A pinched nerve occurs when anatomical structures in its immediate vicinity encroach upon the nerve. In other words, the nerve becomes compressed by obstructions such as bones, tendons, muscles, or cartilage. The application of too much pressure subsequently interferes with that particular nerve’s ability to function. This translates to pain, numbness, and uncomfortable symptoms for the patient.
This situation can occur in different parts of the body although it mainly affects the back or neck. And, although this condition can be remedied by proper rest including sleep hygiene and massage, sometimes, nothing short of a visit to the orthopedic surgeon will provide comfort.
Damage caused by a pinched nerve can be transient in its duration or long-lasting. And while doctors can’t fully cure this condition in some patients, the right treatment will alleviate pinched nerve pain.
Symptoms of Pinched Nerves
This condition usually comes with a number of symptoms which signal to its presence. The most common sign of its occurrence, however, is the presence of pain. Other signs and symptoms that herald the occurrence of a pinched nerve include:
- A decline in sensitivity and feeling of numbness in the area controlled by the pinched nerve
- Paresthesia (or a pins-and-needles tingling sensation) in the limbs
- Tingling in the area of the pinched nerve
- A feeling of fatigue when performing certain activities
- Radiating pain which can feel sharp, aching, or burning
- The feeling that a limb is unresponsive or has fallen asleep
Some of the symptoms listed above can worsen when you attempt to move certain parts of your body such as your head or neck. These symptoms can also intensify at night while you attempt to sleep.
Causes of Pinched Nerves
There are several orthopedic causes that can lead to a pinched nerve. For example, one of the most common precipitating factors is poor posture. The following list includes other circumstances that can lead to a pinched nerve:
- Participating in an occupation or activity that involves making repetitive motions
- Maintaining a particular position for long periods of time (e.g. sleeping with your elbows bent)
- Becoming obese or overweight
- Engaging in sporting activities
- Sustaining an injury
- Developing osteoarthritis or rheumatoid arthritis
You will often find that pinched nerves occur in parts of the body that lack soft tissues to cushion the nerves. For instance, pinched nerves often occur near foramina (narrow openings in vertebrae through which nerves radiate outward). Such an occurrence can cause pain to develop in the neck or lower back. If the pain spreads outward from the neck region and into the shoulder or arm, doctors call this condition “cervical radiculopathy.” If the pain radiates from the lower back and into the leg or foot, then doctors term this condition “lumbar radiculopathy” or sciatica.”
Likewise, a pinched nerve can develop from the occurrence of changes in spinal discs, such as a disc’s tearing. Doctors refer to this condition more commonly as a “herniated” or “ruptured” disc.
Treating Pinched Nerves at Home
There are several ways to arrest a pinched nerve situation. Some of these are simple treatments that you can attempt within the confines of your home. The particular remedy you use should depend on the area of the body where the pinched nerve occurs and the underlying cause. Likewise, the time it takes to fully eradicate symptoms will vary depending on the individual. The following are some ways that you can address pinched nerves at home:
1. Improve your posture.
One of the many causes of pinched nerves is poor posture. This means that you can often remedy a pinched nerve by simply adjusting your posture throughout the day. The use of neck rests, cushions, and pillows will assist you in achieving a neutral spine position. This ideal position decompresses spinal nerves and may even lead to a resolution of your pain.
2. Get more rest and better sleep.
Another way that you can treat pinched nerves at home is to achieve longer and more restful sleep. The body undergoes a process of cellular repair while we sleep. This, combined with resting the affected nerve from strenuous activities, will encourage healing.
3. Perform routine stretching.
Performing regular stretching activities, such as yoga exercises, can also soothe pinched nerves. You should do your best to ensure you are not overdoing it, however. If you attempt to do too much too soon, you may actually worsen your condition. If you experience discomfort while stretching, you are advised to stop and immediately consult your doctor.
4. Use medications as prescribed or needed.
Certain medications are also useful in treating pinched nerves. Medications such as ibuprofen, which is a non-steroidal anti-inflammatory drug (NSAID), can eliminate your pain and swelling. In some cases, a reduction in inflammation can also put an abrupt end to nerve compression.
