health not only interferes with the timely implementation of the planned tasks, but also significantly spoils the mood, makes a person irritable and tired.

It is especially difficult when the pain makes it difficult to complete the simplest tasks. So, for example, symptomatic manifestations of plexitis of the shoulder joint can disable the hand, making it impossible not only to move it, but even sleep on the sore side.

Plexitis is a disease of the nerves, this name hides the inflammation of a specific area or the entire branch of the nerve fiber located in the shoulder. The first very unpleasant manifestation of the disease is pain, the intensity of which increases in proportion to the time the patient is inactive.

In addition, over time, serious complications may appear that threaten the loss of control over the entire arm, therefore, if there is a suspicion of the development of plexitis, it is necessary to undergo an examination in a hospital.

The prognosis of treatment depends entirely on the patient's reaction rate - the earlier the problem is detected, the more likely a positive treatment result is. Shoulder plexitis is an inflammatory disease in which the nerve structures of the shoulder are affected.

The plexus includes the anterior branches of the four lower nerves of the cervical spine and the first thoracic spinal nerve. The shoulder, as an anatomical unit, is distinguished by its large size and complexity of its structure.

It is located on the lower and upper sides of the clavicle, and also originates from the spine and continues to the lower border of the armpit. This pathology is quite serious, because it can cause disability.

Moreover, this concept includes not only the loss of the opportunity to work. Patients with plexitis lose the ability to perform even the simplest hand movements, so they cannot take care of themselves and require constant care.

More often, the pathology affects middle-aged people. It also develops as a result of the injury inflicted at the birth of the fetus. It is especially difficult for a patient to adapt to new conditions when the arm is damaged, with which he performs all the basic actions.

In such cases, it takes a lot of effort, time and desire to retrain to make any movements with the other limb. In addition, brachial neuritis gives patients intense pain due to the development of the inflammatory process of the nerve plexuses.

The painful sensations are significantly increased when trying to make some movements, for example, raising a hand or taking it to the side. Also, this symptom becomes more intense at night. At the same time, fine motor skills suffer.

It is difficult for the patient to perform actions with his fingers (tying laces, holding objects, opening locks in doors, etc.) With the progression of the disease, the limb completely loses its sensitivity, paralysis, paresis, muscle atrophy of the right arm or the left one develop, depending on the location of the pathological process.

Pathogenesis of plexitis

The muscles of the shoulder girdle and upper limb are affected, deep reflexes on the upper limb decrease or disappear. Vegetative-trophic disorders develop in the form of cyanosis or pallor of the hand, pasty hand, sweating, violations of the trophism of nails, and more.

Plexite has two stages of flow:

1. 1. neuralgic
   2. paralytic.

The neuralgic stage is characterized by spontaneous pain, which increases with compression of the plexus and with movement. Paralytic steel is characterized by peripheral paresis and paralysis of the muscles innervated by the branches of the affected plexus, a decrease in the corresponding deep reflexes, a violation of all types of sensitivity and trophism in the innervation zone, which is manifested by swelling, pastiness, and so on.

When the disease affects the cervical plexus, the occipital region begins to hurt, paresis of the deep muscles of the neck and diaphragm progresses. Irritation of the phrenic nerve leads to hiccups. The defeat of the brachial plexus causes pain, localized in the supra- and subclavian regions, radiating to the arm.

In most cases, brachial plexitis affects the working hand: in most patients, plexitis of the right hand occurs, and in left-handers, the left hand. Often, plexitis of the shoulder joint leads to the inability to live a full life - the patient cannot move his arm, lie on the sore shoulder, becomes helpless in many everyday situations, and loses his ability to work.

Classification and types

The brachial plexus is divided into external, posterior and internal bundles, which form a kind of cocoon around the axillary artery. These bundles are composed of sensory and motor nerves, which are responsible for the corresponding functions in the hands.

The defeat can affect both the entire plexus (total plexitis), and some part of it (upper, or otherwise Duchenne-Erb, paralysis and lower, Dejerine-Klumpke), mainly on one hand (occasionally both).

