Median nerve symptoms. Neuropathy of the median nerve of the arm

Neuritis median nerve is an inflammatory disease of the peripheral nerve that can cause various types of pain throughout the nerve. A person may experience loss of sensitivity and muscle weakness in the area that this nerve innervates.

Affecting several nerves at once, the disease is called polyneuritis. This disease is diagnosed by a neurologist. In order for neuritis to be correctly and accurately diagnosed, a specialist must conduct a general examination and perform all sorts of specific functional tests. In addition to general inspection the doctor must conduct electromyography, electroneurography and a specially designed study of VP.

A disease such as neuritis can be caused by many reasons. This could be ordinary hypothermia, or various infections, which entered the human body during various injuries, as well as with some vascular disorders, with hypovitaminosis.

Moreover, intoxications such as exogenous and endogenous can also lead to the development of neuritis. Most often, peripheral nerves can affect the musculoskeletal canals. It is worth noting that the anatomical narrowness of this canal can lead to such an unpleasant disease as neuritis and develop the so-called tunnel syndrome.

Often, such a disease can appear due to compression of the trunk of the peripheral nerve itself. This can happen at any time, during surgery or even during sleep. Let's take, for example, a person who long time moves exclusively with the help of crutches. During this time, he may develop neuritis of the axillary nerve.

If a person squats for a very long time, he may develop. If a person’s profession involves constant flexion and extension of the wrist, then he can develop neuritis of the median nerve (this most often applies to people who play the piano and cello).

Causes of median nerve neuritis

There are many reasons for this disease. The appearance of this disease can be provoked by all kinds of injuries to the upper extremities, nerve damage in the process of violating the necessary technique during internal injection into the ulnar vein, various wounds that exist on the surface of the forearm, and overexertion of the hand, which are of a professional nature.

The functionality of the median nerve allows it to be defined as mixed. Due to the fact that it is able to innervate large quantity muscle groups, as a result of their contraction, such types of movements as extension and flexion of two wrist fingers, namely the second and third, are produced. There are also types of movements that are produced by some muscles of the median nerve along with the ulnar muscles. Its general composition includes all kinds of sensory fibers that are capable of innervating the skin on the radial carpal surface, the palmar surface, starting with the first and ending with the fourth finger of the hand, as well as the dorsal surface of all existing distal phalanges of the above fingers.

Symptoms and diagnosis of median nerve neuritis

If a patient has neuritis of the median nerve, symptoms such as weakness when flexing the hand, weakness in flexing the first and second fingers, especially the terminal phalanges, appear. The sensitivity of the palmar surface of the first and second fingers is significantly reduced.

The most successful and successful treatment for median nerve neuritis is to therapeutic effects occurred precisely at the point of damage to the nerve itself. In order to simplify and improve treatment somewhat, the attending physician should know the following:

• in order to carry out targeted treatment, the specialist will ask which specific point is affected;
• what reasons led to such an illness (this could be all kinds of injuries, scars and compression in the area of ​​a particular nerve);
• it is important to determine the extent and level of damage to a particular nerve.

Various diagnostic methods have already been discussed above. Now in more detail about some of them.

Electroneuromyography. Thanks to this examination, you can easily determine the speed and volume of impulses along the existing nerve. Moreover, thanks to this examination, you can easily detect the damaged area and determine the recovery time of the existing nerve. In addition, electroneuromyography allows you to accurately assess the effect of any type of treatment, so you can choose the most suitable and effective method.

When performing radiography and computed tomography, you can get a complete necessary information about the deformation of a particular joint and all existing bone canals of a given nerve. Moreover, the causes and points of damage can be determined with greater confidence.

Treatment of the disease

Once the specialist has managed to find out the reason why this nerve is being compressed, all kinds of treatments become more effective and correct. During the treatment process, the specialist must resort to etiotropic therapy.

This therapy includes treatment with antibiotics, all kinds of antiviral and vascular drugs.

Moreover, in the treatment of this complex illness should include various decongestant and anti-inflammatory medications. It is necessary to carry out various physical procedures, specially designed massage and exercise therapy.

If the nerve is compressed, the main treatment goals are:

1. Relieving compression of the median nerve. To do this, it is necessary to carry out quite powerful resorption therapy. In order for this therapy to be carried out, you need to start with the use of all kinds of enzymes, as well as take various agents and drugs that absorb and soften scar tissue, and much more. There are also cases where for a complete cure it is enough only manual therapy and massage at the site of injury.
2. Acceleration of healing and, of course, restoration of the nerve itself. To do this, it is necessary to resort to the use of some modern medicines who are capable of restoring those freed from all harmful factors nerve.
3. Restoration of muscle function and muscle volume. In order for the treatment to lead to a positive result, it is necessary to perform all kinds of restorative procedures. A rehabilitation specialist can help each patient with this issue.

When the median nerve is injured, first of all it is necessary to decide on a conservative or surgical treatment. Each doctor will be able to solve this issue only when needle myography is performed, thanks to which it will be possible to determine the extent of the damage.

After the doctor makes a diagnosis and clarifies all the questions that interest him, only then will he choose the most suitable treatment method for each patient.

The median nerve stretches from inner surface shoulder, passes through the area elbow joint, continues on the palmar surface of the forearm, innervating the round and quadratus muscles and, crossing the carpal tunnel, ends on the palmar part of the hand. In the forearm area, the median nerve innervates the muscle of the anterior group of the forearm, with the help of which the fingers bend and the hand moves.

The nerve is often injured in the area of ​​the lower third of the forearm, since it is located superficially there. The medianus nerve is responsible for the motor and sensory abilities of muscles. It consists of fibers of the spinal nerves of the median and lower trunk of the brachial plexus. Due to a number of reasons, often associated with injury, neuropathy of the median nerve occurs. This disease can also be caused by injury to the nerve in the carpal tunnel area.

Neuropathy is a pathology that manifests itself as a result of a fracture in the hand, bruise or cut. Even if the nerve itself remains intact during the injury, the scars that form during the wound healing process can compress it, which causes the development of neuropathy. This disease develops when rheumatoid arthritis, arthrosis, diabetes mellitus. Its obvious symptoms are decreased sensitivity and muscle atrophy. Numbness in the fingers is especially noticeable at night. Patients complain not only of loss of sensitivity, but also of decreased grip strength of the hand and swelling of the hand.