5. Test out ergonomic aids.
Consider switching to ergonomic office equipment to improve your workday posture. An ergonomic mouse and keyboard will result in less pressure being exerted on the wrists. Also, adjusting the position of your computer screen to eye-level will reduce the need to incline your neck. This will reduce muscular strain on your neck and alleviate any pinching..
6. See a massage therapist.
Massaging the affected area and its surrounding structures can relax muscles and pinched nerves. As the tension releases, you may also find that your pinched nerve vanishes.
7. Lose weight.
Remember to keep your BMI within the normal range, even if this means adjusting your eating and exercising habits. Overweight individuals are more prone to a host of orthopedic issues, including pinched nerves and osteoarthritis.
8. Apply ice & heat to the affected area.
Applying ice to the affected area will help to alleviate local inflammation, whereas heat application will improve blood flow to the region. Blood carries essential components associated with healing, which can speed the recovery process from a pinched nerve.
If you do not find relief by using the methods above, then seek out the services of a board-certified orthopedic surgeon. When conservative methods fail to deliver relief, you may need surgery. The purpose of surgery for pinched nerves to ease the pressure on the nerve and as such, put an end to it. The surgery that your doctor performs, however, will depend on the nerve that is being compressed.
The mere occurrence of a pinched nerve is more or less a warning. And if it persists past a couple of days and defies all treatment, it can result in severe damages. If you observe the following symptoms, then, you should immediately see a doctor.
- Sudden paralysis or muscular weakness in your limbs
- Bladder or bowel incontinence
- Numbness in the saddle region (the rectum, inner thighs, and buttocks)
Enlisting the help of an orthopedic surgeon will allow you to determine the best course of treatment for you. For example, if your doctor diagnoses you with a herniated disc, then you may need to undergo an artificial disc replacement. This surgery involves the removal and replacement of the herniated disc with an artificial model. Other surgeries that individuals with pinched nerves undergo include laminotomies and foraminotomies. Both of these surgeries involve removing sections of bone in order to create more room for pinched nerves.
A laminectomy, for example, involves the removal of a part of the lamina, or the backside of a vertebra. A type of decompression procedure, this technique releases pressure on the spinal cord and nerve roots. Such pressure might be a consequence of an injury, herniated discs, or even tumors.
A foraminotomy is also a decompression procedure. Your surgeon will perform this particular technique to widen the foramina, permitting the nerves to pass through unfettered.
Do you have a pinched nerve that requires intervention? If so, you don’t have to suffer any longer. Let a seasoned orthopedic team with over 20 years of clinical experience handle your case. Contact our pinched nerve doctors at Orthopedic & Laser Spine Surgery and rest assured that your recovery is in good hands!
Jumper’s knee was a term first coined in 1973 as a layman’s word for insertional tendinopathy. Such an injury describes damage to an athlete’s tendon at the point where it meets the bone. Patellar tendinitis involves the point where the kneecap tendon meets the lower kneecap pole. The condition, more specifically, refers to functional stress overload as a direct result of repetitive jumping.
Jumper’s knee is a common form of tendinopathy among athletes with mature skeletons. In fact, the condition occurs in as many as 20% of all jumping athletes. Both genders are equally affected when it comes to developing jumper’s knee on both sides of the body simultaneously. Although this may be the case, one-sided jumper’s knee is twice as likely to affect males as it will females.
Causes of Jumper’s Knee
Generally speaking, repetitive stress on either the patellar or quadriceps tendon during jumping often leads to this condition. This injury specifically affects athletes, especially those who partake in sports with ample amounts of jumping (e.g. basketball, volleyball, long jumping, etc.) Occasionally, jumper’s knee may occur in soccer players, weight lifters, and cyclists (although this is more unusual).
General risk factors for developing this condition include:
- Deformities that lead to an increased angle of the knee
- An unusually low or high kneecap
- Having a difference in leg lengths
- Performing sports on hard surfaces
Factors that influence the condition also include poor flexibility in the quadriceps and hamstrings, vertical jump ability, and the techniques that the athlete uses to jump and land. All of these considerations influence tendon loading.