Erb-Duchenne palsy (upper plexitis). The manifestations in this form of the disease are similar to the symptoms of irritation of the radial and axillary nerve. The work of many muscles is impaired, in particular, the brachial, biceps, deltoid, brachioradial, sometimes infraspinatus and supraspinatus suffer.

In the absence of treatment, the pathological process leads to their atrophy. With this form of the disease, it is difficult for the patient to raise and move the shoulder aside, to bend the limb at the elbow. The reflexes of the biceps muscle weaken, and over time they can fade completely.

On the outside of the forearm and shoulder, there is an increase in sensitivity or its complete absence. The pain is diffuse and is most intense in the upper shoulder. Above the collarbone, during examination, the doctor can determine the Erb pain point, which is located closer to the outside of the fixation point of the sternocleidomastoid muscle.

Dejerine-Klumpke's paralysis (lower shoulder plexitis). Lower plexitis is characterized by damage to the nerve plexuses of the shoulder, elbow, skin and part of the median nerve. In this form, the main blow falls on the muscles of the hand, except for the area that is regulated by the radial nerve.

Dejerine-Klumpke's paralysis is manifested by paresis and paralysis of the muscles of the forearm and hand. Atrophic changes extend to such small muscles as the hypotenar, vermiform, interosseous, flexors of the fingers and hands.

There is a violation of motor skills, finger movements are significantly hampered, the carporadial reflex fades away. Sensory disorders and pain sensations extend to the inner part of the shoulder and forearm, ring finger, little finger. The same symptoms occur on the dorsum of the hand. In addition, it is possible to detect Horner-Bernard syndrome.

Total plexitis. This form is very rarely diagnosed. The spread of the pathological process over the entire length of the nerve plexus of the shoulder is characterized. Pain sensations are localized in the supraclavicular region and under it, can be given to the hand.

There is a violation of sensitivity in the entire arm, its complete paralysis occurs. All this leads to the development of atrophic processes in muscle tissue. Periosteal and tendon reflexes disappear.

In addition, severe vegetative-vascular disorders can be found in patients, which manifest themselves in the form of edema, dysregulation of the temperature of the hand and forearm, sweating, pulsation of the wrist artery.

The pathology is included as a "brachial plexus lesion" in the International Classification under the code G54.0. The disease is quite common in all age groups, reaching a maximum frequency in the period from 20 to 60 years.

In newborns, a similar injury, often accompanied by a fracture of the clavicle, also occurs due to:

• • prolonged presence of the child in the birth canal;
  • wide shoulders of the fetus;
  • lowering the baby's thrown back hand.

Among the patients of neurologists with this pathology, men predominate. Also, shoulder plexitis is a frequent birth injury, developing due to overstretching of the trunks of the nerve plexus during difficult childbirth (when the fetus is squeezed out, its foot or breech presentation).

In addition to the fact that the pathology delivers discomfort and pain to the patient, it can lead to disability up to the complete lack of the possibility of self-service.

Causes

Plexitis of the shoulder joint is a very unpleasant disease, accompanied by damage to the nerves of the brachial plexus. Every day the pain increases and leads to the fact that the patient cannot move his hand or lie on the sore shoulder.

The pain radiates to the scapula, neck, elbow. The causes of plexitis of the shoulder joint are: being in an uncomfortable position for a long time (while working in the garden or sleeping), sprains or dislocation of the shoulder joint, prolonged physical activity, injuries in the area of ​​the cervical roots. The disease can also be a complication of gout, osteochondrosis of the cervical and thoracic spine, diabetes mellitus.

The clinical picture of brachial plexitis is usually classic with a standard set of symptoms, which cannot be said about the primary source of the disease. A large number of plexuses of nerve fibers are concentrated in the shoulder, this part of the body itself has a complex structure and relatively large size, which is why there can be a lot of causes of nerve inflammation, and they are very diverse.

