Plexit code by mcb. Brachial Plexopathy: Symptoms and Treatment

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Treatment of plexitis with folk remedies and with the help of medications

Shoulder plexitis is an inflammation of the brachial plexus nerve. The disease can occur for various reasons and, when it appears, causes discomfort in the brachial plexus. If you do not pay attention to the main symptoms of the disease, then as a result this can lead to weakening of the muscles or to complete paralysis of the hands. Therefore, in order to determine the disease in time, it is necessary to know its main causes and methods of treatment.

Symptoms of plexitis

The first symptoms of the onset of the disease include the presence of a painful sensation, including at night. Also, pain occurs with movements of the hand and with pressure on the brachial plexus. According to ICD 10, plexitis of the shoulder joint can have a number of symptoms by which the presence of the disease can be determined. The first symptoms are that there is partial or complete immobility of the brachial plexus, including the inability to fully bend the arm and move the fingers.

With every movement of the hand, the symptoms are aggravated and it is very painful to put the hand behind the back or lift it, yet the patient cannot keep the heavy weight on weight. The work of fine motor skills is also disrupted, and if the case with the disease is neglected, this can result in muscle atrophy.

With inflammation of the brachial plexus nerve, the pain may be shooting, aching or breaking.

Basic Treatments

If inflammation of the brachial plexus nerve was found, the disease should be treated with the help of both medications and folk remedies. In addition, it is necessary to immobilize the limb as much as possible, as well as to ensure peace.

To alleviate the patient's condition, doctors put a plaster splint on the shoulder and prescribe drugs that will help relieve inflammation from the nerve and anesthetize the limb as much as possible.

Medical treatment

The most common treatment for inflammation of the brachial plexus nerve according to ICD-10 is medication. It must be carried out, because it is impossible to fully treat the disease without medicines. Basically, doctors prescribe non-steroidal drugs to the patient, which have an anti-inflammatory effect and analgesics.

Para-articular blockades, which include anti-inflammatory drugs, are also prescribed. Also, in the treatment of plexitis, gymnastics is necessary, which helps to relieve pain and feel lightness in the sore spot. It consists in the development of the brachial plexus, muscles and joints. Gymnastics is forbidden to be carried out during an exacerbation of the disease.

In addition, massage is prescribed, but the course of its implementation is selected strictly on an individual basis in order to prevent muscle atrophy. Properly selected massage will help alleviate the patient's condition and, in combination with the use of medications, will help you get back on your feet very quickly.

Treatment with folk remedies

Treatment with folk remedies deserves separate consideration, because many of the recipes have an amazing effect in treating the disease.

ICD 10 also implies treatment with folk remedies, which include taking therapeutic baths, applying compresses or drinking decoctions.

Use of warming ointments

To prepare a compress, you will need 15 grams of horseradish root, marshmallow root, Adom root and aloe leaves. All these components must be finely chopped, add 100 grams of bee honey to them and pour vodka. The resulting mixture must be put in a dark place, let it infuse for three days. After the expiration date, wipe the sore spot three times a day.

To prepare the next ointment, you will need 10 grams of hops, St. John's wort, sweet clover, grind everything well. Add 50 grams of Vaseline to the resulting mixture and mix everything well. Apply three times a day on the affected area.

The use of therapeutic baths

Peppermint bath. Grass should be collected during flowering and dried well. Take one glass of dried flowers and pour three glasses of hot water over them. Let it stand for half an hour, infuse and after that you can pour it into a bath with a water temperature of at least 38 degrees. After taking a bath, you need to dry yourself and put on warm clothes, lie down under the covers.

Treatment with folk remedies will help to significantly alleviate the patient's condition and restore ease of movement to him. It is necessary to carry out treatment with folk remedies only together with the use of medications.

Many doctors prescribe the patient treatment with folk remedies, because compresses, ointments and medicinal baths with herbs will become an additional incentive on the path to recovery.

Basic exercises for plexitis

All exercises should be performed only in a standing or sitting position. Exercises consist in raising the shoulders up and bringing the shoulder blades back. Such exercises are performed 10 times.

It is also necessary to turn the forearm and hand towards you and back, also performed 10 times. For the next exercise, you need to lean forward, bend your arm at the joint and then straighten it again. Repeat the procedure six times.

Exercises along with folk remedies will help you get on your feet faster and feel significant relief in the brachial plexus.

Preventive measures

Plexitis of the shoulder joint can occur both at birth in a child, and can be obtained after any injury. Therefore, it is necessary to know the basic measures that will help to avoid the disease. Young children who have received plexitis during childbirth need daily massage, which, in addition to basic treatment, will help speed up the recovery process.

If nothing is done, it will be noticeable how the shoulder joint noticeably lags behind in development, and as a result, limited movement of a person may occur. In order to prevent the development of plexitis, it is necessary to avoid hypothermia and it is necessary to stab the body regularly. Try to eat healthy and balanced. It is necessary to begin timely treatment of all diseases and it is necessary to strengthen the body. Take care of your health, because the disease is easier to prevent than to cure.

Shoulder plexitis

The brachial plexus is formed by nerve fibers extending from the lower cervical vertebrae and the upper thoracic vertebrae. Due to various factors, the nerves can become inflamed, which leads to a disease called plexitis.

Shoulder plexitis

The etiology of the disease is multiple, the cause of the development of plexitis can be both injuries and infectious pathogens, as well as toxins entering the body. Pathology is marked by the ICD code 10 G55.0.

People of all ages can become victims of plexitis, although it is most common in the working-age population. Factors associated with traumatizing the nerve endings of the shoulder through professional or sports loads, the development of an inflammatory process as a result of infection, intoxication or hypothermia will prevail here.

Symptoms

The defeat of the brachial plexus of nerves can be unilateral - on the left or right, as well as bilateral. The latter option is considered the most problematic, since it not only extends to a larger area, but also because it completely deprives a person of the opportunity to carry out habitual actions.

Symptoms proceed in phases:

Neuralgic - when pain of varying intensity is felt in the hand. Often, increased pain accompanies physical activity with amplitude movements, an attempt to move the arm back.
Paralytic - the second phase, which marks the processes associated with impaired innervation of the muscles, the surface of the skin. A person can lose the sensitivity of the upper limb up to complete immobilization.

Pain can be localized in the supraclavicular region or in the armpit. Considering that the nerves of the cervical region are included in the plexus, numbness of the back of the neck and the occipital region may be felt.

In the case when pathologies of an immune nature become the cause of impaired mobility, attacks of pain can proceed in waves. In this case, after the weakening of the pain symptom, the patient feels weakness in the muscles of the shoulder, problems with sensitivity. At the same time, he can perfectly move his hand in the elbow and wrist joints.

The diagnosis of "plexitis of the shoulder joint" is established by a neurologist after a complete and thorough examination of the patient.

In addition to the survey and study of the anamnesis, electroneuromyography is used, as the most effective method in this situation, which allows assessing the state of all nerves in the affected bundle. CT, MRI and ultrasound of the area are also performed to exclude other factors from the musculoskeletal system that could provoke a malfunction of the shoulder.

Plexitis can manifest itself in the following ways:

Paralysis of the deltoid muscle, when the patient cannot move his arm to the sides. A synonym is the name "Erb's syndrome";
Paralysis of the supraspinatus and infraspinatus muscles. If you ask a person to straighten his back and rotate his shoulders, he will not be able to perform shoulder rotation.
Paralysis of the biceps brachii. Here the forearm loses mobility even in the elbow joint.

If the pathological process has affected all the nerves of the brachial plexus, then the limb may completely lose sensitivity and the ability to move.

Treatment

When making a diagnosis of "Plexitis", regardless of its etiology, first of all, immobilization of the shoulder is carried out using a fixing bandage or plaster splint.

The initial stage of the disease is characterized by the fact that the treatment with medicines is carried out on an outpatient basis.

First of all, drugs that block pain are prescribed. This measure helps to relieve muscle tension and release the pinched nerve fiber. In addition, stress levels are reduced.
Depending on the etiology, drugs are prescribed that help relieve the inflammatory process. These can be NSAIDs, corticosteroids, as well as antibiotics and antitoxic drugs if inflammation has developed as a result of infection or toxic poisoning in the body.
To prevent the development of muscle atrophy and weakening of the conduction of the nerve fiber, anticholinesterase agents are prescribed. Their purpose is to eliminate the feeling of weakness in the muscles and the state of paresis.
Another task is to restore normal nutrition to the affected area. For this, vitamin complexes and a nootropic group of drugs are involved.
If a pronounced swelling of the shoulder develops, appropriate means are prescribed to help remove excess fluid from the body.

After the inflammation subsides, the second stage is prescribed procedures that help restore the mobility of the shoulder and its sensitivity. Mud compresses, physiotherapeutic procedures, hirudo and reflexology are additionally prescribed here.

The doctor selects the most suitable option for restorative procedures. Another way of rehabilitation is massage, which allows you to maintain or restore muscle tone and restore sensitivity.

If plexitis develops as a consequence of an injury or pinching occurs due to the anatomical features of the shoulder, then surgical intervention will help solve the problem. After the examination, the doctor will eliminate the cause of infringement and inflammation, freeing the nerve bundle and allowing nerve impulses and blood circulation to circulate freely within the tissues.

Is it possible to treat plexitis with folk remedies? We'll have to disappoint, but in this case, lotions and poultices without conservative methods of therapy will be useless. When used together, baths with decoctions rich in tannins and having anti-inflammatory properties are shown.