With median nerve neuropathy, the ability to move the hand is impaired and there is no flexion of at least three fingers. The patient is unable to extend the middle phalanges of two fingers and an attempt to clench the hand into a fist remains unsuccessful. With neuropathy, atrophy of the base of the fingers is observed, because of this the little finger and ring fingers are installed in the same plane, the hand looks like a monkey's paw.

In the zone of innervation of the nerve, sensitivity disorders are determined in the radial area of ​​the palm, the palmar surface of the ring and middle fingers and partially the index finger. When the nerve is damaged, gross changes occur in trophism, secretory and vasomotor functions. It is also often possible to experience intense, persistent pain (hyperpathy) and a burning sensation in the limb (causalgia).

Found an error in the text? Select it and a few more words, press Ctrl + Enter

During diagnosis, first of all, a visual inspection of changes in the position of the hand is performed, identifying the area where sensitivity is reduced.

To diagnose median nerve neuropathy, the Phalen test is performed, which determines the degree of numbness of the fingers and muscle atrophy. After this stage of examination, a specialist will prescribe instrumental examination. The electroneuromyography method allows you to observe the passage of an impulse along a nerve. This is how the level of damage is determined. Ultrasonography and ultrasound are used.

The complete picture of the disease is shown by magnetic resonance imaging, showing the type and size of the localization of this lesion. Among modern methods diagnostics used before and after surgery to confirm the dynamics of recovery, excellent results can be obtained using Doppler flowmetry.

Treatment of median nerve neuropathy is always successfully carried out with timely consultation with a doctor initial symptoms. At this stage of the development of the disease, fixation of the limb in a physiological position using a splint is prescribed. Effective in early period taking non-steroidal anti-inflammatory drugs, drugs that normalize the condition of nerve tissue cells and promote their rapid regeneration.

Traditionally, treatment is not complete without physiotherapeutic procedures. Often used surgical method treatment aimed at freeing the nerve from compression by scar tissue. In case of advanced disease, specialists have to resort to sewing in a nerve or plastic surgery, because they already have to ascertain neurogenic contracture of the hand and irreversible changes that provoke muscle contracture.

Also, to correct or prevent neurogenic contractures of the limbs, muscle innervation is restored using the neurotization method.

The disease can occur due to many factors; every person is obliged to take their health seriously and not to trigger the course of the disease. Early detection of neuropathy contributes to a successful treatment outcome.

The median nerve is one of the largest branches of the brachial plexus, along with the brachial and radial nerves. It originates from two bundles - lateral and medial. It goes through parts of the biceps (biceps muscle). In front, through the ulnar region, it reaches the forearm and is localized between the flexors of the fingers. Through the wrist channel it enters the palm. Here it is divided into three parts, which are further divided into seven more branches.

The median nerve innervates almost all upper limb, since it has a long path and gives a huge number of branches along the way. Responsible mainly for flexing the muscles of the forearm, as well as for the movements of the thumb, middle and index fingers, abduction and adduction of the hand, and its rotation. In addition, it is responsible not only for motor activity, but also for the sensitivity of the wrist.

Causes of defeat

Damage to the median nerve is caused by the influence of internal and external factors, namely:

Regular long-term use of a computer mouse and keyboard. Constant identical movements while working at a computer lead to the development of such a pathology as carpal tunnel syndrome - a disease of the peripheral nervous system. The arms are in a static position of flexion or extension, blood circulation and trophism of the nervous tissue are disrupted. The risk factors here are the female gender, since the median nerve canal is anatomically narrower than in males, the third or fourth stage of obesity - the load on the upper limb increases. All types of arthritis. Most problems with the body begin with inflammation. The soft tissues swell, the lumen of the canal narrows, and accordingly the nerve is exposed to external pressure. In addition, due to the chronic pathological process, many tissues become sclerotic and abraded. Articular surfaces gradually grow together as the bone surface is exposed. The hand becomes deformed over time, and due to the incorrect position of the anatomical structures, the patient’s condition worsens. Injuries. Common problem orthopedics in combination with neurology. When a hand is sprained, dislocated, fractured or bruised, the body’s adequate reaction is the expansion of blood vessels and the accumulation of fluid in the soft tissues. As in the previous case, compression of the nerve occurs. In addition, the bones are displaced, there is a risk of improper fusion, which sharply aggravates the situation. The accumulation of large amounts of fluid is associated with concomitant human diseases, for example, nephrosclerosis, acute or chronic renal failure, pregnancy, menopause, lack of thyroid hormone, dysfunction of the genital organs, etc. further. Edema is caused by specific and nonspecific pathogens (tenosynovitis). Pathology can occur as catarrhal form, and with the formation of pus. Microorganisms reach the site of the lesion in several ways: from neighboring anatomical structures, through the blood and directly entering through the wound. Diabetes mellitus. Causal factor there is a violation of glucose metabolism and energy starvation of cells, which gradually die. The nerve fiber is destroyed. Genetic predisposition. If close relatives (brothers, sisters, parents) suffered from similar diseases, then there is a high risk of developing it in the person himself.

Classification

Injuries to the median nerve are classified from a surgical point of view into open and closed. Open wounds include all types of wounds: punctures, lacerations, cuts, chopped wounds, and so on. In addition to nerves and tendons, they can affect muscles and blood vessels.

TO closed injuries include bruise, sprain, concussion and compression.

Diseases according to orthopedic classification are divided into three groups:

Neuropraxia - reversible damage to nerve fibers; Axonotmesis - pathology characterized by degeneration of individual sections of nervous tissue; Neurotmesis - deep damage nerve trunk, including disorders of the connective tissue sheath.

Neuropathy

Median nerve neuropathy is damage due to constant compression of an anatomical formation. Otherwise called carpal tunnel syndrome. The greatest prevalence is among middle-aged people - from thirty to sixty years old.

In most cases, this disease develops on one side. The patient's main complaint is pain and numbness of the upper limb, since its innervation is disrupted and pain receptors, on the contrary, are irritated. At first, discomfort only occurs at night, which prevents a person from sleeping. As the disease progresses, symptoms increase and daytime days, which reduces ability to work and quality of life. Unpleasant sensations are localized not only in the area of ​​large joints, but also along the entire course of the median nerve right up to the fingertips.

There is a loss of strength and muscle tone. In this case, median nerve neuropathy is explained by impaired blood supply to tissues, metabolism and oxygen delivery. The patient sometimes cannot hold even the lightest and smallest things. For the same reason, the color of the skin of the hands changes.

Since the nerve is also responsible for tactile sensitivity, the response to external stimuli is reduced or absent. The patient does not feel touch or temperature fluctuations.