The brachial plexus is formed by the first thoracic spinal nerve and the anterior branches of the four lower cervical nerves. The accumulation of nerve fibers is responsible for the innervation of the upper shoulder girdle, arms, diaphragm.

It contains sensory, motor and vegetative fibers, which are responsible for various types of sensitivity, motility and trophism of innervated tissues. The cervical plexus is located above the brachial plexus, but is closely connected with it both anatomically and functionally.

Involvement in the pathology of the nerves emanating from the plexus leads to a violation in the shoulder, forearm, elbow joint and small joints of the hand. Shoulder plexitis leads to muscle atrophy in the shoulder and upper shoulder girdle. The development of plexitis of the shoulder joint can be provoked by the following adverse factors:

1. 1. injuries of the brachial plexus with a fracture of the clavicle, dislocation of the shoulder, stretching of the ligamentous apparatus of the upper shoulder girdle, including during pathological childbirth;
   2. ischemic lesion of the brachial nerve with prolonged non-physiological position of the upper limb, which occurs in the case of narcotic sleep, unconsciousness, improper hand immobilization, the use of uncomfortable crutches, the development of tumors;
   3. an increase in lymph nodes of an infectious or malignant nature;
   4. periarthritis (inflammation of the periarticular soft tissues) as a result of infections and injuries;
   5. large aneurysms of arterial vessels in the area of ​​the nerve plexus;
   6. osteochondrosis of the cervical and thoracic spine;
   7. infectious and toxic effects on nervous tissue due to bacterial (tuberculosis) and viral (herpes, influenza, cytomegalovirus) diseases, poisoning with alcohol substitutes, heavy metals, mercury salts;
   8. metabolic disorders in the body (gout, hyperthyroidism, diabetes mellitus);
   9. costoclavicular syndrome with the formation of additional cervical ribs;
   10. constant hypothermia.

Shoulder and cervical plexitis in newborns occurs with pelvic and foot presentation, prolapse of the fetal handle during childbirth, prolonged presence of the child in the mother's birth canal.

The most common cause of this disease in newborns is birth trauma. In case of difficult childbirth, incorrect obstetric tactics, hemorrhages, bruises and sprains of the nerve plexuses may occur. Shoulder plexitis occurs as a result of excessive stretching of nerve fibers with:

• • delivery in breech or foot presentation,
  • inconsistency in the size of the fetus,
  • falling out of the hand from the birth canal,
  • long standing of the fetus in the birth canal.

When the nerve fibers are compressed or stretched, the restoration of functions begins in a few days. With the right treatment, it leaves no consequences. With more severe injuries - rupture, bruises, hemorrhage in the nerve plexus, recovery is slow, muscle atrophy occurs, and a lag in the development of the affected limb.

Without intensive treatment and physical therapy, complications can occur in the form of contracture (limited passive movements), osteoporosis and growth retardation. Diagnosis of this disease can be difficult, and treatment should be started as early as possible.

It is worth paying attention to such symptoms in a newborn child - general anxiety, constant screaming, strange abduction of the hand, lack of movement and hypertonicity, the occurrence of pain when touching the hand, swelling in the shoulder joint.

Symptoms

With the development of pathology as a result of the influence of an infectious-toxic agent, the fading of reflexes, impaired sensitivity are observed, and movement is significantly hampered. The latter symptom occurs due to atrophic paralysis and paresis.

This disease is characterized by a mass of serious symptoms that a doctor can determine and, depending on the degree of progression, prescribe a course of treatment. With pathology, patients have the following symptoms:

• • Pain syndrome that spreads along the affected nerve plexus and can be observed both from the back and from the inside of the hand.
  • Paralysis and paresis.
  • Atrophic changes in the muscles that are innervated by the nerve involved in the pathological process.
  • Sensory impairment on the inner side of the limb.
  • Difficulty trying to move the affected limb.

On the side of the localization of the pathological process, sometimes there is a narrowing of the pupil (miosis) and a deepening of the eyeball (enophthalmos).

