Brachial plexitis. Plexitis of the brachial plexus - symptoms of the disease, diagnosis and treatment Plexitis of the left brachial plexus

How to treat shoulder plexitis

Plexitis of the shoulder joint is a pathology in which inflammatory damage to the nerve plexus in the shoulder joint occurs. The brachial plexus consists of nerves that arise from the cervical and thoracic spine.

The causes of the disease can be different: infectious process, trauma, autoimmune reactions, metabolic disorders.

In any case, inflammatory damage to the nerve fibers and disruption of the innervation of the shoulder joint and arm occurs, which is manifested by characteristic signs.

Typical symptoms of plexitis: pain in the periclavicular area, impaired sensitivity, paresis and paralysis, decreased muscle reflexes, impaired nutrition of hand tissues. Most often, unilateral brachial plexitis develops, but the lesion can also be bilateral.

Timely treatment begins to guarantee successful restoration of innervation. For therapy, you can use traditional medicine. This treatment aims to warm the affected area and improve blood flow. Folk remedies are safe and do not cause side effects.

Causes of brachial plexitis

The nerve plexus of the shoulder joint consists of external, posterior and internal bundles that intertwine the axillary artery.

This plexus is formed by motor and sensory nerve fibers that innervate the arm. Most often, a person develops unilateral damage to the nerve plexus.

It can be total or partial, depending on whether the entire plexus or part of it is affected.

Shoulder plexitis can occur in people of any age. Most often, such a lesion develops in physically active young people aged 20 to 60 years. Shoulder plexitis can develop in men and women, but the former suffer from this pathology somewhat more often.

In some cases, plexitis of the shoulder joint develops in newborns and is a birth injury. During long, difficult labor, stretching of the nerve plexus fibers is possible. Often this condition is accompanied by a fracture of the collarbone.

Causes of postpartum plexitis of the shoulder joint:

• prolonged presence of the fetus in the woman’s birth canal;
• broad shoulders of a newborn;
• the hand of the fetus lowered down.

However, most often shoulder plexitis develops in adults. Various reasons can lead to the occurrence of the disease:

1. About a quarter of all patients suffer from an infectious form of brachial plexitis. Infectious damage to nerve cells can be viral or bacterial in nature.
2. Injuries. Various injuries to the arm, back and neck can lead to the development of the disease: sprains, dislocation of the shoulder joint, fractures, bruises, open wounds.
3. Compression of the brachial plexus. Such compression can occur during prolonged use of a crutch, during prolonged stay in an uncomfortable position, as well as due to the growth of a tumor or arterial aneurysm.
4. Autoimmune diseases in which the plexus cells of the shoulder joint are damaged by a person’s own immune complexes.
5. Metabolic diseases, such as diabetes. Metabolic disorders can lead to malnutrition of the brachial plexus.
6. Spinal diseases: osteochondrosis, presence of cervical ribs.
   In most cases, patients develop unilateral plexitis affecting the dominant arm.

This makes the disease even more severe, since in advanced cases the arm on the affected side is completely inactive, and the person is helpless.

Symptoms of the disease

At the initial stage of the disease, pain syndrome develops. A person experiences pain in the shoulder joint, which can often occur at night.

The pain intensifies when the joint moves or when pressure is applied to the nerve plexus. The pain is localized near the collarbone and radiates to the arm.

The pain may be shooting or aching.

As the disease progresses, the pain intensifies, and additional symptoms of dysfunction of the nerve fibers arise:

• impaired fine motor skills of the hands;
• development of paralysis and paresis;
• reduction of muscle reflexes;
• impaired tactile sensitivity;
• deterioration of blood supply to the limb: pallor or cyanosis of the skin, swelling of the hand, increased sweating;
• violation of the process of flexion of the elbow joint;
• Some patients experience constriction of the pupil on the affected side and a deepening of the eyeball.

The patient may experience all or part of these symptoms, depending on how widespread the damage to the nerve plexus is.

Treatment of the disease should be comprehensive and aimed at eliminating the cause of the disease.

The therapy uses folk remedies that warm the joint and improve blood flow in the damaged area.

This helps the body fight inflammation on its own. Anti-inflammatory drugs can also be used.

External folk remedies

1. Folk ointment. It is necessary to prepare a mixture of medicinal herbs: St. John's wort, sweet clover and hop cones. The plants are ground into powder or a paste is prepared if the plants are fresh. This mass is mixed with Vaseline in a ratio of 3:5. The ointment should be stored in the refrigerator and applied to the injured shoulder 2-3 times a day.
2. Pepper. Hot peppers need to be chopped and poured with vodka. For half a liter of vodka, take 1 large pepper. The drug is infused for two weeks. after which it is filtered and used to rub the sore shoulder 2-3 times a day.
3. Willow. White willow leaves can be used to make a compress. They are crushed into a paste, applied to the skin around the joint, and wrapped in cellophane and warm cloth. The duration of the procedure is standard: 10–15 minutes.
4. Willow. An infusion of white willow bark has a healing effect. To prepare it, 15 g of powdered bark is steamed in a glass of boiling water and left for 1 hour. Rub the shoulder with this infusion 2 times a day.
5. Angelica. A sore shoulder can be rubbed with a decoction of angelica roots. To prepare the decoction, pour 15 g of the roots into a glass of boiling water and leave in a thermos for 1 hour. Then the broth is filtered and used warm for grinding.
6. Healing collection. To prepare the mixture, you need to mix equal amounts of horseradish root, marshmallow, Adam's root and aloe leaves. 60 g of this mixture is mixed with 100 g of honey and poured with half a liter of vodka. Mix thoroughly and leave for a week. This infusion should be rubbed on the injured shoulder three times a day.
7. Mumiyo. Shilajit has a healing effect. For treatment, a 10% solution of this substance is prepared. It is also used for rubbing.
8. Salt. In therapy, bandages made from a concentrated saline solution are used. Prepare a 10% salt solution. Seafood is best, but you can also use cookware. The solution is heated and natural fabric (gauze or cotton) is soaked in it. This fabric is used as a compress on the sore shoulder. The duration of the procedure is half an hour. The therapy lasts a month.

Healing baths are also used in the treatment of the disease. Baths can be taken daily or several times a week. The water temperature should not be too hot.

For baths, decoctions of medicinal herbs are used, which have an anti-inflammatory effect. The procedure lasts 15 minutes. Baths are best taken before bed. After them, you need to go to bed, wrap yourself warmly and completely relax.

Baths with mint, chamomile, calendula, sage and other medicinal herbs or infusions have a healing effect. To prepare a bath, 50 g of plant material is poured with half a liter of boiling water, left for half an hour, then filtered and poured into the bath.

Decoctions for oral administration strengthen the immune system and have an anti-inflammatory effect. This treatment improves a person’s overall well-being. The use of such drugs must be combined with healing baths and external remedies.

Traditional recipes for oral administration

• Medicinal collection No. 1. Mix two teaspoons of dandelion roots and leaves and parsley seeds and three tablespoons of buckthorn bark and mint leaves. Steam 2 tablespoons of this mixture in half a liter of boiling water, boil over low heat for 2-3 minutes, then leave to steep overnight and filter. Give the patient ¼ cup of this decoction 2-3 times a day.
• Corn silks. To prepare the infusion in a glass of boiling water, you need to take two teaspoons of crushed corn silks. Boil over low heat for 5 minutes, then filter. Standard dosage: 50 ml 3-4 times a day.
• Strawberries. You need to prepare a decoction of strawberry leaves. For 1 cup of boiling water, take 1 tablespoon of crushed leaves, leave for a quarter of an hour, then filter. Standard dosage: 1 glass of infusion 2-3 times a day.
• Lingonberry. Leaves of this plant are taken for infusion. For a glass of boiling water use 2 dessert spoons of crushed leaves. The drug is infused for 15 minutes and filtered. A glass of infusion is drunk in small portions throughout the day.