Naturally, the kneecap tendon has a much greater mechanical load during landing than it does while jumping. This is due to the off-center muscle contraction of the quadriceps. This unusual muscle action, which occurs naturally when we jump, may lead to mechanical overexertion and subsequent injury.
Jumper’s Knee Classification & Symptoms
Although it may somewhat depend on the nature of the case, jumper’s knee is generally categorized into 1 of 4 stages:
- Phase 1 – Pain only occurs after the athlete completes the activity, with no functional impairment during the activity.
- Phase 2 – The athlete experiences pain during and after the stressor activity. Although there is pain during the activity, the athlete should still be able to perform adequately in their sport.
- Phase 3 – Pain persists during and after athletic activity. At this point, it becomes much more difficult for the athlete to perform at a satisfactory level.
- Phase 4 – The tendon has torn and will require surgery to fix.
Jumper’s knee may manifest as either chronic or acute, meaning that the condition may have a sudden onset or it may result from repetitive motions over time. Individuals with the condition may experience one or several of the following symptoms:
- Pain: The main, most obvious symptom. An athlete may experience throbbing pain beneath the kneecap during activities that stress the knee joint. Usually, pain worsens with activity continuation and diminishes with rest. Over time, however, the pain may become constant, even during periods of no activity. Actions such as kicking, running, and bending the knee can all exacerbate the pain associated with the condition.
- Swelling: Jumper’s knee may lead to minor swelling of the knee joint, thereby reducing the athlete’s range of motion.
- Bruising: Discoloration of the knee may be observable in cases of acute jumper’s knee.
- General Discomfort: If the case is bad enough, symptoms may manifest from daily activities such as climbing stairs, bending down, or kicking.
If you suspect you have jumper’s knee, then you should consider resting. Otherwise, the condition will only become progressively worse with time.
Jumper’s Knee Diagnosis
If you suspect that you have a sustained knee injury, then you should always seek medical help. Especially if you are an athlete. For a knee injury, the diagnostic procedure often includes:
- Physical Exam: Your doctor will almost always perform some variation of a physical exam if you walk in with a knee injury. A physical exam is useful for detecting anomalies such as swelling, limited range of motion, bruising, abrasions, and more. Your symptoms will tell your doctor a lot about the nature of your case. Throughout this process, your physician will ask you a series of questions about the causes of your injury, the kind of symptoms you are experiencing, and the intensity of your pain.
- Medical History: Almost any visit to a doctor’s office will involve providing your detailed medical history. Sustained knee injuries are no different in this regard. Your medical history is important to your physician as it will be able to tell him or her whether a pre-existing medical condition has had any bearing on your case.
- Imaging Tests: Once your physician has conducted a physical examination and reviewed your medical history, he or she will then order imaging tests (such as x-rays or MRIs). Whatever avenue your doctor decides to use will help to solidify his or her final diagnosis of your condition.
Treatment for Jumper’s Knee
As with most medical conditions, treatment for jumper’s knee usually breaks down into conservative options or surgical procedures. Usually, your doctor will attempt to exhaust conservative treatments first before considering surgery. But, this obviously depends upon the nature of your case.
If you have an immediate injury that needs attention, then you should consider using NSAIDs and the R.I.C.E method (rest, ice, compression, and elevation). Both of these methods help to reduce pain and swelling around the affected area.
The list of conservative treatments for a knee injury is quite extensive. Your doctor may recommend the following methods:
- Exercise Training: Involves a series of knee-strengthening exercises to alleviate the symptoms of your condition. These techniques are often used in conjunction with bracing to support the knee during the healing process.
- Injection Therapy: Only used for more advanced cases, this involves administering a corticosteroid injection to the athlete to reduce inflammation and accelerate healing.
- Platelet-Rich Plasma Therapy: Involves injecting the patient with their own platelet-rich plasma as a means to accelerate the healing process
- Dry Needling: With this treatment, a needle without a syringe is inserted into the injured area and moved using the guidance of an arthroscopic camera. The goal of this is to break up degenerative structures at the injury site that may be contributing to the patient’s condition.