Movement disturbances and muscle atrophy are gradually observed.

Median nerve neuropathy is diagnosed mainly by tests for pain and tactile sensitivity, symptoms intensifying with increasing pressure on the forearm or lifting the limb for a while.

For clarification, referrals for laboratory and instrumental diagnostics are issued. Blood and urine tests provide an expanded understanding of the patient’s health status and concomitant pathologies (hypothyroidism, diabetes mellitus, nephrosclerosis). This is important for the attending physician, since neuropathy of the median nerve could develop precisely because of them.

Electroneuromyography directly examines the carpal tunnel. It determines the location of the lesion, its size, and depth. It is based on connecting electrodes installed on the hand to a computer, which reads electrical impulses from the nerve fiber at rest and during movement.

Treatment begins with fixing the wrist in the correct position using an orthopedic bandage. Drug therapy includes the use of drugs with B vitamins, non-steroidal anti-inflammatory drugs (Diclofenac), glucocorticosteroids (Prednisolone), vasodilators (Pentilin), diuretics according to indications (Veroshpiron). Anticonvulsants (Pregabalin) and antidepressants (Duloxetine) are used to relieve pain and have a general calming effect. Treatment is complemented by massage and physical therapy.

Median nerve neuropathy sometimes requires surgery to restore or widen the carpal tunnel.

Neuropathy

Neuropathy of the median nerve is a pathology associated with trauma to the upper limb, namely its bruise, wound, fracture.

Due to the deformation of the bones of the limb, the nervous system is almost unable to adequately innervate the hand and fingers. This is where almost all of the clinical picture. The patient complains of pain in the thumb, index and middle fingers, discomfort in inside forearms. The hand is not capable of performing flexion, extension and rotational movements. Externally, muscle atrophy is observed in the area of ​​the tubercle near the thumb. Tactile and temperature sensitivity is lost.

Neuralgia is diagnosed by examining the movements of the fingers and hand as a whole. Nerve damage can be studied in detail using ultrasound diagnostics, ultrasonography and electroneuromyography.

Treatment involves the use of anticholinesterase drugs (Galantamine), muscle relaxants (Norkuron), antioxidants (vitamin E). Therapy is complemented by acupuncture, physical therapy, and massage.

Treat by surgical intervention it is necessary only in case of strong growth of connective tissue at the site of injury, as this negatively affects the functioning of the nerve. Neurolysis of the median nerve is performed using microsurgical devices and a microscope.

Neuritis

Median nerve neuritis is a disease associated with inflammation of an anatomical formation. This group includes pathologies of both infectious and non-infectious etiology.

The patient notes weakness in the hand, difficulty in flexing the upper phalanges of the fingers. There may be a tingling or crawling sensation. Externally there is a change in shade skin, their cyanosis, excessive sweating of the palm, swelling of the limb, disruption of the structure of the skin and nails. As a person’s condition worsens, trophic ulcers, cracks in the epidermis, muscles atrophy and are replaced by connective tissue, in this case restoration motor activity almost impossible.

The neurologist is obliged to study the mobility of the hands, starting with the healthy one. He asks the patient to clench his palm into a fist and bend the limb as much as possible at the wrist. The results of laboratory tests show the presence of inflammation (increase in the number of leukocytes, erythrocyte sedimentation rate, decrease in blood protein).

Median nerve neuritis is additionally diagnosed by radiography, computed tomography and magnetic resonance imaging in order to visually examine the forearm area and the course of the median nerve.

Treatment for the development of microorganisms begins with the use of antibiotic therapy wide range action of the group of penicillins, cephalosporins. To boost immunity, it is necessary to use vitamin complexes, as well as immunomodulatory drugs. Treatment should also include non-steroidal anti-inflammatory and decongestant drugs, analgesics. From physiotherapy greatest effect gives electrophoresis with painkillers, pulsed currents and UHF.

Description:

Neuropathy of the median nerve - damage to n. medianus on any part of it, leading to pain and swelling of the hand, sensitivity disorder of the palmar surface and the first 3.5 fingers, impaired flexion of these fingers and opposition of the thumb. Diagnosis is carried out by a neurologist based on the results of a neurological examination and electroneuromyography; Additionally, musculoskeletal structures are examined using ultrasound and tomography. Treatment includes painkillers, anti-inflammatory, neurometabolic, vascular pharmaceuticals, exercise therapy, physiotherapy, and massage. Surgical interventions are performed according to indications.

Causes of median nerve neuropathy:

The etiological factors causing median nerve neuropathy are very diverse. These include a variety of injuries to the upper limb, nerve damage in case of technical violations intravenous injection into the cubital vein, cut wounds the palmar surface of the forearm above the radiometacarpal joint, as well as overexertion of the hand of a professional nature. The function of the median nerve is mixed. The motor fibers of the median nerve innervate the following muscles of the upper limb: flexor carpi radialis, palmaris longus, flexors of the fingers (superficial and deep), flexors of the first finger of the hand (long and short), pronator teres and quadratus, abductor muscle thumb, as well as the muscle that opposes the thumb to the hand. Due to the fact that the median nerve innervates the above muscles of the upper limb, when they contract, the following types of movement are carried out: flexion and extension of the second and third fingers of the hand. In the area of ​​their middle and distal phalanges, flexion of the first finger of the hand in the area of ​​its distal phalanx, opposition of the first finger of the hand to the rest of the fingers, pronation of the forearm. Some types of movements are carried out by innervation of some muscles by the median nerve together with the ulnar nerve. These types of motor acts include palmar flexion of the hand, flexion of the fingers in the area of ​​their proximal and middle phalanges, with the exception of the thumb. The median nerve includes sensory fibers that innervate the skin on the radial surface of the hand, the palmar surface of the first to fourth fingers of the hand, and the dorsal surface of the distal phalanges of these fingers.

Symptoms of median nerve neuropathy:

Pain in the 1st, 2nd, 3rd fingers, usually severe and causal in nature, pain on the inner surface of the forearm. Pronation suffers, palmar flexion of the hand is weakened, flexion of the 1st, 2nd and 3rd fingers and extension of the median phalanges of the 2nd and 3rd fingers are impaired. The muscles in the area of ​​the eminence of the first finger are most clearly identified, as a result of which it is installed in the same plane as the second finger; this leads to the development of a hand shape that resembles a monkey's paw."