Physical therapy is also important in therapy.

Physical exercises and joint development contribute to a speedy recovery and restoration of normal innervation of the arm. Special exercises are used for treatment.

It is important to remember that intense physical activity is prohibited in this condition, as this can cause additional injuries and worsen the patient's condition. Exercise should be low intensity, but should be done daily.

Therapeutic exercise for the shoulder joint

1. Move your shoulders up and down. Repeat the exercise 10 times.
2. Reduction of the shoulder blades. Retract your shoulder blades as much as possible, then relax. These movements are also repeated 10 times.
3. Circular movements of the shoulders: bend your arms at the elbows, place your fingers on your shoulders and rotate your arm in the shoulder joint, first 8 times forward, then the same number of times back.
4. Bend sideways in the direction of the injury, hang your hand and draw circles with it, first 8 times clockwise, then the same number of times counterclockwise.
5. Bend forward, bend and straighten your arm at the elbow 8 times. If this exercise is difficult to do, you can help yourself with your healthy arm.
6. Extend your affected arm forward, make a fist and rotate it clockwise and counterclockwise. Repeat rotation 10 times.

Prognosis and prevention

With timely diagnosis and comprehensive treatment of the disease, the prognosis is favorable: it is possible to completely restore the innervation of the hand.

To prevent plexitis, you need to lead a healthy lifestyle and exercise. Swimming is a good preventive measure.

This sport provides adequate stress on the shoulder joint, and also promotes well-being and improved health.

Source: http://nmed.org/pleksit-plechevogo-sustava.html

About plexitis of the shoulder joint, characteristic symptoms and treatment methods

The appearance of painful sensations in the body negatively affects a person’s condition in any aspect. But it’s especially difficult when pain makes it difficult or impossible to complete the simplest tasks.

So, the symptoms of plexitis of the shoulder joint can disable the arm.

The success of treating the disease depends on the timeliness and completeness of the diagnosis: if the problem is detected as early as possible, the probability of a complete cure is quite high, but delay threatens the emergence of serious complications, including loss of control over the hand.

Plexitis, or plexopathy, of the shoulder joint in medicine is usually called an inflammatory pathology affecting the branches of the nerve plexus located in the shoulder near the subclavian artery.

The degree of damage to nerve fibers in plexitis of the shoulder joint can vary from local inflammation of individual nerve bundles to the spread of the inflammatory process along the entire long branch of the nerve trunk, innervating the skin and muscles of the adjacent upper limb from the shoulder to the fingertips.

The presence of the disease is indicated by pain not only in the area of ​​the shoulder joint and collarbone, but also in the neck, scapular region, and arm.

Due to the fact that in most cases the pathology affects the dominant hand, a person suffering from plexitis is partially or completely unable to work.

Types of plexitis of the shoulder joint

The disease can be left- or right-sided, and there is also a bilateral form, which is considered the most complex.

Bilateral brachial plexitis is accompanied by excruciating painful symptoms and weakness in both arms and requires longer treatment and a lengthy course of rehabilitation.

Depending on the factor causing the pathology, plexitis is divided into the following types:

• Toxic, in which the disease is preceded by poisoning.
• Traumatic, occurring after mechanical damage to the nerve plexus.
• Infectious, caused by the penetration of pathological microorganisms into the nervous tissue.
• Dysmetabolic, associated with metabolic disorders.
• Infectious-allergic, occurring as a reaction of the body to certain types of vaccines.
• Compression-ischemic, which is caused by prolonged compression of nerves or staying in an uncomfortable position, which disrupts tissue nutrition processes.

Causes of inflammation

The brachial plexus is formed by the lower cervical and upper thoracic spinal nerves.

The following factors can lead to their inflammation:

1. Traumatic injuries – dislocations, fractures, wounds, sprains and bruises in the area of ​​the collarbone and shoulder joint.
2. Long-term irritating effects on the nerves that form the brachial plexus due to the characteristics of professional activity (the effect of vibration), compression of the nerve branches due to an uncomfortable posture during sleep, walking with crutches.
3. Thoracic or cervical osteochondrosis.
4. Hypothermia.
5. Birth trauma in a child.
6. Pathologies of lymph nodes.
7. Viral or bacterial infection (cytomegalovirus, herpes, etc.).
8. Compression of nerve fibers by malignant neoplasms, accessory cervical ribs or an aneurysm - a pathological protrusion of the wall of a nearby blood vessel.
9. Metabolic disorders and related diseases - diabetes, gout, etc.

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Plexitis of the shoulder joint differs in the nature of its course (chronic or acute), the extent of damage to the nerve bundles and the stages of the process.

It is customary to distinguish the following stages of pathology:

1. neuralgic, when the patient is bothered by a sharp pain that worsens when trying to move the arm in the shoulder joint;
2. paralytic, which manifests itself in a decrease in strength in the hand on the side of the affected brachial plexus (monoparesis), or in the complete absence of voluntary movements of the limb (paralysis).

Symptoms are directly dependent on damage to specific bundles of nerves in the brachial plexus. Disruption of innervation contributes to deterioration of trophism in tissues, swelling of the limb, decreased reflexes, and all types of sensitivity.

In some cases, the disease spreads to the cervical plexus, causing pain in the neck, back of the head, paresis of the deep cervical muscles and diaphragm with impaired head movements and persistent hiccups.

The development of shoulder plexitis is characterized by the presence of the following typical symptoms:

• paralysis and atrophy of small muscles of the hand involving the flexor muscles of the fingers and wrist;
• reduction or loss of sensitivity of the skin surface of the forearm and fingers;
• pain localized in the brachial plexus area, as well as spreading along the inner surface of the arm to the hand.

The pain described by patients can be of a different nature. They can be aching, aching, shooting or drilling. Symptoms of paresthesia are mainly observed in the lower part of the affected arm.

With the infectious-toxic nature of the pathology, sensitivity often decreases, reflexes are weakened and lost.

Increased sweating, bluishness of the skin and nails, swelling of the hand, and weak pulsation of the radial artery may appear.

All of the above manifestations are a consequence of vascular and trophic disorders.

With such a development of pathology, additional symptoms of infectious plexitis also appear: regional lymph nodes on the affected side (cervical, supraclavicular, subclavian, axillary, etc.) enlarge and become painful upon palpation.

In rare cases, with complicated plexitis, dysfunction of the eyelids on the affected side, narrowing of the pupil (miosis), and deepening of the eyeball (enophthalmos) may occur.

Diagnostic tests

If plexitis is suspected, after an initial examination, the doctor may prescribe the following diagnostic tests to the patient:

1. X-ray of the shoulder.
2. MRI or CT scan of the affected area.
3. Surface neuromyography (study with a special device of the ability of nerves to transmit impulses under conditions of additional stimulation).
4. Laboratory blood tests.

During the diagnostic process, the doctor excludes the possibility of the patient developing brachial plexus neuritis, glenohumeral periarthrosis and cervical radiculitis.

Treatment methods

The goal of the treatment measures for plexitis is to get rid of the causes that caused the disease. In this case, the following tasks are solved:

• pain is eliminated,
• measures are taken to improve blood circulation and nutrition of the tissues of the affected area,
• normal nerve function is restored,
• the functional abilities of the sore arm return.