A similar clinical picture is pronounced if a viral infection became the cause of the development of plexitis. The pain has a sharp, aching, shooting, breaking character. Sensory impairment in most cases is observed in the lower part of the limb.

In addition, patients often suffer from increased sweating, swelling of the hands, trophic changes in the skin and nails, and a slowdown in the pulse can also be observed. All these symptoms appear due to the development of a malfunction in the vascular system.

Sometimes plexitis of the shoulder joint can be determined by the behavior of the eye located on the side of the diseased shoulder: there may be disturbances in the work of the muscles of the eyelid, deepening of the eyeball and constriction of the pupil.

When the infectious-toxic process spreads to nearby tissues, pain develops, resembling brachialgia in nature. A similar disease can be accompanied by an increase in the cervical lymph nodes from the side of the lesion and their soreness.

With plexitis, patients describe the pain as aching, boring, or breaking. When the cause of the disease is an active infectious process, reflexes are lost, there is increased sweating, changes in the state of the nail plate and swelling of the hand.

Undoubtedly, pain syndrome significantly complicates life, but the main danger of the disease lies not in constant unpleasant sensations. Without proper treatment, nerve fibers are damaged more and more, which at first threatens with a violation of fine motor skills, and subsequently - the shutdown of all functions and atrophy of muscle tissue.

Diagnosis of pathology

When the first symptoms occur, you should not postpone a visit to a specialist, delay threatens with difficulties in treatment and recovery. The doctor may order the following diagnostic tests:

1. 1. x-ray of the shoulder;
   2. CT (computed tomography) of the affected area;
   3. For diagnosis, magnetic resonance imaging (MRI) may be prescribed;
   4. ultrasound procedure;
   5. superficial neuromyography (using a special device, the state of the nerves and the process of transmitting impulses by them with additional stimulation are examined);
   6. blood test.

When diagnosing shoulder plexitis, treatment should be started immediately. It is really necessary to rush to treatment, since in most cases, after a year, the lesion reaches the stage when it becomes impossible to repair the damage.

The specialist also conducts differential diagnostics with diseases such as polyneuropathy, polyneuritis, arthritis of the shoulder joint, reflex-shoulder syndromes, radicular neuritis, radiculitis of the cervical spine.

Shoulder plexitis - treatment

Before therapy, a diagnostic examination is prescribed, which helps to differentiate plexitis from other neurological pathology. For this, electromyography, X-ray of the shoulder joint, computed and magnetic resonance imaging (CT, MRI), and ultrasound are performed.

After establishing the final diagnosis, they begin to treat the disease. It should be remembered: the earlier therapy is started after the first symptoms of the disease appear, the more favorable the prognosis for recovery.

Complex treatment includes measures aimed at the etiological disease that led to the appearance of plexitis. In case of injury, the integrity of the bone is restored, the bone processes are removed, and the injured limb is immobilized.

Osteochondrosis requires the appointment of chondroprotectors, and endocrine disorders - the normalization of metabolic processes in the body. Tumors, aneurysms, additional ribs are removed surgically. Infectious-toxic plexitis is treated with antibacterial agents and detoxifies the body. Symptomatic therapy of the disease, aimed at its manifestations, includes:

• • pain relievers - novocaine blockade, analgin, aspizol, oxadol;
  • non-steroidal anti-inflammatory drugs (NSAIDs) - diclofenac, nimesulide, indomethacin;
  • vitamin therapy based on vitamins of group B, A, C, E - neurovitan, milgamma, aevit, ascorbic acid;
  • anticholinesterase agents that improve the conduction of nerve impulses - proserin, kalimin, invalin;
  • decongestants - beckons, urea;
  • trophic drugs - nicotinic acid, potassium orotate, nerobolum, lidase;
  • means for improving microcirculation - trental, compliant;
  • physiotherapy - ultrasound with hydrocartisone, electrophoresis with novocaine, magnetotherapy, ozokerite;
  • massage during the period of abatement of the acute inflammatory process;
  • physiotherapy;
  • folk treatment;
  • reflexology (acupuncture), laser therapy, balneotherapy (treatment with mineral waters), cryotherapy (local exposure to low temperatures).