- Hypothermic Thermotherapy: This treatment uses both a heating and a cooling source to raise the temperature of damaged tissues at the injury site. During this process, the cooling source ensures that the surface level tissues remain cool.
- Extracorporeal Shockwave Treatment: This entails sending electrical impulses into muscle tissue that surrounds the knee bone to deliver force to affected tissues. The force from these waves encourages damaged tissues to heal faster.
The two most common procedures for treating severe cases of jumper’s knee include:
- Arthroscopic Resection of the Inferior Aspect of the Kneebone: Your doctor will employ this method if the inferior aspect of the patella needs to be removed or realigned. This is performed in order to remove unwanted stress on the patellar tendon.
- Arthroscopic Debridement: A small camera and several specialized surgical implements are inserted into the affected site and then used to remove damaged tissue.
Do you believe that you have a knee injury such as patellar tendinitis? If you think you do, then seek out medical consultation as soon as possible. Unfortunately, untreated injuries will only exacerbate over time, so seek help from a board-certified orthopedic specialist. Our team is composed of passionate experts who run an efficient facility with the goal of getting you back to life and enjoying the things you love. Don’t hesitate, contact us today!
Carpal tunnel syndrome (CTS), which leads to pain, numbness, and tingling in the hand and arm, is a frequent occurrence among office workers. CTS occurs when a component of wrist anatomy compresses the median nerve (a major nerve in the hand that innervates the wrist).
In the vast majority of cases, carpal tunnel syndrome symptoms only worsen with time. Therefore, it is always important to seek a diagnosis and treatment plan as soon as possible. In the early stages, symptoms may be alleviated through conservative measures such as wearing a wrist splint or avoiding certain intensive activities.
That being said, if pressure on the median nerve persists, it may lead to nerve damage—and as a result—exacerbated symptoms. To prevent permanent damage, it may be necessary for some patients to undergo surgery in order to relieve this pressure.
The Anatomy of the Wrist
The carpal tunnel is an inch wide passageway that travels through the wrist. This tunnel is formed by the meeting of small wrist bones that medical experts refer to as the carpal bones. The root of this tunnel is a strong series of connective tissues known as the transverse carpal ligament. These boundaries are very rigid, meaning that the carpal tunnel has little to no flexibility when it comes to increasing its size.
The median nerve headlines the show going on in the hand. It begins as a group of nerve roots in the neck, and these roots bunch together to form a single nerve in the arm. This nerve then travels down the arm and forearm, where it passes through the carpal tunnel located in the wrist and leading down to the hand. The median nerve provides us with feeling in our fingers, as well as control over the muscles surrounding the base of the thumb.
In addition, the nine tendons that bend the fingers and thumb also pass through the carpal tunnel. Medical experts refer to these tendons as flexor tendons.
What is Carpal Tunnel Syndrome (CTS)?
Carpal tunnel syndrome (CTS) occurs when the tunnel that contains the median nerve narrows or when the tissues surrounding the flexor tendons begin to swell. Medical experts refer to these tissues as the synovium, and they may cause pressure on the median nerve when they swell in size. Under normal circumstances, these tissues lubricate the tendons, which allows for greater flexibility in our fingers.
When the synovium swells in size and applies pressure to the median nerve, it leads to pain, tingling, numbness, and weakness in the hand. Most cases of CTS arise from a variety of different factors. Generally speaking, women and the elderly are more likely to develop the condition.
The following list includes other risk factors that may lead to CTS:
- Repetitive Use: Repetitive actions of the hand and wrist over a period of time will aggravate the tendons associated with CTS. This causes swelling, which applies pressure to the median nerve.
- Pregnancy: Changes in the body’s hormone levels during pregnancy may cause swelling that increases pressure on the median nerve.
- Heredity: Genetics may also cause the development of smaller carpal tunnels, which changes the amount of space available in the wrist for the median nerve.
- Health Conditions: Other conditions such as rheumatoid arthritis, thyroid gland imbalances, and diabetes may lead to CTS.