Depending on the factors that triggered the development of the disease, the following treatment methods are used:

1. After an injury that causes plexitis, treatment consists of immobilizing the damaged area - applying a fixing bandage to the area of ​​the shoulder joint for a certain period or using a special orthosis. Subsequently, a course of therapeutic exercises is prescribed, starting from the simplest exercises and ending with complex ones.
2. If plexitis is infectious, the nature of the infection is determined, the necessary medications are selected correctly, and antiviral or antibacterial therapy is prescribed. Antibacterial treatment may be accompanied by local or general anti-inflammatory and analgesic therapy. Additionally, a course of vitamin therapy is carried out, in which special attention is paid to B vitamins.
3. Compression plexitis caused by a tumor is treated with surgery.
4. Plexitis caused by cervicothoracic osteochondrosis can be treated with non-steroidal anti-inflammatory drugs, muscle relaxants, massage, physical therapy and physiotherapeutic procedures.
5. For plexitis of ischemic and metabolic-dystrophic etiology, gradual and long-term therapy is necessary.

After the main course of treatment and elimination of the factor contributing to the development of plexitis, they move on to healing types of procedures designed to eliminate all the symptoms of the disease, restore normal blood supply, trophism in the tissues, sensitivity and motor functions of the shoulder joint and the affected limb.

1. therapeutic ozokerite, paraffin and mud applications;
2. if the pain syndrome persists, electrophoresis using lidocaine and novocaine;
3. massage shower;
4. balneotherapy;
5. acupuncture;
6. amplipulse therapy (electrical stimulation of the shoulder area);
7. exercise therapy classes.

The success and speed of treatment of brachial plexitis directly depend on the speed of the patient’s visit to the doctor after the discovery of characteristic symptoms.

According to statistics from American doctors, the lack of adequate treatment for plexitis within a year causes an extremely low percentage of complete recovery (less than 10% of cases).

To avoid such an outcome, the appearance of persistent pain in the shoulder requires immediate examination by an experienced specialist in order to identify the cause of the pathology and prescribe appropriate treatment.

Source: http://pomogispine.com/bolit-v/konechnosti/pleksit-plechevogo-sustava.html

Plexitis of the shoulder joint - how to treat?

After a bad fall, injury, viral infection, or for no apparent reason, pain suddenly occurs in the shoulder joint, the inability to move your fingers or raise your arm. What kind of disease is this - plexitis of the shoulder joint, why is it dangerous and how to quickly recover and avoid complications?

Plexitis in the shoulder joint is a very unpleasant disease that occurs for various reasons. It results in the inability to move the affected arm and is accompanied by severe pain.

What is it, how to determine plexitis? This is an inflammation of the nerve fibers or area of ​​nervous tissue in the shoulder joint, which leads to disruption of innervation and movement in the affected joint.

There may be a decrease in the sensitivity of the skin on the outside of the shoulder and forearm and damage to the muscles responsible for moving the arm. When the entire brachial plexus becomes inflamed, paresis (muscle weakening) or paralysis of the arm is possible.

The patient cannot move his fingers or bend his arm, and this gradually leads to muscle atrophy.

Causes of plexitis of the shoulder joint

The brachial plexus is formed by branches of many nerve fibers - 4 lower branches of the cervical nerves, 1 branch of the thoracic nerve.

In addition, it has quite significant dimensions and a complex structure. The causes of the disease are varied: from birth injuries to viral infections.

Therefore, it is not always possible to accurately determine what caused the onset of the disease.

The most common reasons:

• Injuries to nerve endings as a result of dislocations, sprains, fractures of the bones of the shoulder joint, and fracture of the collarbone.
• Compression of the brachial plexus as a result of prolonged stay in one position, when working in uncomfortable conditions, in bedridden patients or small children.
• Osteochondrosis of the cervical and thoracic vertebrae is one of the most common causes of plexitis.
• Birth trauma – leads to plexitis of newborns.
• Metabolic disorders - diabetes, gout, hormonal disorders.
• Injuries resulting from blows, bruises and gunshot wounds to the neck.
• The constant occurrence of microtraumas as a result of professional activities, the use of crutches, etc.
• Cooling, viral and bacterial infections, inflammatory diseases of nearby organs.

What are the symptoms of the disease

In order to determine whether it really is plexitis, the doctor conducts an examination and pays attention to the following signs:

1. Complete or partial impairment of the functions of the upper limb - the inability to bend the arm, move the fingers, or perform any actions with the affected arm.
2. Pain when moving your arm - especially when trying to lift your arm or put it behind your back.
3. Decreased muscle strength - the patient cannot lift heavy objects or keep them suspended.
4. Impaired fine motor skills.
5. In severe cases, paresis and paralysis of the arm occurs, accompanied by muscle atrophy.

Newborns and older children are susceptible to the disease.

The most common cause of this disease in newborns is birth trauma.

During a difficult birth and incorrect obstetric tactics, hemorrhages, bruises and sprains of the nerve plexuses can occur.

Brachial plexitis occurs as a result of excessive stretching of nerve fibers due to:

• childbirth in the breech or leg presentation,
• mismatch in fetal size,
• hand falling out of the birth canal,
• prolonged standing of the fetus in the birth canal.

When nerve fibers are compressed or stretched, restoration of function begins within a few days. With proper treatment, it leaves no consequences.

With more severe injuries - rupture, bruises, hemorrhage in the nerve plexus, recovery is slow, muscle atrophy occurs, and developmental delays in the affected limb occur. Without intensive treatment and physical therapy, complications may arise in the form of contracture (limited passive movements), osteoporosis and growth retardation.

Diagnosis of this disease can be difficult, and treatment must begin as early as possible.

It is worth paying attention to the following symptoms in a newborn baby - general anxiety, constant crying, strange abduction of the arm, lack of movement and hypertonicity, pain when touching the arm, swelling in the shoulder joint.

Shoulder bandage

Diagnosis and treatment of plexitis

If the first signs of the disease occur, you should immediately contact a specialist.

The sooner treatment is started, the greater the chance of functional restoration and the absence of complications.

To make a diagnosis, the shoulder joint is examined and additional research methods are prescribed:

1. radiography;
2. neuromyography;
3. computed tomography;

In the acute period of the disease, it is necessary to ensure complete rest of the injured limb, give it an abduction position and fix the arm with a plaster splint, bending it at the elbow joint. After this, treatment is necessary to relieve inflammation and restore the functions of damaged nerves and muscles.

• Drug therapy - analgesics to relieve pain and non-steroidal anti-inflammatory drugs, locally and orally.
• Periarticular blockades using anti-inflammatory and analgesic drugs.
• Physiotherapeutic procedures - UHF on the area of ​​the affected joint, electrophoresis with nicotinic acid, diadynamic currents and more.
• Massage should be selected taking into account muscle lesions and aimed at eliminating muscle tissue atrophy.
• Therapeutic exercise – special exercises are prescribed after an acute period of the disease.
• Treatment with traditional methods - there are many traditional medicine recipes used for this disease. For example:
  • compress with white willow bark - pour 15 g of crushed herbs into 1 cup of boiling water and leave for 1 hour,
  • rub 10% mumiyo into the affected joint,
  • soothing baths with mint infusion.

Traditional medicine - help in treatment

If any signs of the disease occur, you should not self-medicate; it is better to consult a specialist and follow his instructions.

Source: http://sustavu.ru/sustavy/plechevoj/pleksit-plechevogo-sustava.html

Treatment of shoulder plexitis

There are many ailments that can affect our body. Every disease tends to incapacitate us, make us incapacitated and poison our lives. And brachial plexitis is no exception to these rules.

This disease is characterized by acute, severe pain that occurs due to damage to the nerve fibers of the joint.

Most often, the disease bothers the working hand, as a result of which we lose the ability to perform our usual activities.

Description of the disease

Our body is completely littered with nerve centers. Such plexuses of nerve fibers are the beginnings of the largest sections of the peripheral nervous system.

There are five such centers in total: brachial, sacral, lumbar, cervical and coccygeal. Plexitis is the name given to diseases that affect these same centers.

Among the most common is brachial plexitis, which is divided into upper, lower and total.