Superficial sensitivity is impaired in the area of ​​the radial part of the palm and on the palmar surface of the 1st, 2nd, 3rd fingers and half of the 4th finger. The main tests for identifying movement disorders: 1) when clenching the hand into a fist, fingers I, II and partly III do not bend; 2) when pressing the hand with the palm of the hand to the table, scratching movements with the second finger are not successful; 3) the patient cannot rotate the first finger around the other (symptom of the mill) with the remaining fingers crossed; 4) the opposition of the 1st and 5th fingers is impaired.

Diagnostics:

Classically, median nerve neuropathy can be diagnosed by a neurologist through a thorough neurological examination. To identify motor impairment, the patient is asked to perform a series of tests: clench all fingers into a fist (the 1st and 2nd fingers do not bend); scratch the surface of the table with the nail of your index finger; stretch a sheet of paper, grasping it only with the first two fingers of each hand; rotate thumbs; connect the tips of the thumb and little finger.
In case of tunnel syndromes, Tinnel's symptom is determined - pain along the nerve when tapped at the site of compression. It can be used to diagnose the location of the lesion n. medianus. With pronator teres syndrome, Tinnel's symptom is determined by tapping in the area of ​​the pronator snuff box (the upper third of the inner surface of the forearm), with carpal tunnel syndrome - by tapping on the radial edge of the inner surface of the wrist. With supracondylar process syndrome, pain occurs when the patient simultaneously extends and pronates the forearm while flexing the fingers.
To clarify the topic of the lesion and differentiate neuropathy n. medianus from brachial, vertebrogenic syndromes (radiculitis, disc herniation, cervical spondylosis), and polyneuropathy, electroneuromyography helps. To assess the condition of bone structures and joints, bone x-rays, MRI, ultrasound or CT of joints are performed. For supracondylar process syndrome on radiography humerus a “spur” or bone spur is revealed. Depending on the etiology of neuropathy, a traumatologist, orthopedist, and endocrinologist take part in the diagnosis. According to indications, blood tests for RF and C-reactive protein, blood sugar levels, and hormonal studies are performed.

Treatment for median nerve neuropathy:

Initially, conservative treatment methods are used, such as B vitamins and anticholinesterase drugs. If there is no positive dynamics within 1–2 months, it is necessary to resort to surgical methods of treatment. Physiotherapeutic treatment of median nerve neuropathy is carried out during conservative therapy or at the postoperative stage.

1. Analgesic methods: transcranial electroanalgesia, short-pulse electroanalgesia.

2. Anti-exudative methods: UHF therapy, drug electrophoresis anti-inflammatory drugs.

3. Anesthetic methods: local cryotherapy, fluctuarization, drug electrophoresis of anesthetics.

4. Reparative and regenerative methods of treating neuropathies: infrared laser therapy, ultrasound therapy, ozokerite therapy, peloid therapy.

5. Vasodilating methods: drug electrophoresis with vasodilators, infrared irradiation, red laser therapy, ultratonotherapy, high-frequency magnetic therapy.

6. Trophostimulating methods: local darsonvalization, massotherapy, vibration therapy.

7. Neurostimulating methods for treating neuropathies: neuroelectric stimulation, bioregulated electrical stimulation.

8. Methods that irritate free nerve endings: turpentine, sage, mustard baths.

Reparative and regenerative methods of treating neuropathies.

Ozocerite therapy. Under the influence of thermal and chemical factors ozokerite stimulates the reparative regeneration of nerve conductors, which leads to an improvement in the functional properties of the affected nerves. Treatment is carried out in the form of applications of ozokerite heated to 45-50 °C on the area of ​​the affected nerve, for 30-60 minutes, daily; course 10-12 procedures.

Peloid therapy. Therapeutic mud stimulates anabolic and inhibits catabolic processes in nerve conductors, increases the viscosity of the neurolemma, enhances the resorption of inflammatory products, and induces reparative regeneration processes. By increasing the activity of the antioxidant system, they inhibit lipid peroxidation at the site of inflammation and restore cellular respiration in neurons. In case of defeat peripheral nerves mud applications are carried out on the innervation zone or on segmental reflex areas. The temperature of the mud is 42-44 °C, the duration of procedures carried out every other day or with a break on the 3rd day is 15-20 minutes (sulfide mud) or 25-30 minutes (sapropel and peat mud); course 12-18 procedures.

Vasodilator methods of physiotherapy for median nerve neuropathy.

High frequency magnetic therapy. The high-frequency magnetic field induces eddy currents in the tissues, resulting in the release of heat, and the tissues heat up by 2-4 ° C. A magnetic field with a frequency of 13.56 is used; 27.12 or 40.68 MHz, in a thermal dose (3-4th power level), 10-15 minutes, daily; course 10 - 12 procedures.

Low frequency magnetic therapy. By relaxing vascular smooth muscles and reducing blood viscosity, capillaries expand and impaired local blood flow is restored. Apply a magnetic field with a frequency of 50 Hz, induction up to 35 mT, for 10-12 minutes, daily; The course of treatment for median nerve neuropathy is 10-12 procedures.

Ulypratonotherapy. The silent discharge induces conduction currents in the underlying tissues, which cause heat generation and tissue heating. The transformation of electromagnetic energy into thermal energy causes vasodilation with increased venous and lymphatic drainage. Impact on the area of ​​innervation of the affected nerve with alternating current with a frequency of 22 kHz, high voltage (4-5 kV) using a labile technique, 10-15 minutes, daily; course of treatment is 10-12 procedures.

Contraindications to treatment: diseases and injuries of peripheral nerves in the acute period of the disease, as well as accompanying sudden violations in the motor sphere and vegetative-trophic disorders.

Sanatorium-resort method of treating median nerve neuropathy.

Patients with neuropathies in the early and late periods, including contracture, 2 months and later from the onset of the disease are sent to climatic and balneotherapy resorts: Pyatigorsk, Staraya Russa, Sochi, Zelenogorsk, Sestroretsk, Svetlogorsk, Anapa, Southern Coast of Crimea, Berdyansk, Kuyalnik.

Improvement in the condition of patients with consequences of diseases and injuries of roots, plexuses, and nerve trunks is determined by complete or significant recovery:

1. muscle strength of the affected limbs,

2. volume and pace of active movements,

3. disorders of sensitivity, muscle tone, tendon reflexes and vegetative-vascular reactions,

4. neuromuscular conduction,

6. cessation or reduction in the severity of pain, .

Contraindications to sanatorium-resort treatment of median nerve neuropathy are diseases in the acute period, as well as severe disturbances in the motor sphere.