Self-treatment at home can lead to the fact that plexitis becomes chronic and will remind you of yourself after physical exertion or hypothermia. A periodically taken away hand will become a real hindrance if you do not pay due attention to the problem in time.

Another way of rehabilitation is physiotherapy exercises. Do not underestimate physical exercises that can restore muscle mobility and sensitivity. Often the cause of the development of plexitis is osteochondrosis of the cervical or thoracic region. In this case, the nerve endings are pinched next to the spine, which complicates the possibility of complete release.

Video: exercises from Dr. Evdokimenko

Exercise therapy helps to strengthen the muscular corset and restore mobility of the spine. In addition, it has long been noted that the restoration of muscle sensitivity and tone contributes to their better nutrition and more active metabolism in tissues. Innervation is restored much faster if physical education and massage are combined, since kinesthetic receptors are activated both actively and passively.

With plexitis of the shoulder joint, doctors recommend swimming. This type of physical activity has a beneficial effect on the work of the shoulder girdle, gives a moderate load due to the support of water and has a beneficial effect on the psycho-emotional state.

Shoulder plexitis in newborns

Surprisingly, a barely born baby can also become a victim of plexitis. In the case of newborns, inflammation of the nerve fibers of the brachial plexus often becomes traumatic as a result of complications of the birth process.

The baby's shoulder can be squeezed when the fetus is presented inside the mother's womb with a raised handle or when passing through the birth canal. Obstetrical manipulations and an attempt to squeeze the fetus or stretch it out with weak labor activity can also be harmful.

The cause of problems with the brachial plexus can be hematomas and neoplasms that put pressure on the nerve fibers, preventing normal innervation, tissue nutrition and the further development of the inflammatory process.

When examining a newborn, the doctor should show maximum attention, because the child cannot tell about his feelings. A missed problem can lead to serious complications, which will take many months to treat.

When symptoms of plexitis are detected, the child's pen must be fixed and a set of therapeutic measures is carried out. In some cases, the damage can be very serious and require a long recovery period. To prevent muscle atrophy due to immobilization, a set of restorative measures is carried out using massage, physiotherapy such as electrophoresis and acupuncture, and physiotherapy exercises.

The faster a problem is detected, the less time it takes to fix it. If plexitis was not detected immediately or its cause lies in an infectious agent, this can become a cause that will seriously limit the mobility of the limb, up to complete paralysis.

Plexitis is an unpleasant problem that can disable even a strong working person for a long time. Long-term wearing of a heavy bag on the shoulder, a sharp pulling of the arm back with an injury, a constant load due to vibration, hypothermia - all these seemingly insignificant factors can develop into a serious problem. Even with minor symptoms, it is worth being examined by a doctor and taking preventive measures in order not to literally be left “without hands” at a crucial moment.

Types of osteochondrosis
- Cervical
- thoracic
- Lumbar
About the disease
- Symptoms
  - cervical
  - chest
  - lumbar
- Causes
- Development
- Prevention
- Aggravation
Treatment
- Medical treatment
- injections
- Pills
- Massage
- Manual therapy
- Exercises
- Medications
Tips for those who are sick
- How to live with osteochondrosis
- The nature of pain
- Quick Pain Relief Methods
- Symptoms, syndromes and complications

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What you need to know about the symptoms and treatment of shoulder plexitis?

Plexitis of the shoulder joint is an inflammatory disease, accompanied by damage to the nerve plexuses localized in the shoulder area. This is a very unpleasant disease, which is accompanied by a violation of innervation, limited mobility of the affected joint and a significant deterioration in the quality of life of the patient.

Most often, plexitis affects the working hand, which bears the greatest load. As a result, the patient becomes helpless in many everyday situations and professionally, as he loses the ability to move the affected limb. The disease is usually diagnosed in men from 20 to 60 years old, engaged in heavy physical labor. In the ICD10, plexitis of the shoulder joint is included under the code G54.0 "Brachial plexus disease".

A bit of anatomy

The brachial plexus is formed by nerve fibers that emerge from the cervical and thoracic spinal cord. Together with blood vessels, they form the posterior, external and internal nerve bundles, which create a kind of cocoon around the axillary artery.

Nerve fibers innervate the muscles and skin of the shoulder girdle and provide the motor activity of the upper limbs, ending with small nerve branches in the hands. The bundles are formed by two types of nerves: motor and sensory. Therefore, when the brachial plexus is affected, not only numbness of the limb is noted, but also loss of mobility (paresis, paralysis).

Causes of plexitis

Many external or internal factors can provoke inflammation of the brachial plexus. Taking into account the causes of occurrence, experts distinguish the following varieties of the disease:

Post-traumatic shoulder plexitis. The most common cause of damage to the nerve plexuses in the shoulder girdle. Any injury (bruise, dislocation, sprain of the shoulder, fracture) is accompanied by damage to the nerve bundles and can subsequently lead to the development of inflammation. Injuries can also be caused by stab or gunshot wounds to the shoulder or neck. Often, the characteristic symptoms of plexitis occur with regular work with vibrating instruments or develop in patients who are forced to use crutches for a long time. In obstetric practice, this form of plexitis is diagnosed in newborns who have been injured during difficult, pathological childbirth, as a result of breech or foot presentation of the fetus, its large size, and a number of other reasons.

Compression-ischemic type plexitis. It occupies the second place in prevalence and is caused by compression of the fibers of the nerve plexus. The reason may be an uncomfortable position of the hand during sleep, compression of the plexus by a tumor, intervertebral hernia, subclavian artery aneurysm, hematoma, or enlarged lymph nodes. Squeezing of nerve fibers can occur as a result of improperly performed immobilization of the injured hand or prolonged maintenance of a forced posture in bedridden patients.

Infectious plexitis. The inflammatory process in the nerve plexuses develops against the background of tuberculosis, herpes infection, cytomegalovirus, syphilis, brucellosis, or after colds and viral infections (tonsillitis, influenza, SARS). Plexitis of an infectious-allergic nature can develop as a response to an administered vaccine.

Dysmetabolic. In this case, the provoking factors are diseases associated with metabolic disorders - diabetes mellitus, gout, dysproteinemia, thyroid pathology.

Toxic. This type of shoulder plexitis develops as a result of intoxication of the body with salts of heavy metals, alcohol surrogates or chemical components.

Other causes that contribute to the development of plexitis include frequent hypothermia, costoclavicular syndrome, lymphadenitis, poor posture, curvature of the spine (scoliosis), or radiation received during radiation therapy for cancerous tumors. Often the cause of shoulder plexitis is cervical or thoracic sotheochondrosis, salt deposition in the cervical region. Such pathological processes lead to the development of inflammation, swelling of muscle tissues and compression of the nerve roots of the brachial plexus.

Forms of shoulder plexitis

In medicine, there are three forms of the disease:

Upper brachial plexitis (Duchenne-Erb syndrome) - is caused by a lesion of the upper trunk of the brachial plexus, manifested by pain in the supraclavicular part of the shoulder.
Lower shoulder plexitis (Dejerine-Klumpke syndrome) - accompanied by damage to the lower nerve trunks and pain radiating to the forearm and elbow.
Total plexitis (Kerer's paralysis) - combines the symptoms of previous forms, but is accompanied by severe consequences associated with the death of nerve fibers, muscle paralysis and loss of mobility of the upper limbs. This form of the disease is rare.

Taking into account the characteristics of the course of the disease, two stages are distinguished:

Neuralgic - characterized by spontaneous severe pain, aggravated by movement.
Paralytic - manifested by a violation of sensitivity, peripheral paresis and paralysis of the muscles innervated by the branches of the affected nerve plexus.

Shoulder plexitis symptoms

Shoulder plexitis manifests itself with sharp, shooting pains in the shoulder or collarbone. They give to the neck, elbow or spread to the entire upper limb. The pain syndrome intensifies when moving the hand and does not let go even at night. Soon, muscle weakness in the arm, numbness and loss of sensitivity, accompanied by edema, tissue atrophy, paresis and paralysis, joins the pain and gradually progresses.

With Duchenne-Erb paralysis, weakness increases and there is a decrease in muscle tone in the proximal parts of the upper limbs, which makes it difficult to move the shoulder joint, making it impossible to raise, bend and move the arm with a load to the side.

The defeat of the lower trunks of the nerve plexuses is reflected in the functions of the distal parts of the hand and is accompanied by weakness of the hands. The patient cannot hold a cup, cutlery, open the door with a key, fasten a button and perform other actions related to fine motor skills of the fingers. As a result, the patient loses his ability to work, cannot even perform simple daily household chores.

Trophic disorders due to damage to peripheral nerve fibers gradually increase. This is expressed by increased sweating of the palms, excessive dryness, pallor and thinning of the skin, brittle nails. The skin of the injured limb is easily injured, while the wounds do not heal for a long time.

The paralytic stage occurs when the initial symptoms are ignored and there is no timely treatment. Advanced cases are characterized by a persistent decrease in reflexes, loss of muscle mass, while the immobile limb looks thinner than healthy. Over time, if left untreated, the injured limb can dry out.

Sometimes there are symptoms that at first glance have nothing to do with damage to the shoulder joint, but these phenomena are also based on a violation of the functions of nerve fibers. So, if the phrenic nerve is affected, there may be a narrowing of the pupil and a sinking of the eyeball on the side of the lesion, or breathing problems may occur.

Total pathology of the brachial plexus is rare. This is the most severe form of plexitis, in which motor and sensory disorders cover the entire limb, leading to a complete loss of mobility. Only the function of shoulder movement is preserved. This form of the disease is difficult to treat, causes disability and disability.