This disease is characterized by severe acute pain, which is initially localized in the collarbone area, and then begins to spread to the arm, neck, and shoulder blade.

More often it affects one specific limb - right or left. It depends on which one you use most often.

So, in right-handed people, plexitis of the shoulder joint of the right hand is more common.

Causes of the disease

Knowing the causes of a disease may be necessary in order to accurately determine the presence of the disease itself, as well as to prevent it in the future by eliminating factors from your life.

A quarter of all calls to specialists with complaints of pain in the shoulder joint of the limb are provoked by infectious diseases.

In second place are various damages, and in third place are disorders in the immune system.

We can list the most common culprits that cause concern to the patient. These are infectious diseases, including damage to the body by viruses.

Various injuries in the shoulder joint - sprains, fractures, bruises, cuts and others.

All kinds of microtraumas of the brachial plexus, most often resulting from prolonged compression of the nerve center. Metabolic disorders in the body.

Diabetes can be cited as the most common culprit in this group. Damage to the lymph nodes. Injuries resulting from childbirth and other less common causes, including hypothermia, osteochondrosis.

Having studied the main causes of damage to the brachial ganglion of the nervous system, you can move on to the symptoms to more accurately determine the disease.

Symptoms

Symptoms of plexitis of the shoulder joint are characterized by the presence of several manifestations at once: paralytic and neuralgic.

Neuralgic symptoms include the most important symptoms of the disease - severe and acute pain, which is localized to the collarbone area.

The pain may intensify with pressure or movement.

Very often the pain spreads along the nerve fibers. Specialists have to fight to eliminate it in the arm, shoulder blade and even neck.

Paralytic symptoms concern the muscles of the arm, the sensitivity of which, as well as motor activity, depends on the conductive function of the nerve plexus of the shoulder joint:

1. Paralysis and paresis, decreased arm strength, inability to perform basic actions, and in rare cases, muscle atrophy.
2. Reduced sensitivity.
3. Increased sweating of the palms.
4. Failures in reflexes - reactions to hot or cold, sharp pain.
5. Pallor of the hand, swelling, predominance of blue skin tone.

The symptoms presented are not a complete list.

Other discomforts or problems with the muscles attached to the arm bone may occur, but are less common.

In addition, you can list the symptoms characteristic of one or another group of causes of damage to the nerve plexus of the shoulder joint.

Treatment methods

Damage to the nerve plexus of the shoulder joint should be treated only after a comprehensive diagnosis. Based on its results, the exact cause of the disease will be determined, and during treatment it will be affected specifically.

Nerve plexus disease should be treated according to an individually developed scheme by a neurologist.

Most often, the complex of such measures includes additional conditions, such as preventing the arm muscles from freezing in the cold, standardized physical exercises.

exercise and stopping work with highly toxic substances.

If this is not done within a year, atrophy of the muscles of the limb may develop, which will ultimately lead to disability.

During treatment, painkillers are prescribed.

After the pain is stopped and removed, they begin to directly eliminate the cause of damage to the nerve plexus.

For this purpose, physical therapy is actively used. exercises, physiotherapy, including electrophoresis, and sometimes resort to folk remedies.

Physiotherapy

Electrophoresis is the most commonly used physical procedure to treat such a disease. Its essence is that medicinal components, under the influence of electric current from electrodes, penetrate into the shallow layers of the epidermis, where they enter the blood through capillaries.

Electrophoresis has three mechanisms of action at once. Reflex - due to indirect reactions. Humoral - due to the fact that drugs penetrate the blood and lymphatic system.

Local - due to the fact that medical agents penetrate into the place where the pain is localized in a concentrated state.

Electrophoresis has analgesic, sedative, and anti-inflammatory effects.

The current from the electrodes helps improve metabolism, nutrition of organs and tissues.

Electrophoresis, thanks to the electric current from the electrodes, promotes the production and release of biologically active substances into the blood.

Physiotherapy

After the most severe pain has been eliminated, you can begin to perform physical exercises to develop mobility of the shoulder joint, as well as to develop the muscles attached to the bone of the affected limb. Such physical exercises can be represented by the following list:

1. alternating raising and releasing the shoulders, bringing and spreading the shoulder blades;
2. performing smooth circular movements with the shoulder joints;
3. flexion and extension movements of the affected limb;
4. a set of exercises on the Swedish wall;
5. performing forearm turns;
6. cross and swing movements.

When performing exercises, you should monitor your condition with special trepidation. If severe pain occurs, you should stop performing such physical procedures.

When medications don't help

The disease can also be treated at home. The main thing is not to forget to follow the doctor’s instructions. Self-massage and folk remedies can be effective helpers in the fight against the disease. Self-massage should be performed standing or sitting.

Treatment with folk remedies can be a serious help in the fight against such a serious illness.

Folk remedies were developed by our ancestors over many centuries. Their advantages include environmentally friendly components.

Treatment with folk remedies can be represented by the following list:

Cabbage compress. Hold a white cabbage leaf over steam and apply it to the area of ​​pain before going to bed. Remove the compress in the morning.

Willow bark compress. Pour 15 grams of finely chopped bark into 250 ml of boiling water, leave for an hour, then strain, wet a towel and apply to your shoulder overnight.

Propolis ointment. Crush three grams of propolis and mix with 50 grams of lard. Rub the ointment into your shoulder, shoulder blade and upper arm.

Willow porridge. Grind the willow leaves to a paste, then apply to the sore joint and secure with a bandage.

Mint bath. Pour the prepared mint decoction into a bath with comfortable water. Water procedures should not exceed 15 minutes. After them, you should immediately lie down in a warm bed. Contraindicated for persons with cardiovascular diseases.

The presented folk remedies are not a complete list. You can find many more methods of treatment that can be called traditional.

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

The progression of this disease can be caused by injury to the nerve plexus due to fractures, a history of disorders such as tuberculosis, diabetes mellitus or syphilis, allergies or drug overdose. In a newborn, the disease develops against the background of birth injuries. The severity of symptoms depends on the type, location and severity of the disease. The first sign is pain, which is constant and increases with movement or minor physical activity.

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

Etiology

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

• oxygen deficiency of the nervous tissue due to prolonged compression by neoplasms and immobility of the limbs;
• complications after major surgical interventions;
• diabetes mellitus, syphilis, tuberculosis and other infectious processes;
• allergies to food, medications or vaccines;
• drug overdose;
• unfavorable environmental conditions;
• harmful working conditions;
• violation of metabolic processes;
• poisoning of the body with chemicals;
• a wide range of injuries - falls, dislocations, cuts or stab wounds;
• birth injury.

Varieties

There are several classifications of plexite, differing in many factors. According to the place of origin of the inflammatory process, they are distinguished:

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

According to the method of spread of the pathological process, the disease is divided into:

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

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

• partial – individual nerve trunks are affected by pathology;
• total - the lesion extends to the entire structure of the plexus.

Symptoms

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

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

Symptoms of cervical plexitis:

• manifestation of pain in the front and side of the neck, which intensifies when bending and turning;
• spread of pain to the back of the head, shoulder blades and ears;
• difficulty moving the head;
• constant hiccups that cause discomfort;
• sensitivity disorder.

Manifestations of plexitis of the lumbosacral region:

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

Symptoms of plexitis of the coccygeal plexus are: impaired emission of urine and feces, disorder of sexual function.

Diagnostics

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

Laboratory studies of blood tests are aimed at detecting additional signs of the disease - an increase in the concentration of leukocytes. Hardware examinations of the patient consist of:

• Ultrasound of the pelvic area;
• electroneurography – measurement of the speed of passage of a nerve impulse;
• electromyography - a technique that allows you to evaluate muscle activity;
• radiography of the affected area;
• CT scan of joints;
• Whole body MRI.