Physioprophylaxis of the disease is carried out in order to prevent the development of the consequences of diseases and injuries of peripheral nerves by improving microcirculation and metabolism of nervous tissue (vasodilating methods), eliminating degenerative processes in the nervous and muscle tissue(trophostimulating methods), restoring excitability and conducting impulses along nerve fibers (neurostimulating methods).

Median nerve neuropathy It occurs quite often in both children and the elderly. The pathology leads to pain and impaired finger flexion. Only a neurologist can diagnose neuropathy.

To begin with, he conducts an examination and prescribes various examinations. If there is minor damage to the median nerve, it will cause discomfort.

This nerve ending is the largest in the hand and is responsible for all important movements. You should definitely contact your doctor so he can prescribe drug therapy. If treatment does not bring any results, then surgery is performed.

The causes of median nerve neuropathy occur due to damage to the nerve ganglia. It could be like various injuries and bruises, as well as other pathologies. We must remember that it is best to consult a doctor at the first manifestations.

The following factors provoke damage to the median nerve:

• Various injuries, bruises, fractures, sprains, all this can easily lead to the accumulation of fluid in the tissues, which causes compression of the nerve endings. Pathology may develop if the bone does not heal properly.
• Arthritis. With this disease they swell soft fabrics and pinching of the nerve node occurs. If the disease occurs in chronic form, this can lead to deformation of the upper limbs.
• The accumulation of fluid in soft tissues occurs against the background of other pathologies. Such as: kidney disease, pregnancy, menopause, nephrosclerosis.
• Median nerve neuropathy can be inherited. If there are close relatives who have this pathology, then there is a high probability of developing the disease.
• Diabetes mellitus can also lead to neuropathy. There is a disruption of the metabolic process and oxygen starvation of tissues, so nerve endings are destroyed.
• Carpal tunnel syndrome occurs because the blood supply is disrupted. Most often, this happens if the hand is for a long time in one position. The syndrome may bother those people who work at a computer with a mouse and keyboard.
• Physical stress on the forearms and hands provokes the development of the disease.

Median nerve neuropathy can even be caused by drinking alcoholic beverages. Everyone knows that alcohol negatively affects all organs. If you take it for a long time, it causes severe harm to the nerve endings.

Poisoning of the body chemicals also leads to the development of neuritis. It is known that intoxication causes a strong blow to the nerves. Infectious diseases HIV, herpes, diphtheria provoke neuropathy of the median nerve ganglion.

Symptoms

Median nerve neuritis refers to a disease of the nervous system. At the initial stage of development of the pathology, the patient may feel that it becomes difficult for him to squeeze some fingers on his hand. The pain can be of a burning nature and on a constant basis.

The following symptoms are observed with median nerve neuropathy:

• Intense pain that covers the forearm and moves to the fingers;
• It becomes difficult to clench your hand into a fist;
• Muscle weakness;
• Numbness of the limbs;
• Loss of sensitivity in fingers and palms;
• Tingling in the forearm area.

If the above symptoms occur, you should consult a doctor. If the disease is started, there may be irreversible complications. The attending physician will be able to refer you for a comprehensive examination and prescribe effective treatment.

You should not ignore the signs of the development of pathology, as this will ultimately lead to a complete loss of finger mobility.

Diagnostics

When visiting a doctor, he first performs a neurological examination. This happens in such a way that the patient must try to clench his hand into a fist. If he can't bend some of his fingers, he most likely has median nerve neuropathy. Treatment of pathology should be aimed at the affected area.

Electroneuromyography is also performed to understand the speed at which impulses travel along the nerve ending. This diagnostic method makes it possible to find out exactly where the damaged nerve is located. CT scan and an x-ray of the hand will help the doctor find out what treatment is best to prescribe.

The specialist may refer you for an MRI to see the condition of the soft tissues. If the doctor prescribes treatment and it does not bring a positive result, then most likely it will be used surgery. In order not to start the disease, it is necessary to contact a medical facility at the first manifestations.

Treatment

Treatment of median nerve neuropathy is primarily carried out by qualified specialists. Hematoma may be drained if affected nerve ending in the event that medications do not help. The operation is carried out by opening the affected area and washing with an antiseptic.

Removal of the tumor may be prescribed if it occurs strong pressure on my nerves. Before surgery, it is imperative to consult an oncologist in order to exclude malignant neoplasms.

Various injuries are treated by restoring bones, ligaments, tendons and relieving swelling in the injured area. If a patient suffers from diabetes, then he constantly needs to monitor his blood sugar levels. This is necessary to avoid complications diabetic angiopathy and polyneuropathy.

Drug therapy is also mandatory to eliminate the inflammatory process and painful sensations. You should not self-medicate, as this can lead to consequences. It is best to consult a doctor at the first manifestations of neuritis.

The following medications are used:

• Non-steroidal anti-inflammatory drugs. Diclofenac helps relieve inflammation and relieve pain. The drug can be purchased in the form of ointments, injections, tablets. Most often, a drug is prescribed for intramuscular administration. The drug must be used carefully as there are contraindications. To ensure that NSAIDs do not cause harm to the mucous membranes, it is recommended to use the products after meals. Ibuprofen reduces inflammation and is considered a pain reliever. Most often used in the form of gels and ointments. It is worth paying attention to contraindications and side effects.

• Glucocorticosteroid drugs they are often used together with non-steroidal anti-inflammatory drugs. Prednisolone helps cope with the inflammatory process and constricts blood vessels. Most often, the drug is injected into the affected area. There are also contraindications; injections should not be used for infections in the affected area.

• Blockade used when it is necessary to remove fast deadlines severe pain. This method brings positive result, but this should only be carried out by an experienced specialist. As a rule, about two blockades are done and this is enough. Novocaine has little toxicity and does not last long. Contraindication is intolerance to the component. Marcaine lasts much longer than other painkillers, but has greater toxicity.

• Agents that have a restorative effect on nerve endings. Milgamma helps relieve inflammation and pain syndrome. It also contains B vitamins and lidocaine. Restores nerve nodes and is used initially in the form of injections, and then proceeds to treatment with tablets. Neuromidin improves the patency of nerve fibers. There are also contraindications and side effects, so the drug must be used with caution.

Median nerve neuropathy can be treated not only with medications, but also in other ways. Massage procedures bring positive results. To do this, the massage is done first from the cervical and thoracic spine. Then you need to gently rub and knead your forearms and hands. As a rule, the course full therapy About twenty procedures are performed.