Even minor pain in the shoulder joint area should be a reason to visit a neurologist. The sooner a correct diagnosis is made, the greater the chance of a quick recovery.

Diagnostics

The diagnosis of shoulder plexitis is sometimes difficult, since it is necessary to differentiate this disease from other diseases with similar symptoms - arthritis, arthrosis, humeroscapular periarthritis, polyneuropathy.

It is important to establish the underlying cause of the disease that provokes the inflammatory process. For this purpose, the patient is referred for a consultation with narrow specialists - a rheumatologist, a traumatologist, an infectious disease specialist, an oncologist, a neurosurgeon. The main diagnostic procedures for suspected plexitis are:

electromyography or neuromyography;
MRI, ultrasound or CT of the shoulder joint;
radiographic study.

If an infectious origin of the disease is suspected, PCR is used - diagnostics, a general blood test is done, which makes it possible to judge the presence of an inflammatory process.

Treatment of plexitis of the shoulder joint

The scheme of complex treatment is selected taking into account the cause of shoulder plexitis. In the post-traumatic form of the disease, the injured shoulder is immobilized with a fixing bandage, painkillers and anti-inflammatory drugs (Ketanol, Iburofen, Nurofen, Diclofenac) are prescribed. If tumors or hematomas become the cause of inflammation, they are removed surgically.

In the treatment of infectious plexitis, according to indications, antibacterial or antiviral agents are prescribed, the action of which is aimed at eliminating the underlying disease. In metabolic pathologies, first of all, they try to correct metabolic disorders. The toxic form of plexitis is eliminated by therapeutic measures aimed at detoxifying the body.

With severe pain syndrome, novocaine blockades are used or ultraphonophoresis with hydrocortisone is prescribed. In mild forms of pathology, it is recommended to use local agents with anti-inflammatory, analgesic and decongestant effects. These are creams, gels and ointments based on nimesulide, diclofenac, indomethacin. If necessary, muscle relaxants or antispasmodics are used to relieve muscle spasms.

Additionally, the doctor may prescribe drugs that improve blood circulation, drugs to relieve swelling, medicines that improve tissue nutrition - lidase, nicotinic acid, potassium orotate.

The emphasis in treatment is on metabolic and vasoactive therapy, which provides tissue with nutrients and restores the function of nerve fibers. For this purpose, a solution of pentoxifylline, multivitamin complexes containing a combination of B vitamins are prescribed. Drugs such as Milgamma, Kombilipen, Trigamma are necessary to improve nerve conduction and reduce the severity of radicular syndrome. They are used in the form of intramuscular injections. With motor dysfunctions, anticholinesterase agents (Prozerin, Invalin) are included in the treatment. Diuretic drugs are prescribed to reduce swelling.

After the inflammation and pain subside, a variety of physiotherapeutic procedures are recommended, the action of which is aimed at improving blood circulation and tissue nutrition. Among them:

electrophoresis;
mud treatment;
reflexology;
amplipulse therapy;
applications with paraffin or ozocerite.

Massage and a course of physiotherapy exercises will help restore muscle tone and mobility of the upper limbs. Exercises are selected individually by the exercise therapy instructor, classes begin with the simplest movements and gradually increase the load as the condition improves. It is especially useful to combine physical activity with swimming or a therapeutic shower. The following exercises form the basis of therapeutic exercises:

mixing-breeding of the shoulder blades;
shoulder movements up and down;
rotational movements with arms bent at the elbows;
flexion - extension of the upper limbs;
torso forward, backward, to the sides;
circular movements with a straightened hand;
handling small objects.

Special exercises should be performed regularly until the mobility of the shoulder joint is fully restored.

Folk remedies

At home, in addition to the main drug treatment, you can use proven folk remedies. The basis of home therapy is compresses, therapeutic baths, rubbing.

Therapeutic baths

Warm baths with sea salt, decoction of mint, sage, chamomile have a calming and relaxing effect, help relieve muscle spasm, reduce pain, improve joint mobility. Water procedures should be taken 2-3 times a week, the duration is 15-20 minutes.

Rubbing with aloe

To prepare a medicinal composition, peel 5-6 fleshy leaves of aloe from the skin and thorns, chop the pulp, add grated horseradish root and a glass of liquid natural honey. Stir the mass thoroughly, pour a bottle of vodka and leave in a dark place for 5 days. Strain the finished infusion and use it to rub the sore shoulder before going to bed. After rubbing the medicinal composition, the shoulder should be bandaged with a warm scarf or scarf and no longer get out of bed until the morning. The procedure can be done every other day.

Rubbing with pork fat

For the procedure, interior pork fat is suitable. It must be melted in a water bath and combined with powdered propolis in the ratio of 100 g of fat per 1 tbsp. l. propolis. This mixture should be rubbed on the sore arm and shoulder daily. This procedure will speed up blood circulation, help relieve swelling and reduce pain.

Rubbing with turpentine

Turpentine and ammonia are taken in equal volumes (30 ml each), mixed. Two eggs are beaten until foamy and added to this mixture. The affected areas of the shoulder girdle and upper limbs are rubbed with a therapeutic composition before going to bed, after which they cover themselves with a warm blanket and remain in bed until morning. For the same purpose, you can use an alcohol infusion of mummy, which you can cook yourself or buy at a pharmacy.

Homemade ointment

An ointment based on medicinal plants has good softening and relaxing properties. To prepare it, you need to finely chop the fresh leaves of hops, sweet clover and St. John's wort. Measure out 2 tsp. vegetable raw materials and mix them with petroleum jelly. This ointment can be rubbed on the sore shoulder several times a day.

In order not to provoke unwanted complications, be sure to consult your doctor before using folk recipes.

Forecast

As a result, joint contractures and muscle atrophy are formed, which can lead to complete immobility of the affected arm and even its drying out. As a result, the patient is assigned a degree of disability, as he loses his ability to work and cannot serve himself. Careful attention to your health and seeking medical help at the first sign of pathology will help to avoid such a development of events.

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Before using medications, consult your doctor!

As a rule, an isolated pronounced motor deficit of the type of Duchenne-Erb syndrome (lesion of the upper, primary, bundle of the brachial plexus)

Characterized by amyotrophic syndrome

The rapid development of amyotrophy is a characteristic feature of the disease

In about 10% of cases, a pronounced residual motor deficit persists.

Changes in blood and cerebrospinal fluid are absent or nonspecific.

EMG reveals signs of neural damage.

ENMG can reveal a decrease in the amplitude of sensory potentials when the zone of innervation of the lateral cutaneous nerve of the forearm or the area of the thumb innervated by the fibers of the median nerve extending from the upper primary bundle of the brachial plexus is irritated. Conduction along the median or ulnar nerves in most cases remains intact. Often, a decrease in the M-response and conduction velocity is recorded during stimulation of the musculocutaneous nerve.

With needle EM H, signs of denervation in the involved muscles are revealed, indicating the axonal nature of the lesion.

Radiography, CT, MRI allow to differentiate neuralgic amyotrophy from secondary lesions of the brachial plexus (for example, with a tumor, fractures, etc.).

Absence of gross paresis

No decrease in the amplitude of the M-response and signs of denervation on ENMG

Nerve root and plexus lesions (G54)

In Russia, the International Classification of Diseases of the 10th revision (ICD-10) is adopted as a single regulatory document for accounting for morbidity, reasons for the population to contact medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Brachial plexus lesions

Definition and background[edit]

Syndromes of lesions of the brachial plexus

Along with an isolated lesion of individual nerves emerging from the brachial plexus, the plexus itself may be affected. Damage to the plexus is called plexopathy.

Etiology and pathogenesis[edit]

The etiological factors of damage to the brachial plexus are gunshot wounds of the supraclavicular and subclavian regions, fracture of the clavicle, 1st rib, periostitis of the 1st rib, dislocation of the humerus. Sometimes the plexus is affected due to its overstretching, with a quick and strong abduction of the arm back. Damage to the plexus is also possible in a position where the head is turned in the opposite direction, and the hand is behind the head. Brachial plexopathy can be observed in newborns due to traumatic injury during complicated childbirth. Damage to the brachial plexus can also be caused by carrying weights on the shoulders, on the back, especially with general intoxication with alcohol, lead, etc. The cause of compression of the plexus can be an aneurysm of the subclavian artery, additional cervical ribs, hematomas, abscesses and tumors of the supraclavicular and subclavian region.

Clinical manifestations[edit]

Total brachial plexopathy

Leads to flaccid paralysis of all muscles of the shoulder girdle and arm. In this case, only the ability to “raise the shoulder girdle” can remain due to the preserved function of the trapezius muscle, innervated by the accessory cranial nerve and the posterior branches of the cervical and thoracic nerves.

Syndromes of damage to the trunks (primary bundles) of the brachial plexus

Occur when the supraclavicular part of it is damaged. In this case, it is possible to distinguish syndromes of damage to the upper, middle and lower trunks:

Syndrome of lesions of the upper trunk of the brachial plexus

Synonyms: Erb-Duchenne upper brachial plexopathy

It occurs when the anterior branches of the V and VI cervical spinal nerves or the part of the plexus in which these nerves connect, forming an upper trunk after passing between the scalene muscles, are damaged (usually traumatic). This place is located 2-4 cm above the collarbone, approximately a finger's width behind the sternocleidomastoid muscle, and is called Erb's supraclavicular point. Upper brachial Erb-Duchenne plexopathy is characterized by a combination of signs of damage to the axillary nerve, long thoracic nerve, anterior thoracic nerves, subscapular nerve, dorsal nerve of the scapula, musculocutaneous and part of the radial nerve. This is characterized by paralysis of the muscles of the shoulder girdle and proximal parts of the arm (deltoid, biceps, brachial, brachioradial muscles and arch support), impaired shoulder abduction, flexion and supination of the forearm. As a result, the hand hangs down like a whip, is adducted and pronated, the patient cannot lift it, bring the hand to the mouth. If the hand is passively supinated, it will immediately turn inward again. The reflex from the biceps muscle and the wrist (carporadial) reflex are not caused. In this case, radicular-type hypalgesia usually occurs on the outer side of the shoulder and forearm in the zone of dermatomes C V -C VI. Palpation reveals tenderness in the region of Erb's supraclavicular point. A few weeks after the defeat of the plexus, an increasing hypotrophy of the paralyzed muscles appears.