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

Treatment

Treatment of plexitis is aimed at completely eliminating the factors causing the disorder. If the disease is infectious, patients are prescribed antiviral and antibacterial medications. Metabolic plexitis is eliminated by normalizing sugar levels. Medical intervention is necessary for post-traumatic and compression type of illness. Therapy involves removing tumors and blood clots that may be compressing the plexus. For any etiology of plexitis the following is prescribed:

• painkillers and hormonal medications;
• vitamin complex;
• physiotherapy – treatment with current and magnetic fields, acupuncture and hydrotherapy;
• a course of physical therapy both in a rehabilitation room and at home.

Plexitis of the shoulder joint - characteristics

Painful sensations, no matter what location they have, negatively affect a person’s condition in all aspects. Poor health not only prevents you from completing planned tasks in a timely manner, but also significantly spoils your mood, making a person irritable and tired.

It is especially difficult when pain makes it difficult to perform the simplest tasks. For example, symptomatic manifestations of plexitis of the shoulder joint can disable the arm, making it impossible not only to move it, but even to sleep on the affected side.

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

In addition, over time, serious complications may arise that threaten loss of control over the entire arm, so if you suspect the development of plexitis, you should undergo examination in the hospital.

The prognosis of treatment depends entirely on the speed of the patient’s reaction - the earlier the problem is detected, the greater the likelihood of a positive treatment result. Plexitis of the shoulder joint is an inflammatory disease in which damage to the nerve structures of the shoulder is observed.

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

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

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

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

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

The pain increases significantly when you try to make some movements, for example, raise your arm or move it to the side. Also, this symptom becomes more intense at night. At the same time, fine motor skills suffer.

It is difficult for the patient to perform actions with his fingers (tying shoelaces, holding objects, opening locks on doors, etc.) As the disease progresses, the limb completely loses sensitivity, paralysis, paresis, and atrophy of the muscles of the right or left hand develop, depending on the location of the pathological process.

Pathogenesis of plexitis

The muscles of the shoulder girdle and upper limb are affected, deep reflexes in the upper limb decrease or disappear. Vegetative-trophic disorders develop in the form of cyanosis or pallor of the hand, pasty hands, sweating, impaired trophicity of the nails, etc.

Plexitis has two stages of progression:

1. 1. neuralgic
   2. paralytic.

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

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

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

Classification and types

The brachial plexus is divided into external, posterior and internal bundles, which form a kind of cocoon around the axillary artery. Such bundles consist of sensory and motor nerves that 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 Duchenne-Erb, paralysis and lower, Dejerine-Klumpke), mainly on one arm (occasionally - both).

Erb-Duchenne palsy (superior plexitis). Manifestations in this form of the disease are similar to symptoms of irritation of the radial and axillary nerve. The work of many muscles is disrupted, in particular, the brachialis, biceps, deltoid, brachioradialis, and sometimes the infraspinatus and supraspinatus suffer.

If left untreated, the pathological process leads to their atrophy. With this form of the disease, it is difficult for the patient to lift and move the shoulder to the side, and bend the limb at the elbow. The reflexes of the biceps muscle weaken and may eventually disappear completely.

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

Dejerine-Klumpke's palsy (inferior plexitis of the shoulder). Inferior plexitis is characterized by damage to the nerve plexuses of the shoulder, elbow, skin and part of the median nerve. With this form, the main impact falls on the muscles of the hand, except for the area that is regulated by the radial nerve.

Dejerine-Klumpke palsy manifests itself as paresis and paralysis of the muscles of the forearm and hand. Atrophic changes extend to such small muscles as the hypothenar, lumbrical, interosseous, flexors of the fingers and hands.

There is a violation of motor skills, finger movements become significantly more difficult, and the carporadial reflex fades. Sensitivity disorder and pain spread to the inner part of the shoulder and forearm, ring finger, and little finger. The same symptoms occur on the dorsum of the hand. In addition, it is possible to detect Horner-Bernard syndrome.

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

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

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

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

In newborns, such an injury, often accompanied by a fracture of the collarbone, also occurs due to:

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

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

In addition to the fact that the pathology causes discomfort and pain to the patient, it can lead to disability up to a complete lack of ability to self-care.

Causes

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

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

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

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

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

Involvement of the nerves emanating from the plexus in the pathology leads to disturbances in the area of ​​the shoulder, forearm, elbow joint and small joints of the hand. Brachial plexitis leads to atrophy of the muscles of the shoulder and upper shoulder girdle. The development of plexitis of the shoulder joint can be provoked by the following unfavorable factors:

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

Shoulder and cervical plexitis in newborns occurs with pelvic and leg presentation, prolapse of the fetal arm during childbirth, and prolonged stay of the child in the birth canal of the mother.

The most common cause of this disease in newborns is birth trauma. During a difficult birth and incorrect obstetric tactics, hemorrhages, bruises and sprains of the nerve plexuses can occur. Brachial plexitis occurs as a result of excessive stretching of nerve fibers due to:

• • childbirth in the breech or leg presentation,
  • mismatch in fetal size,
  • hand falling out of the birth canal,
  • prolonged standing of the fetus in the birth canal.

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

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

It is worth paying attention to the following symptoms in a newborn baby - general anxiety, constant crying, strange abduction of the arm, lack of movement and hypertonicity, pain when touching the arm, swelling in the shoulder joint.

Symptoms

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

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

• • A pain syndrome that spreads along the affected nerve plexus and can be observed both on the back and on the inside of the arm.
  • Paralysis and paresis.
  • Atrophic changes in the muscles innervated by the nerve involved in the pathological process.
  • Loss of sensitivity on the inside of the limb.
  • Difficulty when trying to move the affected limb.

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

A similar clinical picture is clearly expressed if the cause of the development of plexitis is a viral infection. The pain is sharp, aching, shooting, aching in nature. Sensory impairment in most cases is observed in the lower part of the limb.

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

Sometimes plexitis of the shoulder joint can be determined by the behavior of the eye located on the side of the affected shoulder: disturbances in the functioning of the eyelid muscles, deepening of the eyeball and narrowing of the pupil may be observed.

When the infectious-toxic process spreads to nearby tissues, pain develops, reminiscent of brachialgia in nature. This disease may be accompanied by enlargement of the cervical lymph nodes on the affected side and their pain.

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

Undoubtedly, pain makes life much more difficult, but the main danger of the disease does not lie in constant discomfort. Without proper treatment, nerve fibers become increasingly damaged, which initially threatens to impair fine motor skills, and subsequently to disabling all functions and atrophy of muscle tissue.

Diagnosis of pathology

If the first symptoms occur, you should not postpone a visit to a specialist; delay can lead to difficulties in treatment and recovery. The following diagnostic tests may be prescribed by your doctor:

1. 1. shoulder x-ray;
   2. CT (computed tomography) scan of the affected area;
   3. Magnetic resonance imaging (MRI) may be prescribed for diagnosis;
   4. ultrasonography;
   5. superficial neuromyography (using a special device, the state of the nerves and the process of transmitting impulses with additional stimulation are studied);
   6. blood analysis.

When diagnosing plexitis of the shoulder joint, treatment should be started immediately. It is really necessary to rush into treatment, since in most cases, after a year, the damage reaches the stage where it is no longer possible to restore the damage.

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

Plexitis of the shoulder joint - treatment

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

After the final diagnosis is established, treatment of the disease begins. It should be remembered: the sooner therapy is started after the first symptoms of the disease appear, the more favorable the prognosis for recovery.