Complications

If you ignore the symptoms of median nerve neuropathy, serious complications can arise. It will no longer be possible to correct the changes that have occurred. There is a loss of mobility in the hands, the muscles weaken, and the fingers may practically not move. Without a certain load, joints become thinner and arthritis occurs. The place where the nerve ending was compressed hurts constantly.

If the disease has been completely advanced, then there is a complete cessation of finger mobility. The patient cannot write, eat, or fasten his belt independently. In order to avoid such unpleasant complications, it is necessary to consult a doctor in a timely manner. He will prescribe a comprehensive examination and effective treatment. Everyone should know that the sooner treatment is started, the less consequences there will be.

Prevention

In order to avoid median nerve neuropathy, you must adhere to some recommendations. Nutrition should be balanced so that everyone can eat essential vitamins and minerals. Lead a healthy lifestyle and walk more in the fresh air.

If you work constantly at the computer, then you need to hold the mouse in different hands more often and take breaks. Try to do exercises every morning and avoid stressful situations. It is best to take a complex of vitamins for prevention. Get examined once a year at a medical facility.

Median nerve neuropathy responds well to treatment initial development. If you consult a doctor in time, you can avoid serious consequences. If the disease is advanced, there may be impaired mobility of the fingers. Treatment should be prescribed only by the attending physician, otherwise there may be complications. It is best to seek help from a medical facility at the first symptoms.

Neuropathy of the median nerve (nervus medianus), otherwise neuritis, neuropathy, is pathology manifested as a result of damage to its membrane or the nerve fiber itself, which leads to dysfunction and manifests itself in motor and sensory disorders.

Being a mixed nerve fiber, it innervates the muscles of the forearm involved in flexing the hand, the muscles of the fingers, and is also responsible for the sensitivity of the palmar surface of the hand, 1-3 and partially 4 fingers (except for the little finger).

Classification

Due to the occurrence should be distinguished:

1. Traumatic neuropathies
2. They occur when there is direct damage to the nerve due to injury or fractures.
3. Neuropathies caused by inflammatory and degenerative joint diseases;
4. Neuropathies in endocrine diseases
5. For example, diabetic polyneuropathy, narrowing of capillaries due to hypothyroidism. In such cases, pathological process affects various nerve fibers and usually does not occur as an isolated lesion of the median nerve.
6. Compression-ischemic neuropathies (tunnel syndromes)
7. They are the most common cause of the development of isolated neuropathies of the median nerve. It is formed by compression, which occurs in the anatomically narrowest places where n lies. medianus:

• Carpal syndrome – compression in the carpal tunnel;
• Pronator teres syndrome – compression of the pronator teres muscle in the forearm;
• Compression by a spur (supracondylar process) of the humerus.

Causes of defeat

1. Injuries to the upper extremities lead either to direct damage to the fiber or to compression and disruption of nutrition.

• Fractures of the bones of the shoulder, forearm, wrist;
• Bruises, dislocations, sprains and ruptures of ligaments and tendons, accompanied by the formation of hematomas and severe tissue swelling;
• Wounds (puncture, chopped, cut, gunshot, etc.).

1. Prolonged static loads on the hand, overstrain of the muscles of the hand and forearm, which occurs in people of certain professions (ironers, carpenters, dentists, musicians) or with high monotony physical activity. All this can lead to disruption of trophism and compression of nerves, possible development tunnel syndrome. Recently, the reason has often been prolonged work at the computer while incorrect position brushes Compression by the process of the humerus is sometimes a consequence of an awkward position of the arm (prolonged pressure on the arm bent at the elbow). In addition to people in relevant professions, the risk group also includes women and overweight people;
2. Arthritis, arthrosis, rheumatism and other diseases can lead to swelling of adjacent tissues, joint changes, bone deformation, which also often has a pathological effect on the neurovascular bundle;
3. Endocrine diseases (diabetes mellitus, acromegaly, hypothyroidism) cause circulatory and metabolic disorders in the body and, as a rule, lead to systemic lesions - polyneuropathy. In diabetes mellitus, a disorder of glucose metabolism occurs, which leads to hypoxia and degenerative changes nervous tissue. This can also manifest itself as a pathology such as, for example, visual impairment;
4. Tumor processes in the upper limb can also affect nerve formations. The most common are hygromas, lipomas, hemangiomas, neurofibromas, and schwannoma. Less common malignant formations soft tissues and bones;
5. Atherosclerotic changes, arterial vascular insufficiency;
6. Prolonged compression syndrome of the upper limb;
7. Pathological processes on bone formations (spur of the humerus);
8. Infectious diseases;
9. Consequences of injections in the vicinity of the passage of nerve fibers with the formation of infiltrates.

Ask your question to a neurologist for free

Irina Martynova. Graduated from Voronezh State Medical University named after. N.N. Burdenko. Clinical resident and neurologist of the BUZ VO \"Moscow Polyclinic\".

Symptoms

Pain

Burning pain, depending on the level of damage, is localized in the forearm, hand, and moves to the first 3 fingers (thumb, middle, index). It intensifies when external influence(touch, bright light, noise, stress) and may subside when immersing hand in water or wrapping in wet cloth.

Expert opinion

Mitrukhanov Eduard Petrovich

Doctor -

This nature of pain in medicine is called causalgic.

Movement disorders

Manifest in muscle weakness, inability to squeeze the hand, abduct the thumb, paresis. Sometimes there are changes in the form of muscle atrophy in the area of ​​the thumb pad.

Sensitivity disorders

They manifest themselves in numbness, decreased perception of pain, cold and hot. Such disorders are determined in the innervation zone - the palmar surface of the hand and 1-3 fingers. Along with hypoesthesia (decreased sensitivity), paresthesia (sensations of heat, cold) may occur.

Vegetative changes

May cause changes in skin tone in the affected area (redness, pallor), swelling, coldness.

Diagnostics

Neuritis can be detected during a neurological examination. To do this, the following diagnostic tests are performed:

1. When asked to clench your hand into a fist, 1-3 fingers do not bend;
2. When pressing the palm against the table, the patient cannot perform scratching movements with the index finger;
3. It is impossible to cross the index and middle fingers;
4. It is not possible to contrast the thumb with the little finger.

Expert opinion

Mitrukhanov Eduard Petrovich

Doctor - neurologist, city clinic, Moscow. Education: Russian State Medical University, State Budgetary Educational Institution of Further Professional Education, Russian Medical Academy of Postgraduate Education of the Ministry of Health of the Russian Federation, Volgograd State Medical University, Volgograd.

When tapping with a neurological hammer in the direction of movement n. medianus, the location of its lesion or compression can be detected by the occurrence of acute pain (Tinnel's symptom).