Erb-Duchenne brachial plexopathy often occurs with injuries: it is possible, in particular, when falling on an outstretched arm, it may be the result of compression of the plexus during a long stay with the arms wound under the head. Sometimes it appears in newborns during pathological childbirth.

In accordance with the anatomical structure of the brachial plexus, the syndromes of damage to its trunks (primary bundles) and bundles (secondary bundles) are distinguished.

Syndrome of lesions of the middle trunk of the brachial plexus

Occurs when the anterior branch of the VII cervical spinal nerve is damaged. In this case, a violation of the extension of the shoulder, hand and fingers is characteristic. However, the triceps muscle of the shoulder, the extensor of the thumb and the long abductor of the thumb are not completely affected, since along with the fibers of the VII cervical spinal nerve, fibers that have come to the plexus along the anterior branches of the V and VI cervical spinal nerves also participate in their innervation. This circumstance is an important sign in the differential diagnosis of the syndrome of damage to the middle trunk of the brachial plexus and selective damage to the radial nerve. The reflex from the tendon of the triceps muscle and the wrist (carporadial) reflex are not called. Sensitive disturbances are limited to a narrow strip of hypalgesia on the dorsum of the forearm and the radial part of the dorsum of the hand.

Syndrome of defeat of the lower trunk of the brachial plexus

Synonyms: Dejerine Klumpke's lower brachial plexopathy

It occurs when the nerve fibers entering the plexus along the VIII cervical and I thoracic spinal nerves are damaged. In this case, signs of damage to the ulnar nerve and cutaneous internal nerves of the shoulder and forearm, as well as parts of the median nerve (its inner leg), are characteristic. In this regard, with paralysis of Dejerine Klumpke, paralysis or paresis of the muscles occurs mainly in the distal part of the arm. At the same time, the ulnar part of the forearm and hand suffers mainly, where sensitivity disorders and vasomotor disorders are detected. It is impossible or difficult to extend and abduct the thumb due to paresis of the short extensor of the thumb and the muscle that abducts the thumb, innervated by the radial nerve, since the impulses going to these muscles pass through the fibers that are part of the VIII cervical and I thoracic spinal nerves and the lower trunk of the brachial plexus. Sensitivity in the hand is disturbed on the medial side of the shoulder, forearm and hand. If, simultaneously with the defeat of the brachial plexus, the white connecting branches leading to the stellate node (ganglion stellatum) also suffer, then manifestations are possible Horner's syndrome(constriction of the pupil, palpebral fissure and slight enophthalmos). In contrast to the combined paralysis of the median and ulnar nerves, the function of the muscles innervated by the external pedicle of the median nerve is preserved in the syndrome of the inferior trunk of the brachial plexus.

Paralysis of Dejerine Klumpke often occurs as a result of a traumatic lesion of the brachial plexus, but may also be the result of compression of its cervical rib or Pancoast tumor.

Syndromes of lesions of the secondary bundles of the brachial plexus

They occur during pathological processes and injuries in the subclavian region and, in turn, are divided into lateral, medial and posterior beam syndromes. They practically correspond to the clinic of combined lesions of peripheral nerves, which are formed from the corresponding bundles of the brachial plexus. In this case, the syndrome of the lateral bundle is manifested by a violation of the functions of the musculocutaneous nerve and the upper pedicle of the median nerve, the syndrome of the posterior fascicle is characterized by a violation of the functions of the axillary and radial nerve, and the syndrome of the medial fascicle is expressed by a violation of the functions of the ulnar nerve, the medial pedicle of the median nerve, the medial cutaneous nerves of the shoulder and forearm. With the defeat of two or three (all) bundles of the brachial plexus, a corresponding summation of clinical signs occurs, characteristic of syndromes in which its individual bundles are affected.

Brachial plexus lesions: Diagnosis[edit]

Differential diagnosis[edit]

Brachial plexus lesions: Treatment[edit]

Prevention[edit]

Other [edit]

scalene syndrome

Synonyms: thoracic outlet syndrome, TOS

Definition and general information

Scalenus syndrome is a group of diseases characterized by paresthesias, pain and weakness in the upper extremities due to compression, stretching or inflammation of the neurovascular bundle passing through the exit of the chest. There are 3 forms of scalene syndrome with different clinical presentation and etiology: neurogenic TOS, arterial TOS, and venous TOS (Paget-Schrotter's disease).

This diagnosis remains controversial, so the true frequency is unknown. The neurogenic variant is the most common, about 95%. Venous ( Paget-Schrotter disease) is 2% -3% of all cases.

Etiology and pathogenesis

Depending on the subtype, the syndrome is due to obstruction of the subclavian vein (venous TOS), compression of the subclavian artery (arterial TOS), or inferior trunk of the brachial plexus (neurogenic TOS) as a result of compression or scarring of the scalene muscle, poor posture, or a congenital anomaly.

Compression usually occurs in the interscalene triangle of the costoclavicular space between the first thoracic rib and the clavicle, or under the coracoid process behind the pectoralis minor tendon, causing pain, paresthesia, and weakness in the upper extremities. Patients are unable to perform the "open and close fist" exercise when the arms are in a raised position for 3 minutes (Roos test).

Various options for surgical treatment are considered (resection of the first rib, angio- or neuroplasty without removal of the rib), botulinum toxin injections into the scalene muscle of the neck are used.

Radiation-induced peripheral neuropathy

Definition and general information

Radiation-induced peripheral neuropathy is a chronic, disabling condition, often progressive and usually irreversible, usually manifesting several years after radiation therapy. The most common form of pathology is radiation-induced brachial plexopathy after radiation therapy for breast cancer.

The pathology is rare but tends to increase due to improved long-term survival of cancer patients. The incidence of radiation-induced brachial plexopathy today is<1-2% у пациентов, получающих суммарные дозы <55 Гр.

Etiology and pathogenesis

The pathophysiological mechanisms are not yet fully understood. Nerve compression resulting from massive radiation-induced fibrosis plays a central role in pathogenesis, in addition to direct trauma to nerve bundles through axonal injury, demyelination, and vascular injury due to ischemia of the capillary network.

Clinically manifested by paresthesia or dysesthesia, which then usually decreases with the development of hypoesthesia, and then anesthesia. Neuropathic pain is usually rare. Motor weakness is progressive, often observed after several months, accompanied by the development of fasciculations and amyotrophy. The intensity of symptoms gradually increases and after a few years can lead to the development of paralysis of the upper limb in the range of 0.2-5 years from the first signs of the disease.

Electroneuromyography allows you to determine the level of plexus injury.

Treatment is symptomatic. Pain is usually treated with non-opioid analgesics, benzodiazepines, tricyclic antidepressants, and anticonvulsants. Membrane stabilizing drugs (carbamazepine) can reduce nervous excitability.

Surgical manipulations are not effective. It is important to prevent any stretching of plexuses immobilized by fibrosis by avoiding heavy carrying and extensive movements.

Sources (links): [edit]

General neurology [Electronic resource] / A. S. Nikiforov, E. I. Gusev. - 2nd ed., corrected. and additional - M. : GEOTAR-Media, 2015. - http://www.rosmedlib.ru/book/ISBN.html

Plexitis of the shoulder and lumbosacral

Plexitis is a group of diseases in which the common is the suffering of the entire plexus of the spinal roots.

Anatomically, there are several plexuses of spinal roots in the human body (cervical, thoracic, lumbar, sacral, coccygeal, solar, etc.), however, due to functional features, the plexus located near large joints most often suffers completely. Such plexuses are the most vulnerable to trauma, they suffer faster with vascular pathology, radiation and other adverse factors.

Thus, in the plexitis section, two major subsections of diseases should be considered: shoulder plexitis and lumbosacral.

Shoulder plexitis

Shoulder plexitis can be caused by obstetric trauma, radiation, vasculitis, diabetes. In this case, either the upper plexus bundle suffers most often, then the term Erb-Duchenne palsy is used, or the lower portion, in this case we are talking about Dejerine-Klumpke palsy. According to ICD 10, such states are encrypted under the code G54.0. Separately considered plexitis of the brachial plexus, caused by trauma, compression of the tumor. Such states are encrypted under the G55.0 code.

lumbosacral plexitis

Lesions of the lumbosacral plexus are less common. They are caused by causes similar to those of brachial plexopathies, in addition, the causes may be abdominal aortic aneurysms, pelvic abscesses, hemorrhages in the iliopsoas muscle. Manifestations of the disease are expressed in weakness of the muscles of the lower extremities and pelvis, loss of reflexes, decreased sensitivity, and trophic disorders. The disease occurs against the background of pain in the hip joints, radiating to the legs. Pelvic disorders in plexitis of the lumbosacral plexus develop only with a bilateral extensive lesion.