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

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

• • painkillers - novocaine blockades, analgin, aspizol, oxadol;
  • non-steroidal anti-inflammatory drugs (NSAIDs) – diclofenac, nimesulide, indomethacin;
  • vitamin therapy based on vitamins B, A, C, E - neurovitan, milgamma, aevit, ascorbic acid;
  • anticholinesterase drugs that improve the conduction of nerve impulses - proserin, kalimine, invalin;
  • decongestants – beckons, urea;
  • trophic drugs – nicotinic acid, potassium orotate, nerobol, lidase;
  • means for improving microcirculation - trental, complamin;
  • physiotherapy – ultrasound with hydrocartisone, electrophoresis with novocaine, magnetic therapy, ozokerite;
  • massage during the period of subside of the acute inflammatory process;
  • physiotherapy;
  • traditional treatment;
  • reflexology (acupuncture), laser therapy, balneotherapy (mineral water treatment), cryotherapy (local exposure to low temperatures).

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

To relieve pain, the doctor prescribes painkillers (selected individually based on the patient’s condition). The main therapy for plexitis is anti-inflammatory. Non-steroidal anti-inflammatory drugs are often prescribed; they perform two functions at once - they reduce the inflammatory process and relieve pain.

These medications are available in both tablet and injectable liquid form. When the disease is at an advanced stage, more serious hormonal-type drugs are required to reduce inflammation.

They effectively fight inflammation and promote tissue regeneration. The type of treatment depends on the underlying cause of the disease. So, if plexitis provoked an infectious process, then antibiotics will definitely be present in the prescription.

Treatment is often supplemented with a course of vitamins to improve processes occurring in the body. During drug treatment, in order to prevent or slow down muscle atrophy, electrical stimulation is prescribed - an electrical effect on soft tissue, which stimulates the muscles to contract and thereby keeps them in good shape.

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

1. 1. to reduce pain, electroanalgesia with short pulses or medicinal electrophoresis is prescribed;
   2. UHF therapy will help prevent the accumulation of fluid in the joint to prevent the accumulation of fluid in the joint capsule - UHF therapy;
   3. infrared laser therapy and ultrasound therapy will help accelerate tissue restoration;
   4. neurostimulating procedures – neuroelectric stimulation and bioregulated stimulation;
   5. vasodilation will be facilitated by irradiation with infrared rays and high-frequency magnetic therapy.

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

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

Sometimes severe injuries require surgery. Doctors often prescribe antibiotics, vitamins and other medications to treat shoulder plexitis. However, the main focus is on physiotherapy, massage and therapeutic exercises.

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

Physiotherapy

To treat plexitis, special physical training and massage sessions are additionally prescribed. In both the first and second cases, a set of exercises is compiled individually for each patient to achieve the best effect.

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

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

Finger motor skills are restored by grasping, feeling and moving small objects - beads, peas, screws. It is useful to engage in swimming and water aerobics. It is necessary to avoid hypothermia, intense sports, and heavy physical labor.

As for massage, you should start the procedures with professional sessions, and then you can continue on your own. The process usually comes down to a thorough kneading of the neck, arms and shoulder girdle, often with a technique of targeted impact on biologically active zones.

After recovery, it is imperative to follow preventive measures to avoid recurrence of the disease. As a preventive measure, experts recommend swimming and other physical activities, but within reasonable limits.

ethnoscience

Uncomplicated plexitis of the shoulder joint can be cured using folk remedies. However, before using this technique, you must consult your doctor. In the treatment of plexitis of the shoulder joint, a natural product such as mumiyo is often used.

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

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

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

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

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

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

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

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

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

Plexit - what is it?

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

Types of plexites

There are not many large nerve plexuses in the human body.
These are the brachial plexus, lumbosacral, cervical plexus and lumbar, respectively, and there are just as many varieties of plexitis, i.e. brachial plexitis (also known as brachioplexitis), cervical plexitis, lumbar and lumbosacral. If the disease affects only one limb, we are talking about a unilateral process; with a bilateral process, both limbs are affected.

Causes of plexitis

There are not many reasons for the occurrence of plexitis, but according to statistics, various injuries come first. And not only those received in adulthood (for example, a strong blow to the plexus area, a fracture or bruise of the arm, or a fall on the tailbone). Obstetricians are also familiar with post-traumatic plexitis, since the disease can also occur as a consequence of birth trauma - Duchenne-Erb's palsy. Other causes of plexitis include:

1. 1. Metabolic disorder (diabetes mellitus)
   2. Alcohol abuse (especially “left”)
   3. Infections (tuberculosis, Lyme disease and many others)
   4. Dislocations are especially dangerous, since along with them there is also overstretching of the nerves (but they can also be attributed to post-traumatic causes)
   5. Osteochondrosis of the cervical spine.
   6. Distortion of posture.
   7. Prolonged and frequent stay of a person in an uncomfortable position

Symptoms of plexitis

Unfortunately, our people (especially the “Soviet” generation) go to the doctor only when they feel really bad. Few people pay attention to minor pain in the neck or back. Well, just think, I’m tired at work, now I’ll lie down and everything will pass. Meanwhile, it is pain in the shoulder area that can indicate the occurrence and development of brachial plexitis.
When cervicobrachial plexitis occurs, pain is localized in the neck or scapula area. When you move your arm and tilt your head (especially in the direction of the injury), the pain worsens (even to the point of a sharp shooting).

Pain in the thigh that radiates to the buttock may indicate lumbar plexitis. Plexitis of the coccygeal plexus is characterized by the absence of the anal reflex, disorders of defecation, urination and sexual function.
Painful sensations can occur both on their own and during movement. At night the pain intensifies.

Complications with plexitis

Unfortunately, it is difficult to cure plexitis completely and without consequences, even with the modern level of development of medicine. But the earlier the disease can be diagnosed and treatment started, the greater the chances. But if plexitis is not treated, the consequences can be disastrous:

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

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

Diagnosis of plexitis

Determining the development of plexitis visually is quite difficult. To obtain a more accurate picture, X-rays of the affected area, neuromyography (a procedure to determine the extent of nerve damage), magnetic resonance imaging (to identify the cause of the disease), and blood samples are taken.
It is very important not to confuse plexitis with other diseases that have similar symptoms, for example radiculitis.

Otherwise, there is a chance that the person will be treated for a long time and unsuccessfully, and even for another disease. An additional consultation with a neurosurgeon will also not be superfluous.

Treatment of plexitis

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

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

• • magnetotherapy and electrophoresis with novocaine
  • Light massage to improve blood circulation and restore sensitivity to damaged tissues
  • Therapeutic exercise to improve metabolism, as well as to restore the strength and elasticity of atrophied muscles
  • acupuncture
  • Swimming and water aerobics help a lot
  • For faster recovery, ultrasound and laser therapy are used.

Plexitis code according to ICD 10

In the ICD (International Classification of Diseases) reference book, plexitis is located in the following sections:

G54.1- damage to the lumbosacral plexus

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

Brachial plexitis is a pathology of the shoulder joint, which is accompanied by damage to the nerves of the brachial plexus. The disease manifests itself as acute pain in the collarbone area, with pain radiating to the neck, shoulder blade and arm. Most often, brachial plexitis affects the working arm; most patients develop plexitis of the right hand; if a person is left-handed, then brachial plexitis of the left hand develops. Quite often, this disease becomes the reason for the inability to live a full life; the patient loses the ability to move his arm, cannot lie on the affected side and becomes completely helpless even in simple everyday situations, not to mention the loss of ability to work.

Symptoms of the disease

Acute pain in the shoulder, arm, collarbone, which usually gets worse at night. Over time, the pain progresses and becomes more severe.

When performing hand movements, pain occurs, especially if a person loads the affected limb or lifts weights.

The hand often swells, becomes numb, a bluish tint to the skin appears, and often a feeling of coldness appears.

Increased sweating of the palms.

Impaired sensitivity of the skin.

Difficulties in making sudden movements in everyday life (working with a computer keyboard and mouse, unfastening a button, movements when eating).