With carpal syndrome it determined at the inner edge of the wrist. When compressed by the pronator teres – in the snuffbox of the above-mentioned muscle (this is a hole in the upper third of the forearm). A pathognomonic symptom of compression of the fiber by the supracondylar process of the humerus is pain that occurs when the forearm is extended and rotated inward with the hand bent.

Instrumental research methods

ENMG - electroneuromyography, consists of recording neuromuscular conductivity and muscle excitability using electrodes, allows you to evaluate functional state peripheral nerves. Is used for differential diagnosis with others neurological diseases and allows you to assess the degree of damage to the fiber.

X-ray examination, MRI, CT

They are used in cases where it is necessary to assess the condition of bones, ligaments, joints, damage and diseases of which could lead to neuritis. In such cases, fractures, arthrosis, pathological bone formations, and the presence of osteochondrosis of the cervical spine can be detected, which can also cause similar symptoms.

Ultrasound

Sometimes it is carried out to determine the width of the nerve fiber in order to further use this data when performing injections into the affected area.

Other laboratory and instrumental methods(blood tests, rheumatic tests, hormone studies) may be needed to diagnose endocrine, systemic inflammatory and infectious diseases that cause damage to the peripheral nervous system.

Treatment

Treatment comes first aimed at eliminating the cause the occurrence of neuropathy and can be carried out medical specialists different profiles.

• Drainage of a hematoma that has caused nerve damage is a surgical procedure and is carried out when conservative methods do not allow it to resolve, in large volumes or in cases of suppuration. Represents opening of the hematoma cavity, washing antiseptics, drainage and subsequent suturing of the wound.
• Tumor removal is carried out in cases where it disrupts the functions of neighboring tissues, including nerves. Consultation with a surgeon is required, sometimes with an oncologist to rule out malignant process. These specialists determine further surgical tactics.
• For injuries of the musculoskeletal system, treatment is carried out in trauma departments and is aimed at restoring the functions of bones, ligaments, tendons, joints, and reducing swelling in the area of ​​injury.
• Correction of endocrine disorders is carried out by an endocrinologist.
• In case of diabetes mellitus, it is necessary to stabilize and constantly monitor blood sugar levels in order to avoid complications of diabetic angiopathy and polyneuropathy. If there is insufficient function of the thyroid gland, the use of thyroid hormonal drugs is indicated.

In parallel with etiotropic treatment, drug therapy is carried out aimed at eliminating inflammation in the affected area and relieving pain.

For this purpose it is prescribed:

NSAIDs

Diclofenac

It has a pronounced anti-inflammatory, analgesic and moderate antipyretic effect. Available in the form of tablets, gels, ointments, and injection solutions. For the treatment of neuritis, external or intramuscular use is most justified. Contraindications are ulcerative processes in the gastrointestinal tract, hematopoietic disorders. To avoid negative impact on the gastric mucosa, most NSAIDs should be taken after meals. The price, depending on the form of the medication, varies from 10 to 150 rubles.

Ibuprofen

Pharmacological effects are manifested in a decrease in the inflammatory response and a moderate analgesic effect. Local application in the form of ointments and gels and oral administration are provided. Do not use in case of ulcers and bleeding in the gastrointestinal tract, bleeding, renal and liver failure, pregnancy, lactation, and under 12 years of age. The cost ranges from 30 rubles to 300 rubles for patented ibuprofen-based drugs.

Nimesulide (nise, nimesil)

It has a similar mechanism of action to diclofenac, but is a more selective drug. Has a pronounced anti-inflammatory and analgesic effect. It is produced in the form of ointment, gel, tablets, powder for the preparation of suspensions (nimesil). Contraindications are similar to those for ibuprofen. The cost of the drug is 50-250 rubles.

Artrosilene

A drug based on ketoprofen, available in various forms suggesting its local, oral and parenteral use. Along with reducing inflammation, it has a strong analgesic effect, which is realized both locally and through the central nervous system. Contraindications also include ulcerative necrotic lesions digestive system, third trimester of pregnancy, severe dysfunction of the liver and kidneys. Price: 180 – 450 rubles.

Movalis

The active ingredient is Meloxicam. More modern drug, capable of selectively inhibiting inflammatory mediators. The advantages include a powerful anti-inflammatory effect, with a lower risk of adverse reactions compared to other classic NSAIDs. In addition to ointments and tablets, it has an injection form. Use is limited in the same cases as for Artrosilene. The price ranges from 500 to 850 rubles.

Glucocorticosteroid drugs

Are used with severe pain syndrome and inflammation in combination with NSAIDs.

Their use is especially justified by the presence of joint pathology and inflammation of ligaments.

Prednisolone

Suppresses the activity of leukocytes and macrophages, blocks the synthesis of prostaglandins, constricts blood vessels, affects carbohydrate, protein and fat metabolism. Significantly reduces inflammation and migration of immune cells. Available in different forms. But for the treatment of neuritis, it is used topically, and is also administered parenterally, into the cavity of the inflamed joint or tissue. A contraindication for injection into the affected areas is the presence of an infectious process in the lesion, bleeding. Topical use may be limited to fungal and infectious skin diseases. The cost in pharmacies is from 25 to 150 rubles.

Diprospan (Betamethasone sodium phosphate)

It is a suspension for injection, has an immunosuppressive, good analgesic effect, especially when administered intra-articularly and interstitially. Contraindications are the same as for the injectable form of prednisolone. Price: 200-220 rubles.

Dexamethasone

A glucocorticosteroid drug, in case of neuropathy, is usually used by injection into the affected area. It has similar indications and contraindications to other representatives of the group. Cost: 30-180 rub.

Blockade

Used in cases where there is the need to quickly relieve severe pain. Of course, the effect is not very long lasting. However, blockades can be carried out repeatedly, and stable therapeutic effect. The idea is to introduce a local anesthetic into the affected area, which prevents the occurrence of excitation in the nerve fiber. Sometimes adrenaline is added to the solution to cause vasospasm and reduce the resorption of the anesthetic into the blood. This method gives good results but must be done with caution an experienced doctor. To block the carpal tunnel or pronator teres, a mixture of anesthetics with NSAIDs and HA is used. (diprospan with lidocaine, movalis with novocaine).

Usually 2-3 such blockades are enough to eliminate carpal tunnel syndrome.

Novocaine (procaine)

It has a large therapeutic range, low toxicity, but also a relatively short period of action. The only contraindications are individual intolerance to the components. Price – 15-75 rubles.