Most of the lumbosacral plexitis is encoded under the code G54.1. The diagnosis indicates the side of the lesion, syndromic manifestations of the disease, the main cause, phase. Plexopathies caused by trauma or joint surgery are coded under code S34.4. Developed during the tumor process - in the heading G55.0.

Treatment

Treatment of all plexitis should be comprehensive. Vasoactive drugs, neuroprotectors, vitamins are used medicinally. Symptomatic use of nonsteroidal drugs. Non-medical therapy includes physiotherapy (magnetic and laser therapy, electrical stimulation for muscle weakness), massage, manual therapy, exercise therapy.

What is plexitis and plexopathy

Plexitis is an inflammatory process of the nerve plexuses, consisting of branches of the spinal nerves. Depending on the location of the lesion, it can be shoulder, cervical, and lumbosacral plexitis is also isolated.

Regardless of the cause of the disease, there is a destruction of the structure of nerve tissues - dystrophy. The disease is characterized by motor, sensory and autonomic disorders.

It is listed in the international classifier of diseases microbial 10, where its full description is given. You can find information under the codes G50-G59, where all lesions of the nerves and plexuses are considered. The manifestation of symptoms depends on the degree of damage.

Causes

The following causes of the disease are distinguished:

a variety of injuries that occur as a result of sprains, dislocations, fractures, as well as obstetric plexitis during childbirth;
prolonged compression of the nerve plexuses that occurred during surgery, with long-term wearing of gypsum or from exposure to tumors;
infectious diseases, for example, bacterial infections of the hand, which have moved to the nerve plexuses. It can also be complications after a sore throat or flu;
sometimes vaccinations can affect the onset of the disease;
poisoning with toxic substances;
metabolic disorder, which can occur with diabetes or gout.

The sooner you pay attention to the disease, the greater the chance of a full recovery. And knowing the causes of plexitis, you can apply a variety of preventive measures.

Symptoms

Depending on the area of the disease, the symptoms may differ:

intense pain in the lateral surfaces of the neck, can radiate to the occipital region and occur in attacks;
violation in the respiratory system, the stomach is drawn in on inspiration, and breathing becomes superficial. This is due to violations of the phrenic nerve, while it is difficult to speak and cough;
weakening of the neck muscles, it becomes difficult to turn the neck and perform inclinations;
often there is a long and painful hiccups. This is obtained as a result of inflammation of the phrenic nerve, which causes involuntary contractions of the diaphragm.

weakening in the muscles of the hands, a condition may occur when the hand cannot be raised at all;
sharp pain in the collarbone, which gives into the arm and intensifies with any movement of the limb;
the sensitivity of the skin of the shoulder and arm decreases;
swelling of the hands;
cold skin of the hands and severe pallor;
fingernails become brittle.

pain in the lower back, thigh, foot and lower leg, which increase with vigorous activity;
decreased sensitivity of the skin;
swelling of the limbs;
nails become brittle;
there is weakness in the legs, in which there are difficulties with movement;
limbs become pale and cold to the touch.

Forms

Depending on the location of the inflamed nerve plexus, the following forms of the disease are distinguished:

cervical plexitis develops in the neck, it is characterized by pain in the neck and occipital region. In advanced form, it can cause muscle paralysis, also accompanied by debilitating hiccups.
pain in the collarbone and arm indicates the occurrence of shoulder plexitis. At the same time, muscle strength is lost, and reflexes are reduced. There is sweating in the palms and cyanosis of the extremities.
Lumbosacral plexitis can provoke paralysis of the lower extremities and various trophic disorders. There is a generic form of the disease.

In newborns, this disease can occur as a result of birth trauma. The inflammatory process can spread to individual branches and nodes, as well as affect the entire plexus as a whole. There is a bilateral and unilateral plexus lesion.

There are two stages of the disease:

Diagnostics

If characteristic symptoms occur, the following diagnostic measures are taken:

complaints of pain and weakness in the muscles of the limbs and neck, brittle nails and hiccups, how long ago such symptoms appeared;
what caused these signs, such as vaccination, injury or surgery;
the presence of concomitant diseases: gout or diabetes mellitus.

Treatment of plexitis

The method of treatment of this disease depends on the nature of the course of the disease and on the stage of the disease. Most often, treatment is carried out on an outpatient basis, but placement in a hospital is also possible.

Doctors may prescribe drugs that increase blood circulation in the vessels and restore the function of all reflexes.

The following medicines are distinguished:

antibiotics;
painkillers (baralgin, indomethacin);
vitamin complexes, especially group B;
anti-inflammatory drugs (ibuprofen, voltaren);
dehydrating drugs.

Treatment is aimed at eliminating pain symptoms and eliminating muscle tension. After getting rid of the pain, a restorative course is carried out, which consists of balneological methods and therapeutic exercises.

In addition to drug treatment, the following methods of treatment can be used:

surgery for injuries that contribute to compression of the nerve plexuses;
with an infectious form of the disease, special treatment is prescribed: painkillers and blockade injections are prescribed;
physiotherapy procedures are prescribed:

acupuncture techniques and a healing shower;
electrophoresis;
ultrasound and magnetotherapy;
heat treatment with special compresses - paraffin treatment;
therapeutic gymnastics and swimming;
mud therapeutic baths (hydrogen sulfide and radon);
various types of massage;
diadynamic therapy and amplipulse therapy.

When forced to use crutches, it is important to use them correctly.

For a full-fledged treatment, the normalization of metabolism is important.

Some chronic diseases can provoke plexitis, so it is important to carry out the necessary treatment on time.

It is important not to delay the implementation of therapeutic measures, but to undergo treatment at an early stage.

As an additional treatment, you can use folk recipes:

sore spots are rubbed with a mixture of several grams of propolis and five tablespoons of fat;
infusion of chamomile flowers;
cabbage leaf is heated over steam and applied to the sore spot.

Complications

If you do not exercise vigilance and do not seek medical help on time, the following complications may develop:

the chronic form of the disease and the persistence of a stable neurological symptom in the form of paralysis, with weakness in the limbs and loss of sensitivity;
disability due to the emerging neurological disease and dystrophy, muscle weakness makes it difficult to perform normal activities.

Advanced forms of the disease lead to loss of physical activity.

Prevention

To prevent the occurrence of such a dangerous disease, some preventive measures should be taken:

it is necessary to treat infectious diseases in time, using antiviral and antibacterial drugs;
you can not supercool, in winter you need to wear warm clothes;
it is important to maintain active activity, and it is better to do health-improving gymnastics;
proper rest and observance of the sleep regimen;
hardening procedures;
follow the rules of a rational and healthy diet:
- apply a fractional nutrition system: 4-5 times a day and in small portions;
- eat foods high in fiber: fruits, vegetables;
- refusal of fried and spicy foods;
- it is necessary to consume foods that contain vitamin B6: cheese, millet, sardines, beef liver, cauliflower;
- also foods rich in vitamin B1: fish, nuts, green peas and seeds;
- foods containing vitamin B 12: eggs, fish and meat.

A person suffering from plexitis may feel a burning, shooting, stabbing, boring pain. In this case, the pain is permanent in nature, but subsides somewhat at rest, acquiring a constant aching character.

You can do simple exercises:

standing straight, reduce and spread the shoulder blades;
hands to make large circles, in each direction 5-10 times;
standing still, lower and raise your shoulders;
put your hands on your shoulders and make circular movements with your elbows, back and forth.

Perform all movements 5 to 10 times.

If you follow all the instructions, you can return the full performance of all muscles.

When, after waking up, a person cannot raise his hand, he usually does not attach any importance to this and thinks that it is just numb. Often this happens, but if the mobility of the arm is not restored after a few hours, it may be plexitis. Plexitis is divided into several types: Cervical It is characterized by pain in.

Shoulder plexitis is an inflammatory disease in which there is damage to the nerve structures of the shoulder. The plexus includes the anterior branches of the four lower nerves of the cervical region and the first thoracic spinal nerve. The shoulder, as an anatomical unit, is distinguished by its large size and complexity.

How to treat plexopathy of the brachial plexus

The mobility of the limbs directly depends on the health of the plexuses of the nerve trunks of the spinal cord. So, in the triangle of the neck and the axillary fossa there is a brachial plexus, formed by the cervical and thoracic spine. If for some reason the nerve fibers are damaged and the work of the shoulder is impaired, a disease called plexopathy develops.

Since with a timely visit to a doctor, at least an improvement in physical condition can be achieved, it is worth considering the nature of the disease, as well as the symptoms and treatment of brachial plexopathy.

Classification by symptoms

The disease, which has the ICD code 10 G54.0, is considered a fairly common phenomenon in medical practice. Its symptoms can appear in people regardless of age and gender. For reasons of formation, plexopathy is divided into several categories:

Disease acquired at birth. Babies are susceptible to it, the birth of which was associated with damage to nerve tissues. In particular, when pulling them out of the womb by the hands.
Plexopathy often develops on the basis of trauma received by an adult. This may be due to damage by a hard, cutting object or dislocation. Similar is observed in people after an accident.
This disease can be caused by a viral disease that has affected the nervous system.
In rare cases, plexopathy can result from injury to the fibers of the nervous system by a hypertrophied process of the seventh cervical vertebra.
Another cause of the disease is considered to be compression from the outside. This may be the effect of a tumor or the result of medical manipulations under anesthesia.
There is a category of persons who suffer from plexopathy for no apparent reason. In this case, idiopathic pathology is diagnosed.

Important. Since trauma rarely damages all nerve fibers, the clinical picture of the disease depends on the muscles whose work is impaired.