Decreased muscle strength (triceps, biceps) and reflexes.

Causes of shoulder plexitis

The most common cause of the development of shoulder plexitis is an injury that was received during increased physical activity, sports training, at work, or in a road accident. In the event of such injuries, stretching of the brachial plexus is observed, and in some cases even its rupture with damage to the artery.

Other possible causes of pathology:

aneurysm of the subclavian artery;

working with vibrating tools;

diabetes mellitus, gout, metabolic disorders;

prolonged stay of the hand in an awkward position or a pinched position, for example, during sleep or in patients bedridden;

shoulder dislocation, collarbone fracture;

osteochondrosis of the spine in the cervicothoracic region;

knife and gunshot wounds;

presence of tumors;

birth injury;

acute infectious diseases;

prolonged exposure to the cold with the development of hypothermia of nerve endings.

It is customary to distinguish three forms of brachial plexitis: total, superior, and inferior.

Inferior brachial plexitis, or Dejerine-Klumpke plexitis, is caused by damage to the lower nerve trunks of the brachial plexus and usually causes pain to radiate to the elbow and forearm.

Superior brachial plexitis, or Duchenne-Erb plexitis, is caused by damage to the superior trunks of the brachial plexus and usually affects the supraclavicular area of ​​the shoulder.

With total plexitis, there is a combination of symptoms of upper and lower plexitis.

Diagnostics

The following methods are used to diagnose the disease:

initial examination;

CT scan;

X-ray examination;

ultrasonography;

MRI of the shoulder joint and soft tissues of the shoulder.

When performing diagnostics, it is extremely important to differentiate plexitis from glenohumeral periarthritis, cervical radiculitis, and brachial plexus neuritis.

Treatment of brachial plexitis

If you experience acute pain in the shoulder area, you should visit a doctor as soon as possible. The sooner treatment for the disease is started, the higher the likelihood of a favorable prognosis and recovery. According to American experts, if you wait a year and do not start treatment for plexitis, muscle atrophy subsequently develops, and recovery occurs very rarely, only in 10% of cases.

Treatment of brachial plexitis is a rather lengthy procedure; it is carried out according to a scheme individually developed for each patient. If the cause of plexitis is an arm injury, the arm must be immobilized with a bandage, and over time, physiotherapy exercises should begin - special exercises: at first quite simple and gradually to more complex ones. In some cases, severe hand injury may require surgery.

Also, quite often, treatment of the disease involves the use of antibiotics, vitamins and other medications, but still the main focus is on physiotherapy, therapeutic exercises and massage.

Among other things, the following can be used to treat brachial plexitis:

acupuncture;

healing shower;

diadynamic therapy;

amplipulse therapy - stimulation of the affected area with electric current;

electrophoresis;

heat treatment - use of ozokerite, paraffin compresses;

warming mud baths.

Treatment of brachial plexitis with folk remedies

Turpentine solution - 2 tablespoons of turpentine are mixed with 2 tablespoons of ammonia and 2 raw eggs. The resulting mixture is whipped to a thick consistency and washed into the shoulder overnight.

Propolis ointment – ​​50 grams of pork fat is mixed with 3 grams of propolis and rubbed into the arm, shoulder blade, shoulder.

Compress with willow – 15 grams of white willow bark is crushed and poured with a glass of boiling water for an hour, then filtered and a compress is applied to the affected area.

Shilajit solution - an 8-10% alcohol solution is rubbed into the affected area for 5-7 minutes for three weeks, followed by a pause of one week and then repeating the course.

Cabbage compress - take a cabbage leaf, lightly steam it and apply it to your shoulder overnight, wrapping it in a bandage and placing a woolen scarf on top of the bandage.

Lingonberry infusion - pour boiling water over two teaspoons of lingonberries and leave for 15-20 minutes, after which they drink 1-2 sips throughout the day.

Prevention of the development of shoulder plexitis

Avoiding injury.

Timely treatment of acute infectious diseases, gout, diabetes.

Exercising regularly in the morning.

Reducing increased stress on the body in general and the shoulder girdle in particular.

Swimming in the pool is an excellent shoulder workout that prevents overuse.

If acute pain occurs in the shoulder area, you should visit a doctor as soon as possible, since otherwise complications and further progression of the disease are possible.

Plexitis of the shoulder joint develops as a result of complete or partial inflammatory damage to the nerves of the brachial plexus. If it lasts for a long time, it can lead to loss of ability to work in the upper limb. It occurs more often in middle-aged people, but is often detected in newborns as a result of trauma during obstetrics.

Causes

The brachial plexus is formed by the lower spinal nerves of the cervical segment and the upper thoracic. Inflammation occurs due to:

• traumatic injuries - fractures, dislocations, sprains, bruises in the area of ​​the shoulder joint and collarbone;
• osteochondrosis of the cervical or thoracic segments;
• long-term irritation of the plexus nerves due to professional activity (vibration exposure), with compression of nerve endings when walking on crutches, with an uncomfortable posture during sleep;
• birth trauma;
• hypothermia;
• infectious and viral diseases;
• compression of nerve endings by a tumor, aneurysm, additional cervical ribs;
• metabolic diseases - gout, diabetes.

Symptoms

Depending on the type of lesion, plexitis is distinguished:

• upper - manifested by damage and spread of pain in the supraclavicular region;
• lower - manifested by damage and spread of pain in the area of ​​the elbow joint, forearm, hand;
• total – manifested by a combination of symptoms.

Plexitis of the shoulder joint occurs in two stages:

• neuralgic – characterized by acute pain in the arm, which intensifies with exercise, wide-amplitude movements and at night;
• paralytic – manifested by impaired sensitivity, numbness, feeling of cold, trophic changes in the skin and nails. Impaired fine motor skills, decreased reflexes and strength of the shoulder muscles. In severe cases, paresis and paralysis of the arm with severe muscle wasting.

In some cases, more often with a viral infection, a disorder of eyelid movement, constriction of the pupil, and deepening of the eyeball on the side of the affected limb may occur.

Diagnostics

To confirm brachial plexitis, the following is performed:

• X-ray examination;
• ultrasonography;
• electroneuromyography;
• Magnetic resonance or computer tomography.

Treatment of shoulder plexitis

During the period of acute manifestations of the disease, drug treatment is used, aimed at eliminating pain and improving nutrition and blood circulation of tissues. Rest of the affected limb is required, with the application of a fixing bandage and maximum limitation of the load.

Drug treatment includes prescribing:

• painkillers for local blockades (with novocaine, analgin);
• non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen);
• neuroprotective agents (milgamma, B vitamins);
• dehydration drugs for severe edema (urea, beckons);
• antibiotics and antiviral drugs for infections.

During the recovery period, physiotherapeutic procedures are used:

• electrophoresis;
• cryotherapy;
• hirudotherapy;
• ozokerite;
• massage;
• reflexology;
• therapeutic exercises.

Surgical treatment is used in cases of compression of the brachial plexus by a tumor, aneurysm, or bone fragments as a result of injury.

Therapeutic exercises for plexitis of the shoulder joint

In a sitting or standing position:

• straightening your shoulders, bring your shoulder blades together and spread them apart;
• raise and lower your shoulders up and down at a calm pace;
• bend your elbows, spread them to the sides, place your hands on your shoulder girdles. Perform a circular rotation in the shoulder joint forward and backward;
• tilt your torso towards the injured arm. Perform a circular rotation in the shoulder joint forward and backward;
• lean forward, bend and slowly straighten the arm at the elbow joint;
• Extend your arms straight, palms up, then down.

Perform each exercise 8-12 times, gradually increasing the number of repetitions to 18-25 times.

