The radial nerve refers to the mixed type nerves and is responsible for the motor function of the upper limb, for example, for the extension of the elbow and radial joints, and for the sensitive innervation of the back surface of the shoulder and forearm and half the surface of the hand of the hand.
Causes of violation of the functions of the nerve are various. Most often, it is a prolonged compression, for example, when applying a tourniquet or during a sleep on a hard surface, a traumatic damage to the radial nerve barrel.
Harmful effects on the nerve can also cause some viral and bacterial infectious diseases or toxic substances (alcohol, lead).
Symptoms of a lesion of a radial nerve is directly related to the loss of its motor and sensory functions.
The main manifestations of the lesion of the radial nerve
The severity of manifestations is related to the level at which the nerve damage occurred. The higher the level of damage, the more pronounced the clinical picture and the more violated the functioning of the upper limb.
If the damage to the nerve occurred at the level of the inferior area of the armpit or in the upper third of the shoulder, then there is:
- A violation of the sensitivity of the areas of the skin, innervated data of the nerve, the type of hyposesthesia - a pathological reduction in skin sensitivity, may manifest as numbness of the posterior surface of the shoulder and forearm, as well as areas of large, indicative and, partially, middle fingers;
- The symptom of "hanging brush" - the result of violation of expansion in the radiopulmonary joint (if the patient is asked to pull his hands forward, parallel to the surface of the floor, then the brush on the affected limb hang down);
- The impossibility of unbending the forearm, as well as bending the arm in the elbow through the paresis of shoulder muscle;
- The impossibility of removing and unraveling the thumb of the upper limb, its connection with the index finger, restriction of movements in the index and middle fingers, for example, the index finger can not be left to impose on other fingers of the hand.
If nerve damage occurs in the middle third of the shoulder, then there are similar symptoms, but the function of the muscles - forearm extensions and the normal sensitivity of the back of the shoulder is maintained.
There is a clinical picture of motor disturbances of the function of the brush and hyposesthesia of the posterior side of the forearm.
If the nerve is damaged in the lower third of the shoulder or the upper third of the forearm, then the function of the extensors of the radiopaxial joint of the hand and the large, forearm and middle of her fingers suffer. Also, there is a symptom of a "hanging brush".
The motor and shoulder functions of the shoulder are usually not affected. The loss of sensitivity is observed solely from the back side of the hand.
Damage of the superficial branches of the radial nerve occurs when the nerve is damaged in the lower third of the forearm or the wrists. It manifests itself as a decrease in the sensitivity of the back of the hand and fingers, and acute pain may occur in the back of the thumb of the hand spreading to the forearm and shoulder (paresthetic neuralgia Vartenberg).
Principles of treatment for damage to the nerve
The choice of the method of therapy depends largely on the cause of the disturbance of the functions of the beam nervous trunk and on what level is the place of its defeat.
Conservative treatment involves the use of medicines (for example, vitamins of group B) and physiotherapy procedures.
Goals for conservative treatment:
- Stimulation of processes of regeneration of nervous tissue;
- Prevention of violations of trophic muscles and maintaining their tone;
- Improvement of blood circulation in the affected area.
Therapeutic exercises and massage help restore the motor function of the upper extremity.
In the traumatic nature of the damage to the nerve, surgical treatment is recommended.
There are several types of surgical intervention on the radius:
- Neurology - scissor excision of the epineurial tissue (nerve tissue) that compresses the nerve tissue;
- Epineural suture - cross-linking the ends of the damaged nerve trunk and the plastic of the damaged nerve through grafts.