If roots No. 5 and 6 are damaged, Erb's syndrome develops, in which a person does not have access to the fold of the forearm and rotation of the hand. In infants, paresis of the limb and the associated slowdown in its growth are observed.

Damage to the eighth cervical and first thoracic roots affect the mobility of the hands. Total pathology can lead to complete paralysis of the hand.

stages

There are 2 stages in the development of the disease.

The first of them, called neuralgic, involves the sensation of severe pain with even small movements of the hand. It occurs immediately after an injury.

If you do not try to stop this process, it goes into a paralytic stage.

At this stage, the destruction of the nerve fibers reaches the point where they can no longer function properly. This affects the sensitivity of the skin, the disappearance of reflexes. And with prolonged inactivity, muscle atrophy begins.

With the viral nature of the disease, the resulting pain radiates to the back of the head. Another external factor is an increase in the axillary and cervical lymph nodes, which are acutely responsive to touch.

Diagnostic methods

Having considered what shoulder plexopathy is, it is important to understand the methods used in medicine to identify this ailment. Since the clinical picture of the disease is often similar to the manifestations of other diseases, a set of methods is required that determines violations in specific nerve connections:

using a blood test, you can identify the presence of viral infections that provoke this disease;
analysis of cerebrospinal fluid will distinguish the viral nature of the disease from the bacterial;
in case of injuries, an x-ray examination is required;
the doctor can also send for MRI, CT, ultrasound studies;
to study the state of muscle tissue, an electroneuromyographic study is often prescribed.

All these methods allow you to quickly and accurately determine the diagnosis, without confusing the disease with similar diseases. This allows you to immediately begin rehabilitation therapy.

Methods of treatment

In the arsenal of doctors there are a number of ways to treat plexopathy of the brachial plexus:

prescribing drugs;
physiotherapy procedures;
massage;
in some cases, surgery is recommended.

The use of medications is an important part of treating illness caused by viruses or bacteria. Antiviral drugs or antibiotics play a leading role here. However, the treatment of post-traumatic plexopathy of the brachial plexus does not pass without painkillers, drugs aimed at restoring soft tissues and nerve fibers.

As soon as the patient's pain syndrome is stopped, doctors prescribe him massage and physiotherapy. This includes applications with paraffin or mud, laser, ultrasound therapy, treatment with pulsed current and magnetic field.

Exercises for plexopathy of the brachial plexus are used in therapeutic exercises.

Here the emphasis is on developing the muscles in this area of the body, which allows you to strengthen their strength and, if possible, restore blood circulation.

Forecast

Not always used therapy leads to complete recovery.

The effectiveness of all these measures largely depends on the type of pathology, the stage of its development, the age and general physical condition of the patient. Therefore, if you suspect a neurological pathology, you should immediately contact a specialist.

Learn how to use Nurofen for pain?

Disease prevention

Although it is rare to avoid the consequences of injuries, existing preventive measures can reduce the risk of inflammatory processes in the joints.

A good way to do this is by exercising in the pool. Other types of moderate physical activity will be no less useful.

Conclusion

Shoulder plexopathy may be the result of an injury or the onset of viral activity. Since the symptoms of the disease are in many ways similar to other diseases, a thorough diagnosis is required to identify the true cause of the deterioration in well-being. And the chances of a full recovery will depend on timely treatment.

Shoulder plexitis is an inflammation of the brachial plexus nerve. The disease can occur for various reasons and, when it appears, causes discomfort in the brachial plexus. If you do not pay attention to the main symptoms of the disease, then as a result this can lead to weakening of the muscles or to complete paralysis of the hands. Therefore, in order to determine the disease in time, it is necessary to know its main causes and methods of treatment.

Symptoms of plexitis

With inflammation of the brachial plexus nerve, the pain may be shooting, aching or breaking.

Basic Treatments

To alleviate the patient's condition, doctors put a plaster splint on the shoulder and prescribe drugs that will help relieve inflammation from the nerve and anesthetize the limb as much as possible.

Medical treatment

Treatment with folk remedies

Treatment with folk remedies deserves separate consideration, because many of the recipes have an amazing effect in treating the disease.

ICD 10 also implies treatment with folk remedies, which include taking therapeutic baths, applying compresses or drinking decoctions.

The use of therapeutic baths

Peppermint bath. Grass should be collected during flowering and dried well. Take one glass of dried flowers and pour three glasses of hot water over them. Let it stand for half an hour, infuse and after that you can pour it into a bath with a water temperature of at least 38 degrees. After taking a bath, you need to dry yourself and put on warm clothes, lie down under the covers.

Many doctors prescribe the patient treatment with folk remedies, because compresses, ointments and medicinal baths with herbs will become an additional incentive on the path to recovery.

Basic exercises for plexitis

All exercises should be performed only in a standing or sitting position. Exercises consist in raising the shoulders up and bringing the shoulder blades back. Such exercises are performed 10 times.

Exercises along with folk remedies will help you get on your feet faster and feel significant relief in the brachial plexus.

Preventive measures

If nothing is done, it will be noticeable how the shoulder joint noticeably lags behind in development, and as a result, limited movement of a person may occur. In order to prevent the development of plexitis, it is necessary to avoid hypothermia and it is necessary to stab the body regularly. Try to eat healthy and balanced. It is necessary to begin timely treatment of all diseases and it is necessary to strengthen the body. Take care of your health, because the disease is easier to prevent than to cure.

Damage to the plexus is called plexopathy.

Etiology and pathogenesis[edit]

Clinical manifestations[edit]

Total brachial plexopathy

Syndromes of damage to the trunks (primary bundles) of the brachial plexus

Occur when the supraclavicular part of it is damaged. In this case, it is possible to distinguish syndromes of damage to the upper, middle and lower trunks:

Syndrome of lesions of the upper trunk of the brachial plexus

Synonyms: Erb-Duchenne upper brachial plexopathy

In accordance with the anatomical structure of the brachial plexus, the syndromes of damage to its trunks (primary bundles) and bundles (secondary bundles) are distinguished.

Syndrome of lesions of the middle trunk of the brachial plexus

Syndrome of defeat of the lower trunk of the brachial plexus

Synonyms: Dejerine Klumpke's lower brachial plexopathy

Paralysis of Dejerine Klumpke often occurs as a result of a traumatic lesion of the brachial plexus, but may also be the result of compression of its cervical rib or Pancoast tumor.

Syndromes of lesions of the secondary bundles of the brachial plexus

Brachial plexus lesions: Diagnosis[edit]

Differential diagnosis[edit]

Brachial plexus lesions: Treatment[edit]

Prevention[edit]

Other [edit]

scalene syndrome

Synonyms: thoracic outlet syndrome, TOS

Definition and general information

This diagnosis remains controversial, so the true frequency is unknown. The neurogenic variant is the most common, about 95%. Venous ( Paget-Schrotter disease) is 2% -3% of all cases.

Etiology and pathogenesis

Radiation-induced peripheral neuropathy

Definition and general information

Etiology and pathogenesis

Electroneuromyography allows you to determine the level of plexus injury.

Surgical manipulations are not effective. It is important to prevent any stretching of plexuses immobilized by fibrosis by avoiding heavy carrying and extensive movements.

Sources (links): [edit]

General neurology [Electronic resource] / A. S. Nikiforov, E. I. Gusev. - 2nd ed., corrected. and additional - M. : GEOTAR-Media, 2015. - http://www.rosmedlib.ru/book/ISBN.html

Nerve root and plexus lesions (G54)

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Plexitis of the shoulder and lumbosacral

Plexitis is a group of diseases in which the common is the suffering of the entire plexus of the spinal roots.

Thus, in the plexitis section, two major subsections of diseases should be considered: shoulder plexitis and lumbosacral.

Shoulder plexitis

lumbosacral plexitis

Treatment

What you need to know about the symptoms and treatment of shoulder plexitis?

A bit of anatomy

Causes of plexitis

Many external or internal factors can provoke inflammation of the brachial plexus. Taking into account the causes of occurrence, experts distinguish the following varieties of the disease:

Dysmetabolic. In this case, the provoking factors are diseases associated with metabolic disorders - diabetes mellitus, gout, dysproteinemia, thyroid pathology.

Toxic. This type of shoulder plexitis develops as a result of intoxication of the body with salts of heavy metals, alcohol surrogates or chemical components.

Forms of shoulder plexitis

In medicine, there are three forms of the disease:

Upper brachial plexitis (Duchenne-Erb syndrome) - is caused by a lesion of the upper trunk of the brachial plexus, manifested by pain in the supraclavicular part of the shoulder.
Lower shoulder plexitis (Dejerine-Klumpke syndrome) - accompanied by damage to the lower nerve trunks and pain radiating to the forearm and elbow.
Total plexitis (Kerer's paralysis) - combines the symptoms of previous forms, but is accompanied by severe consequences associated with the death of nerve fibers, muscle paralysis and loss of mobility of the upper limbs. This form of the disease is rare.

Taking into account the characteristics of the course of the disease, two stages are distinguished:

Neuralgic - characterized by spontaneous severe pain, aggravated by movement.
Paralytic - manifested by a violation of sensitivity, peripheral paresis and paralysis of the muscles innervated by the branches of the affected nerve plexus.

Shoulder plexitis symptoms

With Duchenne-Erb paralysis, weakness increases and there is a decrease in muscle tone in the proximal parts of the upper limbs, which makes it difficult to move the shoulder joint, making it impossible to raise, bend and move the arm with a load to the side.

Even minor pain in the shoulder joint area should be a reason to visit a neurologist. The sooner a correct diagnosis is made, the greater the chance of a quick recovery.