Treatment of plexitis of the shoulder joint is complex and is aimed at solving several problems at once: firstly, relieving pain, secondly, improving tissue nutrition and blood circulation in the affected area, and thirdly, restoring normal nerve function and returning the functional abilities of the affected arm.

To relieve pain, the doctor prescribes anesthetic drugs (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 - they affect the reduction of the inflammatory process, and relieve pain.

These medicines are available in both pill form and liquid for injection. When the disease is at an advanced stage, more serious hormonal drugs are required to reduce inflammation.

They effectively fight inflammation and promote tissue regeneration. The type of treatment depends on the underlying 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 in the body. During drug treatment, in order to prevent or slow down muscle atrophy, electrostimulation is prescribed - an electrical effect on soft tissues, which stimulates the muscles to contract and thereby allows them to keep them in good shape.

Physiotherapy methods for plexitis of the shoulder joint are divided into several groups depending on the type of their influence:

1. 1. to reduce pain, electroanalgesia is prescribed with short-type impulses or drug electrophoresis;
   2. UHF therapy will help prevent fluid accumulation in the joint to prevent fluid accumulation in the joint capsule - UHF therapy;
   3. Infrared laser therapy and ultrasound therapy will accelerate tissue repair;
   4. neurostimulating procedures - neuroelectrostimulation and bioregulated type stimulation;
   5. vasodilatation will be facilitated by infrared irradiation and high-frequency magnetotherapy.

If you experience acute pain in the shoulder joint, you should consult a doctor as soon as possible. The earlier the treatment of plexitis is started, the more favorable the prognosis for recovery. According to American doctors, if you delay a year and do not start treatment for plexitis, then, due to muscle atrophy, recovery occurs extremely rarely (no more than 10% of cases).

Treatment of brachial plexitis is quite long, it is carried out according to an individual scheme for each patient. If the cause of plexitis is a hand injury, then the hand is fixed with a bandage, over time, special exercises for the hands begin to be performed: at first, simple, then more and more complex.

Surgery is sometimes required for severe injuries. Often, doctors prescribe antibiotics, vitamins, and other medications to treat shoulder plexitis. However, the main focus is on physiotherapy, massage and remedial gymnastics.

Surgical measures are indicated for tumor origin of plexitis, and if it is caused by trauma (for example, if the plexus is compressed by bone fragments), aneurysm or cervical ribs.

Physiotherapy

For the treatment of plexitis, special physical education and massage sessions are additionally prescribed. Both in the first and in the second case, a set of exercises is compiled individually for each patient in order to achieve the best effect.

To prevent exacerbation of plexitis, improve blood flow and metabolism in the affected area, restore strength and elasticity of atrophied muscles, a set of exercises for daily performance is recommended.

1. 1. Raising and lowering the shoulders 8-10 times in one approach.
   2. The maximum reduction of the shoulder blades is up to 10-12 times.
   3. Starting position - the arms are bent at the joints, the hands lie on the shoulders. Rotation in the shoulder joint first forward, then backward 6-8 times.
   4. Abduction of the sore arm to the side at right angles to the floor and adduction to the body 10-12 times.
   5. With a straightened injured hand in front of you, make circular movements clockwise and counterclockwise 12-15 times.
   6. Starting position - arms along the body. Flexion and extension of the sick upper limb in the elbow joint 6-8 times, at first you can help with a healthy hand.
   7. The starting position is the same, turn the hand and forearm to the right and left sides 10-12 times.

Finger motor skills are restored by gripping, feeling and shifting small objects - beads, peas, screws. Swimming and aqua aerobics are helpful. It is necessary to avoid hypothermia, intense sports, heavy physical labor.