Lidocaine (xylocaine)

Low toxicity and a more pronounced analgesic effect compared to novocaine make this drug the most used in neurological practice. Cost - from 21 rub.

Marcaine (Bupivacaine)

It has the most prolonged effect (4 times more than lidocaine), but is quite toxic when it enters the bloodstream. Use is limited in persons with hypotension and children under 2 years of age. Price from 800 rub.

Drugs that help restore nerves

Milgamma

It is a medication based on B vitamins and lidocaine, has pronounced antioxidant properties, relieves pain and inflammation, helps restore nerve fibers and endings. Treatment begins with an injection in an amount of 5-10, then switches to taking tablets. Use is limited in severe heart failure, pregnancy, lactation, and childhood.

Neuromidin

Belongs to the group of cholinesterase inhibitors. Improves nerve fiber conduction and neuromuscular transmission. Contraindicated in epilepsy, angina pectoris, bradycardia, bronchial asthma, intestinal obstruction, gastrointestinal ulcers, pregnancy, breastfeeding, and under 18 years of age. Cost in pharmacies from 980 rubles.

Thioctacid

A metabolic drug with antioxidant properties can normalize carbohydrate and lipid metabolism. It is used in the form of tablets and injections. It is also effective for diabetic polyneuropathy. Not used during pregnancy, breastfeeding, childhood and adolescence.

Vascular drugs

Actovegin

It is a preparation made from calf blood and is used as an injection. Increases the ability of tissues to tolerate hypoxia, improves metabolic processes. Also available in the form of an ointment. Not prescribed for pulmonary edema, fluid retention in the body, or kidney pathology. Cost from 110 rub.

Trental (Pentoxifylline)

It has a pronounced antiplatelet, antispasmodic and angioprotective effect, improves tissue nutrition. Used orally, intravenously or intramuscularly. Use is limited for hemorrhages, pregnancy, and breastfeeding. Price - from 130 rub.

Other drugs

Dimexide

For local use only. Able to penetrate deep into tissue, where it has anti-inflammatory, analgesic and antimicrobial effect. Used in the form of ointment or compresses based on its 99% solution. For a compress, the solution is mixed with water and novocaine in equal proportions. Contraindications: impaired renal and liver function, angina pectoris, pregnancy, lactation. Price from 35 rub. per solution up to 140 rub. for the ointment.

Finalgon

An ointment based on capsaicin with an irritating and analgesic effect, which is formed as the substance penetrates deep into the tissue. Use in children and persons with intolerance to the components is limited. (~250 rub.)

Mydocalm

Belongs to the list of muscle relaxants central action. Relaxes muscles, has a moderate analgesic effect, improves peripheral blood circulation. Contraindicated in myasthenia gravis and under 3 years of age. average cost— 300 rub.

Exercise therapy

Medical Physical Culture aimed at improving blood supply to the affected area, restoration of muscle tone.

If n.medianus is affected, it is necessary to give the hand correct position: fix the wrist with a splint, retract the thumb and bend the rest.

Exercises:

• Abduction and flexion of the hand;
• Stretching a rubber bandage with a healthy and sore hand;
• Abduction of 1 finger;
• Flexion of 2-4 fingers;
• Internal rotation of the forearm and hand;
• Circular movements with your thumb.

Massage

The massage begins with the cervical and thoracic spine. Then they move to the upper limb. Massage in the forearm and hand area is carried out by stroking, rubbing, kneading and vibration. Duration 10-15 minutes.

The course of therapy is 15-20 procedures.

Electromyostimulation

Carried out to prevent muscle atrophy by stimulating electric shock, leading to their reduction. All this is combined with one’s own volitional efforts. The technique is carried out several times a day for a short duration to avoid severe overwork muscles. Contraindications: extrasystole, heart rhythm disturbances, severe arterial hypertension, thrombophlebitis.

Mud therapy

Therapeutic mud stimulates anabolic processes in nervous tissue and reduces inflammation. Applications are applied to the innervation zone, the temperature of the mud is 42-440C. Sulfide mud is kept for 15-20 minutes. For sapropel and peat - exposure time is 25-30 minutes.

Mud treatment is carried out once every 2-3 days, the course of therapy is 12-18 procedures.

Ozocerite therapy

It is an application of ozokerite, a natural hydrocarbon, otherwise called mountain wax, to the affected area. The substance is first heated to 45-50 degrees and kept over the affected area for 30-60 minutes. The course of treatment is 10-12 procedures.

Surgery

Held if conservative treatment is ineffective, the inability to restore the functions of the nerve fiber, especially if it is mechanically damaged.

• Nerve suture. It involves suturing the ends of a nerve. Possible in the absence of foci of necrosis and only in cases that exclude strong tension.
• Neurolysis. It is performed when the integrity of the fiber is incomplete or overstretched, when it is compressed by scar and connective tissue. The essence of the operation is to free the nerve from connective tissue growths.
• Nerve plastic surgery. It is carried out in cases where it is impossible to align the edges of the n.medianus. Performed after relief of acute inflammatory process by autotransplantation of the superficial sensitive area of ​​the nerve fiber to the site of damage.

Prevention

Prevention of the development of median nerve neuritis consists of the following rules:

1. Avoid working at the computer long use mice, do not hold your hand suspended for a long time;
2. Limit similar movements that lead to compression of the neurovascular bundle;
3. Periodically perform hand exercises, give them a rest after long, monotonous work;
4. Diagnose and treat endocrine disorders in a timely manner.

Forecast

With timely comprehensive treatment, the prognosis is generally favorable, especially in young people.

In elderly patients, with inadequate treatment, complications may develop in the form of muscle contracture and paralysis, which will lead to dysfunction of the upper limb.

Clinics

Clinics that specialize in the treatment of neuropathies ( price comparison for some services is provided)

Cost of services in Moscow

• Clinic of Restorative Neurology - 1990
• Scientific Center for Neurology – 3000
• Multidisciplinary medical center on Polyanka - 2500

Cost of services in St. Petersburg

Name of the clinic - Primary appointment with a neurologist

• Center for Clinical Neurology - 2800
• Doctrine - 2800
• CMRT - 1100

Median nerve neuropathy is a syndrome that occurs for various reasons.

But most often this condition is associated with inadequate and unphysiological loads on the upper limb. Therefore, they play a significant role preventive measures. If you have encountered such a problem, you still need to see a doctor who will determine the cause of the pain and prescribe adequate complex treatment. In this case, the risk of complications will be minimal.