What is Plexitis of the Shoulder Joint?
Plexitis (shoulder) of the shoulder joint is an inflammatory lesion of the nerves of the brachial plexus. The plexus consists of the first thoracic spinal nerve and the anterior branches of the four lower nerves of the neck. The shoulder has a relatively complex structure and a rather large size. The shoulder is anatomically located from the spinal column to the lower part of the armpit, as well as below and above the clavicle.
Shoulder plexitis is an unsafe disease, it causes discomfort to a person, can lead to disability. Disability in this case means not only a decrease in working capacity, but also the inability to service yourself in everyday life. This is due to a lesion in plexitis of the leading arm – the one with which a person performs basically all the actions. For righties, this is the right hand, for lefties, the left. For an ignorant hand to perform the same functions that the leading always performed, it will take a lot of time and effort. Also, patients are forced to endure pain, which leads to inflammation of the brachial nerves.
The pain worsens at night, and also when a person makes movements with his affected hand. Pain occurs when a person raises his hand or starts behind his back. Fine motor skills are reduced, because it is incredibly difficult for a person to hold a toothbrush, a cup in his hand. He cannot tie shoelaces or start the car with a key, etc. In advanced cases or in severe plexitis, the sensitivity of the arm can completely lose, muscle atrophy, paresis and paralysis can develop.
There are 3 forms of plexitis of the shoulder joint: upper, lower and total.
Causes of Plexitis of the Shoulder Joint
What causes can lead to shoulder plexitis?
There are many reasons why plexitis of the shoulder joint can occur. Here are the most common ones:
- fracture of the clavicle, dislocation of the shoulder joint, sprain, which lead to injuries of the brachial plexus or cervical roots;
- compression of the brachial nerves, which occurs when the patient is in an uncomfortable position for a long time (often in bedridden patients, with an uncomfortable position at work, during a long deep sleep);
- a disease of cervical and thoracic osteochondrosis, which often leads to radiculoplexitis;
- microtraumatization of the brachial plexus over a long period of time if the person was exposed to vibration for a long time, or when wearing crutches;
- plexitis as a result of birth injury in a child;
- diseases associated with metabolic disorders in the body (gout, diabetes, etc.);
- diseases of the lymph nodes;
- concussions, bruises, gunshot and knife wounds of the shoulder joint, neck region of the shoulder girdle;
- additional “cervical ribs” and other variants of the costoclavicular syndrome;
- infectious diseases, including viral ones, such as cytomegalovirus and herpes.
Pathogenesis during Plexitis of the Shoulder Joint
Plexitis has two stages of the course:
The neuralgic stage is characterized by spontaneous pain, which intensifies with compression of the plexus and with movements. Paralytic steel is characterized by peripheral paresis and paralysis of 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, pastes, etc.
When the disease affects the cervical plexus, the occipital region begins to hurt, paresis of the deep muscles of the neck and diaphragm progresses. Irritation of the phrenic nerve leads to hiccups.
The defeat of the brachial plexus causes pains localized in the supra- and subclavian regions, radiating to the arm. The muscles of the shoulder girdle and upper limb are affected, deep reflexes on the upper limb decrease or disappear. Vegetative-trophic disorders develop in the form of cyanosis or pallor of the hand, pasty hand, sweating, disorders of trophic nails, etc.
Symptoms of Plexitis of the Shoulder Joint
With plexitis of the shoulder, the following symptoms are observed:
- paralysis and atrophy of the small muscles of the hand, with the capture of flexors of the hand and fingers;
- pain localized in the plexus and on the inside of the lower arm;
- sensitivity disorder on the inner surface of the arm;
- disorder of the movements of the eyelid on the affected side (in some cases);
- miosis – narrowing of the pupil along the affected side (in some cases);
- enophthalmos – deepening of the eyeball (in some cases).
With this symptom, the probability of infection with viruses is suspected.
The nature of the pain is described as breaking, shooting, drilling, aching. Symptoms of paresthesia may be present in a sore arm, mainly in its lower part.
If plexitis is of an infectious-toxic nature, reflexes may weaken or lose, sensitivity may be upset. The disorders of the motor apparatus, which manifest as atrophic paresis and paralysis, are also recorded. Atrophic, glossy skin, excessive sweating, cyanosis, swelling of the hand, weakening of the pulse on the radial artery, and a change in nails may appear. These are all manifestations of trophic and vasomotor disorders.
As a result of the primary infectious-toxic process, which manifests itself in the surrounding tissues and extends to the brachial and cervical plexuses, in many cases there is pain resembling brachialgia. With this development of the disease, there is an increase and pain during palpation of the cervical lymph nodes on the affected side.
Diagnosis of Plexitis of the Shoulder Joint
The most frequently and effectively used such diagnostic methods:
- X-ray examination,
- ultrasound diagnostics,
- computed or magnetic resonance imaging, etc.
Treatment of Plexitis of the Shoulder Joint
They resort to complex treatment of shoulder plexitis, with preliminary accurate diagnosis and finding out the causes of the disease. Treatment eliminates the symptoms of the disease and its causes.
Prescribe drug therapy. Apply modern drugs with high efficiency. Doctors prescribe analgesics, drugs to restore nerve conduction, anti-inflammatory drugs, drugs to improve blood circulation and trophism, vitamins B1 and B12. If necessary, apply therapy with specific drugs.
The following methods are also used for treatment:
- various types of reflexology,
- laser and cryotherapy,
- balneological methods of therapy.
Surgery is indicated only for tumors, cervical ribs, traumatic plexitis, subclavian artery aneurysms. Patients with brachial plexitis cannot be subjected to cooling, physical stress. Also, patients should not work with toxic substances. After recovery, the preventive measures described below must be applied.
Prevention of Plexitis of the Shoulder Joint
After treatment of shoulder plexitis, preventive measures must be observed. Also, these measures are recommended because they have not encountered this disease.
Swimming helps prevent the development of the disease, keeps the body in good shape. Water helps to get rid of tendon diseases, it is recommended as a remedy for the prevention of arthritis, relieves of many negative symptoms.
Physical activity combined with swimming. This helps to knead joints, preventing their “ossification”, increases the body’s ability to rely on diseases of various nature.