Treatment with folk remedies
As a complement to pharmacological and physiotherapeutic treatment, you can use rubs and ointments made according to traditional medicine recipes:

• mix a quarter cup of Vaseline with crushed herbs St. John's wort, sweet clover and hops. Rub the resulting ointment onto painful areas several times a day;
• To prepare an anti-inflammatory rub, you need to mix half a glass of honey with a mixture of horseradish root, marshmallow, Adam's root and aloe leaves. Pour the resulting composition with half a liter of vodka and leave for 72 hours. Rub the mixture into the affected hand up to 3 times throughout the day;
• angelica tincture for rubbing. Pour boiling water over the crushed angelica root and leave for about 2 hours. Use for rubbing;
• ointment for rubbing. Mix 50-100 g of pork fat with 3-6 g of propolis, rub into the area of ​​the shoulder girdle and into the affected arm;
• anti-inflammatory rub based on turpentine. Mix 30 ml of turpentine with 30 ml of ammonia and 2 eggs, beaten into foam. Rub the resulting mixture into the shoulder area and shoulder blade before going to bed. For rubbing, you can also use an alcohol solution of mumiyo with a concentration of 8-10%;
• warming compress. Grind willow bark, cover with boiling water for 1-2 hours, strain. Use the resulting infusion for compresses on the shoulder joint area.

Plexitis of the shoulder joint (shoulder) is an inflammation of the brachial plexus. Often the cervical plexus is involved in the pathological process due to the anatomically close location of the nerves in the neck and upper shoulder girdle.

The disease is more common in able-bodied patients aged 20-50 years; damage to the dominant hand leads to disability and difficulty in self-care at home. Cervicobrachial plexitis can develop in newborns as a result of birth trauma, which slows down physical development and contributes to impaired motor ability of the affected limb.

Early diagnosis of the disease and comprehensive treatment provide a good chance of recovery. Advanced cases of the disease lead to complete functional failure of the left or right hand.

Causes

The brachial plexus is formed by the first thoracic spinal nerve and the anterior rami of the four lower cervical nerves. A collection of nerve fibers is responsible for the innervation of the upper shoulder girdle, arm, and diaphragm. It contains sensitive, motor and autonomic fibers, which are responsible for various types of sensitivity, motility and trophism of innervated tissues. The cervical plexus is located above the brachial plexus, but is closely connected with it both anatomically and functionally.

When cervical plexitis occurs, especially of an infectious-toxic nature, brachial plexitis often develops and vice versa. As a result of the inflammatory process, the shoulder joint, a large joint responsible for the movement of the upper limb, is primarily affected. Involvement of the nerves emanating from the plexus in the pathology leads to disturbances in the area of ​​the shoulder, forearm, elbow joint and small joints of the hand.

Brachial plexitis leads to atrophy of the muscles of the shoulder and upper shoulder girdle

The development of plexitis of the shoulder joint can be provoked by the following unfavorable factors:

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

Shoulder and cervical plexitis in newborns occurs with pelvic and leg presentation, prolapse of the fetal arm during childbirth, and prolonged stay of the child in the birth canal of the mother.

Clinical picture

Manifestations of plexitis of the shoulder joint depend on the prevalence of the pathology and the stage of development of the disease. The inflammatory process can affect the entire plexus, then they speak of total plexitis, or only individual nerve fibers. When the upper nerve bundles are damaged, Duchenne-Erb's palsy develops, and involvement of the lower nerve bundles in inflammation leads to Dejerine-Klumpke palsy. Rarely does a bilateral process occur, which complicates the course of the pathology. In the international classification of diseases ICD 10, damage to the brachial plexus belongs to subgroup G54.0.

According to clinical manifestations, two stages of plexitis are distinguished. The initial stage is called neurological and is characterized by pain, trophic, sensory, and motor disorders in the upper limb. With a set of therapeutic measures, the symptoms are reversible. The progression of the disease against the background of improper therapy or refusal of treatment causes the transition of plexitis to the paralytic stage, in which persistent paralysis or paresis of the upper extremities develops.

Damage to the shoulder joint due to plexitis impairs muscle contractility

The following clinical signs are characteristic of brachial plexitis:

• intense pain in the shoulder joint at rest, sometimes of a paroxysmal nature, which intensifies during movement and spreads to the arm, supraclavicular and subclavian areas;
• trophic disorders - the skin of the affected upper limb becomes shiny, swollen, cold to the touch, pale or bluish in color, brittle nails and sweaty palms appear;
• decreased sensitivity along the outer surface of the arm in case of Duchenne-Erb palsy and the inner surface of the limb in case of Klumpke-Dejerine palsy;
• weakness and atrophy of the arm muscles, inability to lift the upper limb or move it behind the back, impaired fine motor skills of the fingers, resulting in difficulties in performing basic movements in everyday life and professional activities;
• painful hiccups and difficulty breathing when the phrenic nerve is involved in the inflammatory process;
• rarely, constriction of the pupil and retraction of the eyeball on the affected side occur.

Unilateral or bilateral paralysis of the upper limbs not only causes loss of ability to work, but also leads to loss of self-care skills, which makes patients dependent on the help of others.

Treatment tactics

Before therapy, a diagnostic examination is prescribed, which helps to differentiate plexitis from other neurological pathologies. To do this, electromyography, x-ray of the shoulder joint, computed and magnetic resonance imaging (CT, MRI), and ultrasound are performed. After the final diagnosis is established, treatment of the disease begins. It should be remembered: the sooner therapy is started after the first symptoms of the disease appear, the more favorable the prognosis for recovery.

Plexitis of the shoulder joint in the acute stage requires immobilization of the upper limb

Complex treatment includes measures aimed at the etiological disease that led to the appearance of plexitis. In case of injury, the integrity of the bone is restored, bone processes are removed, and the damaged limb is immobilized. Osteochondrosis requires the appointment of chondroprotectors, and endocrine disorders require the normalization of metabolic processes in the body. Tumors, aneurysms, and additional ribs are removed surgically. Infectious-toxic plexitis is treated with antibacterial agents and detoxification of the body is carried out.

Symptomatic treatment of the disease aimed at its manifestations includes:

• painkillers - novocaine blockades, analgin, aspizol, oxadol;
• non-steroidal anti-inflammatory drugs (NSAIDs) – diclofenac, nimesulide, indomethacin;
• vitamin therapy based on vitamins B, A, C, E - neurovitan, milgamma, aevit, ascorbic acid;
• anticholinesterase drugs that improve the conduction of nerve impulses - proserin, kalimine, invalin;
• decongestants – beckons, urea;
• trophic drugs – nicotinic acid, potassium orotate, nerobol, lidase;
• means for improving microcirculation - trental, complamin;
• physiotherapy – ultrasound with hydrocartisone, electrophoresis with novocaine, magnetic therapy, ozokerite;
• massage during the period of subside of the acute inflammatory process;
• physiotherapy;
• traditional treatment;
• reflexology (acupuncture), laser therapy, balneotherapy (mineral water treatment), cryotherapy (local exposure to low temperatures).

Therapeutic exercises are prescribed to prevent atrophy of the muscles of the shoulder girdle

As an additional method of therapy and prevention of plexitis, you can use folk remedies after the approval of your doctor. The most effective methods include the use of mumiyo with milk, herbal preparations from sweet clover, hops, burdock, and string. Use ointments and baths based on herbal ingredients. It should be remembered that such treatment does not exclude, but complements conservative therapy of the disease.

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

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

Finger motor skills are restored by grasping, feeling and moving small objects - beads, peas, screws. It is useful to engage in swimming and water aerobics. It is necessary to avoid hypothermia, intense sports, and heavy physical labor.

With timely diagnosis and treatment, plexitis of the shoulder joint has a favorable prognosis. Otherwise, persistent motor and sensory disturbances occur in the upper extremities, which leads to disability and loss of self-care ability.