As for massage, it is worth starting the procedure with professional sessions, and then you can continue on your own. The process usually boils down to a thorough kneading of the neck, arms and shoulder girdle, often with a method of targeted action on biologically active zones.

After recovery, it is imperative to observe preventive measures in order to avoid the re-development of the disease. As a preventive measure, experts recommend swimming and other physical activity, but within reasonable limits.

ethnoscience

Uncomplicated plexitis of the shoulder joint can be cured with the help of folk remedies. However, before using this technique, it is imperative to consult a doctor. In the treatment of plexitis of the shoulder joint, a natural product such as mumiyo is often used.

For treatment, you will have to purchase or make yourself an alcohol solution of mumiyo, in which the concentration should be 8 - 10%. This solution should be rubbed into the area of ​​soreness on the shoulder. Each procedure should last at least 5 - 6 minutes.

The full course of such such therapy is up to 20 - 25 days, depending on how the remedy acts on pain. If no improvement was noticed after 4 - 5 procedures, then the use of this remedy should be stopped and a doctor should be consulted.

If the treatment helps, then after 5 to 10 days this course can be repeated. It is also recommended to simultaneously take mumiyo with milk inside in the proportion: 1 part of mumiyo and 20 parts of milk. With this treatment, the tone decreases much faster, and symptoms such as pain and irritation disappear.

Another method is no less effective - the use of propolis ointment. To prepare it, you need to have 3 g of bee propolis on hand. This is about a ball about the size of a pin. It must be mixed with 50 grams of pork fat or lard, which must first be melted.

Rub the resulting ointment into the sore shoulder three times a day. The course is up to a month. Such treatment should be avoided by people who are allergic to propolis and bee products. If this method turns out to be ineffective, you should consult a doctor.

At the initial stage of plexitis, saline dressings on the shoulder area can also help. However, before starting such treatment, you should definitely consult a specialist wasps. To start this therapy, you need to prepare a linen cloth or gauze.

If it is fabric, then it must be folded into four layers, if gauze - then in 8 layers. Then the saline solution should be prepared. It must be cooked strictly according to the instructions. For five hundred ml of water, you need 50 grams of salt. You can take the usual, cooked, without additives.

And you can use the sea. Put a cloth in this solution and keep it in the solution for half an hour. After this time, the solution must be heated, wring out the fabric so that water does not drain from it. Apply a warm compress to the sore joint and fix it with a bandage.

It is very important not to use cellophane. This procedure should be carried out before going to bed for one month. A new salt solution should be prepared each time. It should be remembered that an advanced disease is more difficult to treat and most often causes serious complications. Prolonged paralysis, weakening of voluntary movements and limited passive motor functions worsen the prognosis and can even cause disability.

Plexite - what is it?

Plexitis (plexopathies) is a separate group of diseases that occur when the nerve plexus formed by the spinal nerves is damaged.
"Plexus" - translated from Latin means "plexus", and the ending "it" mainly indicates inflammatory diseases. For example, neuritis - inflammation of a nerve, encephalitis - inflammation of the brain, poliomyelitis - damage to the spinal cord, etc.

Types of plexites

There are not so many large nerve plexuses in the human body.
This brachial plexus, lumbosacral, cervical and lumbar plexus, respectively, and the same number of varieties of plexitis, i.e. brachial plexitis (aka brachioplexitis), cervical plexitis, lumbar and lumbosacral. If the disease affects only one limb, the conversation is about a one-sided process, with a two-sided process both limbs are affected.