Diagnostics

electromyography or neuromyography;
MRI, ultrasound or CT of the shoulder joint;
radiographic study.

If an infectious origin of the disease is suspected, PCR is used - diagnostics, a general blood test is done, which makes it possible to judge the presence of an inflammatory process.

Treatment of plexitis of the shoulder joint

Additionally, the doctor may prescribe drugs that improve blood circulation, drugs to relieve swelling, medicines that improve tissue nutrition - lidase, nicotinic acid, potassium orotate.

After the inflammation and pain subside, a variety of physiotherapeutic procedures are recommended, the action of which is aimed at improving blood circulation and tissue nutrition. Among them:

electrophoresis;
mud treatment;
reflexology;
amplipulse therapy;
applications with paraffin or ozocerite.

mixing-breeding of the shoulder blades;
shoulder movements up and down;
rotational movements with arms bent at the elbows;
flexion - extension of the upper limbs;
torso forward, backward, to the sides;
circular movements with a straightened hand;
handling small objects.

Special exercises should be performed regularly until the mobility of the shoulder joint is fully restored.

Folk remedies

At home, in addition to the main drug treatment, you can use proven folk remedies. The basis of home therapy is compresses, therapeutic baths, rubbing.

Therapeutic baths

Rubbing with aloe

Rubbing with pork fat

Rubbing with turpentine

Homemade ointment

In order not to provoke unwanted complications, be sure to consult your doctor before using folk recipes.

Forecast

Plexit code mcb 10

They represent a unique path not only for conducting nerve impulses, but also for the circulation of micromolecules between the central nervous code and internal organs. Interdigital neuroma of the upper limb. Classification of peripheral neuropathies based on microbial and pathomorphological signs of WHO Acquired as a result of or consumption: Exogenous poisons and drugs: Associated with metabolic disorders: Other causes and types of neuropathy: Idiopathic infectious or post-infectious: With collagen vascular diseases, other plexitis, diabetes mellitus , atherosclerosis.

With compression of positional stretching, separation. Thermal injury and electrical injury. Classification of diseases of the peripheral nervous system All-Union Problem Commission on Diseases of the Peripheral Nervous System, Moscow

Cervicocranialgia, posterior cervical sympathetic syndrome, etc. Cervicobrachialgia with muscular-tonic or vegetative-vascular or neurodystrophic manifestations.

lumbosacral plexitis

Thoracalgia with muscular-tonic code, vegetative-visceral, or neurodystrophic manifestations. Lumboishalgia microbial muscular tonic or Order of the Ministry of Internal Affairs 1228, or neurodystrophic manifestations.

Damage to the nerve roots, nodes, plexuses. Meningoradiculitis, cervical, thoracic, lumbosacral radiculitis. Radiculoanglionitis, spinal ganglionitis, symptomatic truncites. Upper shoulder palsy of Erb-Duchenne.

Lower shoulder paralysis Dezherin-Klumpke. Lumbosacral partial or total. Multiple lesions of roots, nerves. Infectious-allergic polyradiculoneuritis of Guillain-Bare, etc.

With chronic household and industrial intoxications, alcohol, lead, chlorophos, etc. With toxic infections of diphtheria, botulism. Allergic vaccines, serum, drug, etc.

Discirculatory - with nodular periarthritis, rheumatic and other plexitis. Idiopathic and hereditary forms.

The disease is characterized by motor, sensory and autonomic disorders.

Damage to individual spinal nerves. Neuralgia of the trigeminal nerve and other cranial nerves. Neuritis, neuropathy of the facial nerve.

Neuritis of other cranial nerves. Ganglionitis ganglioneuritis of the pterygopalatine, microbial, ear, submandibular and code nodes. Combined and code forms of prosopalgia. In addition to the etiology and localization of the process, it is indicated: The disease is based on direct external trauma, or compression at a certain level of the nerve trunk.

The microbial factor is the superficial location of the nerve on the bone or its passage in plexites, which form bone-ligamentous or muscle elements.

In such anatomical conditions, the corresponding parts of the nerve trunks are especially sensitive to professional chronic or sports trauma, limb compression in deep sleep, etc. In atherosclerosis, diabetes mellitus, periarteritis nodosa and other collagen mononeuropathies caused by ischemia, ischemic neuropathies, direct infection of individual nerves is rarely observed leptospirosis, leprosy.

The only exception is the defeat of the cranial nerves in herpes infection. In a considerable number of cases, the etiology of neuropathies remains unclear. Defeat the main plexitis leads to the loss of all its functions.

Item classification

More distal lesions cause only partial damage. The clinical picture also depends on the degree of damage to the nerve fibers.

arthritis icb code 10

In the anamnesis, it turns out what was the cause: In case of damage to the radial nerve due to paralysis of the microbial forearm and extensors of the hand and fingers, the arm is pronated and half-bent, the hand hangs down. At the same time, they are unevenly bent: There is a violation of the extension of the forearm, hand and fingers, abduction and extension of the large plexitis, atrophy of the triceps muscle of the shoulder, brachioradialis muscle, extensor muscles of the hand and fingers, decrease or absence of reflexes - radial and from the triceps muscle of the shoulder, impaired sensitivity on the back surface of I, II and partially III fingers.

A positive symptom of Beck - with damage to the radial nerve, passive abduction of the arm and rotation of it inward provoke pain at the site of its passage in the groove of the radial nerve of the humerus.

The peripheral nervous system is a collection of nerve fibers that form nerves and plexuses. The inflammatory process can spread to individual branches and nodes, as well as affect the entire plexus as a whole. In half of the cases, the defeat of the hypoglossal nerve is caused by tumors metastases, chordoma, tumors of the nasopharynx, lymphoma, etc.

Syndrome of Saturday night paralysis. Compression neuropathy of the radial nerve at the level of the distal spiral canal formed by the spiral groove of the humerus and the heads of the triceps brachii.

It can develop, in particular, with prolonged pressure on the nerve in this place while sleeping on a hard bed, in an uncomfortable position, especially the Pexit alcohol code, and the code for shoulder fractures. The clinic is the same as with neuropathy of the radial nerve. Mkb sharply at the kkb by the child's hand with a sharp jerk of its tension. In such cases, there is a traumatic lesion of the microbial nerve at the level of the elbow joint.

Manifested by the fact that the hand dangles in a state of pronation, passive movements and especially the supination of the hand in this case are painful. A predisposing factor may be the small size of the head of the radius, as well as the weakness of its annular ligament, in connection with which plexitis of the radius occurs. Painful form of the tunnel syndrome of the radial nerve. The consequence of infringement of the sensitive branch of the radial nerve - posterior cutaneous plexitis of the forearm - at the level of the middle third of the shoulder at the point of passage through the lateral intermuscular septum or in the ulnar region in the zone of passage through the fibrous arcade of the short radial extensor of the wrist.

It is manifested by pain in the elbow region and in the forearm, often aggravated at rest, at night, as well as paresthesia and hyalgesia of the skin of the back surface of the first finger and the adjacent interosseous space.

At the same time, movements are preserved, there are no muscle atrophies.

Item Description

Mkb deep branch of the radial nerve. A code of pain and sensory disturbances occurs, manifesting only as motor disorders in the form of the impossibility of active extension of the fingers and abduction of the first finger, while maintaining the extension of the hand at the wrist joint. In this case, usually increasing atrophy of the muscles of the dorsum of the forearm. Damage to the brachial plexus of non-inflammatory etiology can be caused by trauma, including birth trauma, dislocation of the shoulder joint, compression, diabetes mellitus, vasculitis, oncological pathology, Plexitis code MKb 10, and radioactive irradiation.

Clarify the diagnosis using CT scan. In the case of predominant involvement of the upper sections of the brachial plexus of the roots of CV-VI, Erb-Duchenne syndrome develops: The carpal tunnel is formed by the flexor retinaculum, bones and joints of the wrist, covered with ligaments.

The median nerve in the carpal tunnel branches into terminal sensory and motor nerves, mcb mainly Help ndfl 2 skin surface I, II, III and the radial half of the fingers and the muscles of the elevation of the first finger. Compression-ischemic neuropathy of the distal part of the median nerve is manifested mainly by night pains and paresthesia in the zone of innervation of the branches of the median nerve on the hand - mainly on the palmar surface of fingers I, II, III and the adjacent side of the fourth finger, in the thenar region, which become permanent over time.

The pain is especially pronounced if the arm is in a horizontal position or raised. Pain and paresthesia increase: With a long course of the disease, thenar malnutrition is possible, a decrease in the strength of the short muscle that abducts the thumb and the muscle that opposes the thumb, which leads to a decrease in the pressure force between the thumb and forefinger and the inability to grab the bottle test.

Carpal tunnel syndrome is so common that it can be combined with other more serious diseases - disseminated plexitis, ALS, spondylogenic cervical myelopathy. Therefore, it is important to pay attention to whether there is diffuse atrophy of the hand, revitalization of tendon reflexes and other symptoms that indicate a different disease.

Unlike patients with cervical sciatica, who prefer to press their hand to the body and not make unnecessary movements, patients with carpal tunnel syndrome, on the contrary, shake their hand.

Pain, sensory disturbances on the back of the thigh, on the posterior side of the lower leg and on the foot. Possible vegetative-vascular and trophic disorders in the same place, flaccid paralysis of the foot and its fingers, as well as the muscles that provide flexion of the lower leg and its rotation inward, loss of the Achilles reflex and plantar plexitis.

