Plexitis refers to the various lesions of complex connections of nerve fibers( plexus of nerves).When the diagnosis is made, the area of the lesion is also indicated. Accordingly, the plexitis of the shoulder joint is a pathology of the brachial plexus. The latter is formed from the nerves emanating from the thoracic spinal cord and cervical spine. This compound is located between the muscles that provide the binding of the chest to the neck.
Plexitis of the shoulder joint - description of the disease
The brachial plexus is divided into the outer, posterior and inner fascicles, which form a peculiar cocoon around the axillary artery.
Such bundles consist of sensory and motor nerves, which are responsible for the corresponding functions in the hands.
The lesion can affect both the entire plexus( total plexitis) and some part of it( upper, or otherwise Duchene-Erba, paralysis and lower, Dejerine-Clumpke), mainly on one arm( occasionally both).
Pathology is included as a "defeat of the brachial plexus" in the International classification under the code G54.0.
Also plexitis of the shoulder is a common birth trauma, developing due to overgrowth of the neural plexus trunks during complex delivery( when squeezing the fetus, its foot or gluteal presentation).
In newborns, such a trauma, often accompanied by a fracture of the clavicle, also occurs due to:
- of prolonged childbearing in the birth canal;
- of the broad shoulders of the fetus;
- of lowering the arm of the baby.
In addition to the fact that the pathology delivers discomfort and pain to the patient, it can lead to disability up to complete lack of self-service.
Causes and provoking factors
Up to 25% of plexitis of the shoulder are infectious in nature, immune disorders, injuries and other factors play a significant role in the development of pathology.
Typical causes of shoulder plexitis:
- trauma( sprain, sprains, collar fracture, bruises and injuries in the neck, shoulder, shoulder, trauma, etc.);
- microtraction as a result of prolonged compression of the plexus, for example, when using a crutch, with an uncomfortable posture during sleep or work, a tumor of the pulmonary apex or spine, an aneurysm of the nearby artery, etc.;
- infections, including those caused by viruses( influenza, cytomegalovirus, etc.);
- metabolic disorders( diabetes, etc.);
- osteochondrosis( thoracic, cervical);
- costal-clavicular syndrome( "cervical ribs", etc.);
- affection of lymph nodes;
- hypothermia, etc.
Inflammation of various nerves is most common in neurology. Such diseases are usually called one word "Neuralgia".Lumboschialgia is one of them. It develops quickly enough, more often as a result of hypothermia, and leads to significant limitations of motor functions and pain sensations.
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Symptoms of
Neuralgic( initial) manifestations of plexitis include pains( often nocturnal) that arise or build up when the joint moves and presses on the plexus.
Localization of pain - a near-clypeal area with recoil into the limb.
Paralytic( late) signs relate to the muscles, the action and sensitivity of which provide nerves that emanate from the brachial plexus, and include:
- dysfunction of fine motor function - problems with manipulation of small objects;
- paralysis, paresis;
- reduced reflex responses;
- changing sensitive functions;
- eating disorders( blanching, cyanosis of the skin of the hand, swelling and sweating), etc.
Partial lesion in Duchenne-Erb plexitis is manifested:
- by sensitive dysfunctions outside the forearm and shoulder;
- the inability to bend the arm in the elbow joint and withdraw it in the shoulder joint.
Total plexitis includes symptoms of both of the above lesions.
The virus form is characterized by:
- pain( aching, shooting, drilling, bursting) in the region of the plexus and the inner lower region of the hand;
- weakening of carpal muscles, finger and wrist flexors, paralysis;
- sensitivity dysfunction on the inside;
- in some cases, eye damage from the plexus - narrowing of the pupil, violation of the movement of the eyelid, "retraction" deep into the eyeball.
Infectious-toxic lesion manifests itself:
- by attenuation of reflexes until loss;
- dysfunction of sensitive abilities;
- paresis, paralysis;
- by changing the color of nails;
- impaired pulse;
- visible tissue deficiency, etc.
May increase and soreness of cervical lymph nodes from the patient plexus.
Diagnosis
- Neurological examination.
- X-ray.
- ultrasound.
- Electroneuromyography.
- CT or / and MRI.
- Blood tests.
Differential Diagnosis
Plexitis of the shoulder is differentiated with:
- by shoulder pathologies( arthritis, periarthritis);
- with radicular neuritis;
- with polyneuropathy;
- polyneuritis;
- cervico-brachial reflex syndromes;
- cervical radiculitis, etc.
Treatment of
How to treat plexitis is determined by the cause of the pathology, because therapy is carried out through a whole range of measures.
In this case, the following should be excluded:
- lack of heat;
- excess physical exercise;
- work with chemical compounds with toxic activity.
Also perform an orthopedic laying on a linget or bandage.
Treatment with medicines
- Painkillers( blockades novocaine, analgin, baralgin, etc.).
- Anti-inflammatory drugs( ibuprofen, etc.).
- Preparations for the recovery of nerve conduction.
- Drugs that improve blood circulation and tissue nutrition.
- Vitaminotherapy( B1, B12).
- Anticholinesterase drugs for motor dysfunctions( invalid, proserin).
- Antibacterial agents in the bacterial nature of the lesion( ampicillin).
- Means of dehydration( urea, manite).
Physiotherapy
- UHF.
- Treatment by impulse currents.
- UZT with hydrocortisone.
- Electro- and inductoforez.
- Mud applications.
- Paraffin therapy.
- Cryotherapy.
- Laser therapy.
- Balneotherapy.
- Massage.
Therapeutic physical training
- Lift - lowering the shoulders.
- Reduction - blade dilution.
- Breeding of elbows, circular movements of shoulders with hands fixed on them.
- Flexion, straightening, deflection to the affected limb( straight or bent).
- When tilted in the direction of the defeat of the rotation with a straight arm.
- Throwing your arm backwards - forward.
- Flight and cross movements.
- Turns of the forearm and hand.
- Exercises on the "Swedish" wall, manipulation of objects.
Surgical treatment
Surgical measures are indicated for tumor origin of plexitis, and if it is caused by trauma( for example, if the plexus is squashed by bone fragments), an aneurysm or cervical ribs.
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Nontraditional methods
- Hirudotherapy.
- Acupuncture.
- Laser puncture.
- Homeopathy( Colocynthis, Arnica in appropriate breeding).
Folk remedies
For home treatment, the following are widely used:
- applications of alcohol solution mummy;
- propolis ointment;
- herbal decoction( parsley + buckthorn + dandelion) inside;
- compress from the bark of the white willow bark;
- bath with mint broth.
Consequences and Forecast
Consequences and prognosis are determined by the cause of plexitis.
As a rule, the treatment started in time increases the chances of a successful recovery. It should be remembered that a neglected disease is more difficult to treat and most often causes serious complications.
Prolonged paralysis, easing of voluntary movements and limited passive motor functions worsen the prognosis and may even lead to disability.
Prevention measures
- Timely detection and therapy of the underlying cause( infection, metabolic disorders, etc.).
- Prevention of injuries.
- Swimming.
- Adequate fidelity.
- Hardening.
- Providing comfortable sleep, etc.
Therefore, if the patient has pain in the shoulder area, you should definitely see a doctor to exclude plexitis. Such a pathology can lead to disability, depending on the degree and area of the lesion, but with prompt adoption of adequate measures is completely curable.
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