The causes of plexitis

There are not so many reasons for the occurrence of plexitis, but according to statistics, various injuries are in the first place. And not only those that were obtained already in adulthood (for example, a strong blow to the plexus area, a broken or bruised hand, or a fall on the tailbone). Obstetricians are also familiar with post-traumatic plexitis, since the disease can also occur as a result of birth trauma - Duchenne-Erb paralysis. Other causes of plexitis include:

1. 1. Metabolic disorders (diabetes mellitus)
   2. Alcohol abuse (especially on the left)
   3. Infections (tuberculosis, Lyme disease and many others)
   4. Dislocations are especially dangerous, because nerves are overstretched along with them (but they can also be attributed to post-traumatic reasons)
   5. Osteochondrosis of the cervical spine.
   6. Curvature of posture.
   7. Long and frequent stay of a person in an uncomfortable position

Plexitis symptoms

Unfortunately, our people (especially the "Soviet" generation) go to the doctor only when they are really bad. Few people pay attention to minor pain in the neck or back. Well, think about it, I'm tired at work, now I'll lie down and everything will pass. Meanwhile, it is the pain in the shoulder area that can indicate the onset and development of shoulder plexitis.
When cervicobrachial plexitis occurs, pain is localized in the neck or in the scapula. When you move the arm and bend it (especially towards the damage), the pain worsens (up to a sharp lumbago).

Hip pain radiating to the buttock may indicate lumbar plexitis. Plexitis of the coccygeal plexus is characterized by the absence of an anal reflex, disorders of defecation, urination and sexual function.
Painful sensations can occur both on their own and during movement. The pain is worse at night.

Complications with plexitis

Unfortunately, it is difficult to cure plexitis completely and without consequences even with the current level of development of medicine. But the sooner the disease is diagnosed and treatment is started, the more chances are. But if plexitis is not treated, then the consequences can be dire:

• • partial or complete paralysis of a limb
  • decreased sensitivity followed by muscle atrophy
  • weakness in the arms and legs
  • significant decrease in physical activity

In addition, the disease can become chronic. All these complications can lead not only to loss of working capacity, but also to disability.

Diagnosis of plexitis

It is quite difficult to determine the development of plexitis visually. To obtain a more accurate picture, an X-ray of the affected area, neuromyography (a procedure that allows you to clarify the degree of nerve damage), magnetic resonance imaging (to identify the cause of the disease) are performed, and blood is taken for analysis.
It is very important not to confuse plexitis with other diseases that have similar symptoms, such as sciatica.

Otherwise, there are chances that the person will be treated for a long time and unsuccessfully, and even for another disease. Additional consultation with a neurosurgeon will also not be superfluous.

Plexitis treatment

As in cases with neuritis, plexitis treatment is aimed at eliminating the cause of the disease. Thus, if a patient is diagnosed with traumatic plexitis, then first of all it is necessary that the damaged area be at rest. Those. if it is a hand, then it is fixed with a splint, then actions are taken to restore the integrity of the bone. If plexitis has arisen as a result of infection, antiviral and antibacterial drugs are used. With dysmetabolic plexitis, hypoglycemic drugs are used to normalize blood glucose levels and hypouricemic drugs to reduce uric acid levels.
In any form of plexitis, it is first of all necessary to relieve the patient of pain with the help of painkillers (analgin, aspizol, oxadol). If the pain is very severe and conventional remedies do not help, novocaine blockade is used. It is necessary to take vitamins of groups A, B, C, E (neurovitis, milgamma and other vitamin complexes)
Also, do not forget about drugs to improve tissue nutrition - nicotinic acid, lidase, nerobol, potassium orotate.
If osteochondrosis has become the cause of plexitis, chondoprotectors (chondroitin sulfate, glucosamine sulfate, hyaluronic acid) are used.
There are also methods of alternative treatment, but their effectiveness is not so high, so we will not focus on them.

In addition to medications, in the treatment of plexitis, they help well:

• • magnetotherapy and electrophoresis with novocaine
  • Light massage to improve blood circulation and restore the sensitivity of damaged tissues
  • Physiotherapy exercises to improve metabolism, as well as to restore strength and elasticity of atrophied muscles
  • acupuncture
  • Swimming and water aerobics are very helpful.
  • For faster recovery, ultrasound and laser therapy is used.

Plexitis code according to ICD 10

In the ICD handbook (international classification of diseases), plexitis are in the sections:

G54.1- defeat of the lumbosacral plexus

G54.4- Lesions of the lumbosacral roots, not elsewhere classified