Usually, the nerve is pinched between the sacrospinous ligament and the spastically contracted piriformis muscle syndrome.

general information

Differentiate with radiculopathy L5 - Code. Impossibility of extension in the knee joint. Anesthesia of the anterior thigh and code surfaces underneath. IBC weakness of the iliopsoas muscle hip flexion and quadriceps femoris muscle extension microbial.

In contrast to the defeat of L2-L4 plexitis, for example, Motor transport services with the customer's gsm confirming documents of a paravertebral tumor in the thigh muscle, innervated by the microbial nerve.

A similar clinical picture is possible with diabetic polyradiculoneuropathy. Traction-compression neuropathy of the common plantar mb nerves, caused by compression of their deep transverse metatarsal ligaments between the heads of the bones.

With the infectious nature of plexitis, patients are prescribed antiviral and antibacterial plexitis. Metabolic plexitis is eliminated by normalizing sugar levels. Medical intervention is necessary for the post-traumatic and compression type of the disease.

Therapy consists in removing tumors and blood clots that can compress the plexus. For any etiology of plexitis, the following is prescribed: Preventive measures for plexitis of the shoulder joint, cervical and lumbosacral plexus consist in following simple rules: In cases of plexitis treatment not started on time, the disease has an unfavorable prognosis - the appearance of paresis, paralysis, and disability.

In other situations, the prognosis directly depends on the nature of the disease, the presence of concomitant disorders, the age of the patient and the effectiveness of therapy.

If you think that you have Plexitis and the symptoms characteristic of this disease, then doctors can help you: We also suggest using our online disease diagnostic service, which, based on the symptoms entered, selects probable diseases.

Iron deficiency anemia is a syndrome that is characterized by a decrease in the content of hemoglobin, as well as erythrocytes in the blood. It is usually seen as a symptom of another underlying ailment.

It is a code for anemia that exists due to a decrease in the concentration of iron in the human body due to loss of blood or iron plexitis entering the human body.

Acute osteomyelitis of the microbial disease is a disease characterized by the development of bacterial inflammation of the bone marrow and all structural parts of the bone. The danger of the disease is the essential conditions for renting an enterprise in a variety of courses - from asymptomatic to fulminant. The main source of pathology are pathogens that penetrate the bone code and lead to the emergence of the microbial process.

In addition, there are several development mechanisms and predisposing factors. Chondrosarcoma is the most common malignant neoplastic formation affecting skeletal structures. The tumor originates from the cartilaginous elements of the bones.

A similar disease occurs in every 4th patient diagnosed with sarcoma. Rett syndrome is a degenerative progressive disease that disrupts the functioning of the nervous system, which stops the development of plexitis at an early age. The question of the mechanism and causes of the formation of such a disease currently remains open.

The fundamental source of pathology is the mutation of a large number of genes, their negative impact on the development of such an organ as the brain. Sciatica is inflammation of the sciatic nerve. In some sources, the disease may be referred to as sciatic neuralgia or sciatica.

The most characteristic symptom for this disease is back pain, which radiates to the lower limb. The main risk group is people over 30 years of age. At an earlier age, the disease is almost never diagnosed.

Accordingly, plexitis of the shoulder joint is a pathology of the brachial plexus. Cervicocranialgia, posterior cervical sympathetic syndrome, etc.

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Muscle weakness Fragility of nails Mkb pain in others Plexitis Pain when tilting the head Pallor of the skin Mub Pain when turning the head Disorders Which acts are subject to state registration Restriction of joint mobility Sweating of the palms Pain in the affected area Swelling in the affected area Cold skin Violation of the defecation process Change in gait Sweating of the foot Decreased sensitivity skin at the site of the lesion Violation of sexual function Plexitis is an inflammatory process of large nerve plexuses, in particular the cervical, brachial, lumbosacral.

Etiology Varieties Symptoms Diagnosis Treatment Prevention Become the cause of the progression of this disease can be trauma to the nerve plexus during fractures, a history of disorders such as tuberculosis, diabetes mellitus or syphilis allergy, or an overdose of drugs.

Etiology The main factor in the formation of plexitis is a violation of the transmission of a nerve impulse through the nerve plexuses. Varieties There are several classifications of plexitis, differing in many factors. According to the place of occurrence of the inflammatory process, they are distinguished.

Plexitis is an inflammatory process that occurs in the bundle of spinal nerves. The disease can be triggered by a number of reasons. Brachial plexitis is an inflammatory process that affects the brachial plexus. Often, with brachial plexitis, inflammation extends to the cervical plexus.

Brachial nerve plexitis can be diagnosed in patients of various age categories. The lack of proper and timely treatment often leads to complete immobilization of not only the shoulder joint, but the entire lower limb.

Plexitis of the brachial nerve belongs to the class of unsafe diseases, the severe form of which can lead to disability. Doctors distinguish a huge variety of provoking factors that can cause the development of an inflammatory process in the brachial plexus.

The most common reasons are:

Disease classification

If you subdivide plexitis according to the localization of inflammation, then there are 3 forms:

right hand;
left-sided;
bilateral.

Depending on the root cause that provoked the development of inflammation in the brachial plexus, the disease is divided into the following subspecies:

Traumatic. Occurs after shoulder injuries - dislocation, fracture, sprain. This also includes the congenital form of the disease associated with birth trauma. In addition, traumatic plexitis also includes a process caused by the negative impact of certain substances when a person performs professional duties.
Infectious - the destructive effect of infections and toxins on the nerve fiber of the shoulder joint (with tuberculosis, herpes virus, influenza, etc.).
Toxic - a consequence of poisoning the body with alcohol-containing surrogates, mercury vapor and heavy metals.
Dysmetabolic plexitis develops against the background of the activity of pathologies associated with impaired metabolic processes (diabetes mellitus, endocrine pathologies, etc.).
Compression-ischemic - a consequence of compression of the nerves of the shoulder joint (uncomfortable posture, the presence of a joint tumor or hematoma after injury, swollen lymph nodes).

Clinical picture

The following symptoms indicate inflammation of the brachial plexus:

reduction in the range of motion of the upper limb (full or partial) - the inability to bend or raise the arm, difficulty moving the fingers;
soreness in the area of inflammation with active hand movements;
decreased muscle strength - the inability to lift heavy things or hold for a long time;
change in fine motor skills;
paralysis or paresis, accompanied by muscle atrophy, in a severe form of the disease.

Diagnostics

To confirm the diagnosis, the patient is assigned:

x-ray;
neuromyography;

Plexitis of the shoulder joint was assigned the code for microbial 10 - G 54.0.

The appearance of painful symptoms should not go unnoticed. If the patient is not given timely treatment, then the risk of developing negative consequences greatly increases. Timely prescribed treatment is a guarantee of complete restoration of impaired joint functions.

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Treatment of plexitis of the shoulder joint

As a rule, with plexitis of the shoulder joint, the patient is prescribed conservative treatment. The first thing to do in order to keep the injured joint immobile is to fix the sore shoulder with a plaster splint. Subsequently, the patient is prescribed medication.

To eliminate the inflammatory process, the following means are used:

painkillers (Flupirtin, Analgin);
novocaine blockade (with severe, excruciating and acute pain);
NSAIDs (Indomethacin, Xefocam, Nimesulide, Ibuprofen) - non-steroidal anti-inflammatory drugs can be used in the form of tablets or injections, and external NSAIDs - ointments, creams, gels - are prescribed to the patient as concomitant therapy;
fortified complex (vitamins of groups B, A, C, E) - Milgamma, Neurovitan, Discus Compositum, Aevit;
anticholinesterase agents (Invalin, Kalimin), which improve neuromuscular transmission;
decongestants (Mannitol);
means for stabilizing tissue nutrition (Lidase, Nicotinic acid, Potassium Orotate);
drugs that normalize blood flow microcirculation (Terental, Complamin).

After the suppression of the acute form of the disease, the patient is prescribed physiotherapy, exercise therapy and manual therapy.

How to treat the disease using physiotherapy? With plexitis of the shoulder joint, the following methods of physiotherapy are effective:

acupuncture;
electrophoresis;
ozokerite;
dynamic currents;
phonophoresis;
balneotherapy;
cryotherapy;
magnetotherapy.

Exercise therapy for plexitis of the shoulder joint

Competent and regular performance of special exercises contributes to the acceleration of the therapeutic effect and the rapid recovery of the joint damaged after inflammation.

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The set of exercises includes a light warm-up, which is performed in a standing or sitting position. The following exercises are most effective:

slow rise and then lowering of the shoulders;
with straightened shoulders, reduction and subsequent dilution of the shoulder blades;
circular rotational movement of the shoulder joint;
torso tilts to the side with the inclusion of rotational movements of the body;
unfolding the palms (the arms should be straight and extended forward).

The course and duration of exercise therapy is determined in each case individually. For the average norms can be considered the daily exercise of 10-15 repetitions of each of the above movements.

Modern restorative techniques have been supplemented by a relatively new, but very effective method - hydrokinesiotherapy. It is much easier to perform therapeutic exercises in water, so rehabilitation is faster.

Surgery

Post-traumatic plexitis, the presence of a tumor or hematomas, the ineffectiveness of conservative therapy, the neglect of the disease - all these are indications for surgical intervention (plasty of the nerve endings of the brachial plexus).

Prevention

Preventive measures for plexitis include:

exclusion of traumatism;
professional management of the delivery process;
timely treatment of injuries;
adequate treatment of infectious, viral and inflammatory diseases;
normalization of metabolism.

Physical activity is of particular importance. If a person is busy with sedentary work, moves in a personal car and rests lying on the couch, he will get acquainted with many diseases, including plexitis, before the rest.