- Position: Hand and wrist positions also have a bearing on the development of CTS. Any activity that involves heavy flexion or extension of the hand or wrist over time will irritate the tendons in the wrist.
Carpal Tunnel Syndrome Symptoms
The following list includes common symptoms of carpal tunnel syndrome:
- Sporadic shock-like symptoms that radiate to the thumb, index, middle, and ring fingers.
- Numbness, tingling, and pain in the thumb, index, middle, and ring fingers.
- Pain may also travel up the forearm and into the shoulder
- Weakness in the hand
- Poor hand grip (You may frequently drop objects)
Most of the time, the symptoms of carpal tunnel syndrome begin slowly, and usually without an isolated injury or cause. Symptoms often come and go at first, but as CTS worsens, symptoms may arise more frequently and persist for much longer.
Symptoms at night time are also very common. Many people sleep with their wrists at an angle, and this may lead to insomnia in patients with CTS. During daytime hours, symptoms often occur while holding something for a long period of time with the wrist bent at an angle, such as while holding a coffee mug. Many patients will move or shake their hands to relieve symptoms during this time.
Do I Need Surgery for CTS?
Over time, CTS will weaken your hand and wrist muscles. If symptoms persist for a prolonged period of time, your condition will worsen and muscle damage may occur.
Your doctor may suggest surgery in the following situations:
- Conservative treatments, such as braces, corticosteroids, and physical therapy have not alleviated your symptoms.
- You find it progressively harder to grasp objects than you once did.
- Your symptoms have persisted without getting better for at least 6 months.
There are two types of procedures that doctors commonly use for carpal tunnel release surgery: open surgery and endoscopy. Either way, your doctor will cut ligaments around the carpal tunnel to release pressure from the median nerve. This, in turn, will help to relieve symptoms. After your doctor has completed the surgery, the ligament heals back together and also allows for more room surrounding the median nerve.
Open surgery involves a larger incision that may be as long as 2 inches, extending from the wrist to the palm. Endoscopic surgery works a little differently, by utilizing several smaller incisions and a tiny camera to help guide your surgeon through the procedure. This, of course, is a much easier procedure to heal from than open surgery. That being said, not all CTS cases are viable for endoscopic surgery. You will need to talk with your doctor to find out which procedure is best for your specific needs.
CTS Surgery: The Recovery Process
Some relief may occur on the same day as surgery, but the entire healing process takes a little bit longer than that. Patients should expect to experience pain and swelling immediately after their procedure. Your doctor will prescribe you medications that will alleviate any tenderness that you may experience. Soreness may last anywhere from a few weeks to a few months after your surgery.
Your wound dressing will stay on for at least 1-2 weeks, depending upon your case. During this time, your doctor will likely give you a list of appropriate exercises to perform in order to keep your fingers from becoming too stiff. That being said, you should still be careful to avoid too much strain while completing these exercises. Over time, you will be able to return to normal activities, such as driving, writing, and grabbing objects. This improvement typically becomes apparent by 6-8 weeks out, but full functionality may not return until the 10-12 week mark.
If you have any of the symptoms mentioned above, please contact us at (855) 853-6542. At Orthopedic Laser and Spine Surgery, we pride ourselves on our ability to provide the highest level of care and treatment to our patients in need. At OLSS, you can rest assured that you will be put on a treatment plan that is tailored to address your specific needs. Don’t hesitate, contact us today!
A herniated or slipped disc is the result of a disc moving out of place and applying pressure on nearby nerves or nerve roots. This is a very common problem because this injury often occurs during a variety of everyday events. Engaging in repetitive movements, improper lifting, or even carrying around excess abdominal weight can all result in a lumbar herniated disc.
In addition, as time goes by, we become much more susceptible to disc-related injuries. Our discs begin to break down, dry out, and tear. Furthermore, certain genetic factors may also make a person more susceptible to disc degeneration and a resulting herniated disc.
In the body, you have two sciatic nerves. These are the largest nerves in your entire body. They originate in the spine and extend all the way down the leg to the foot. You might already see where this is going. Herniated discs may put pressure on adjacent nerves, leading to neurological symptoms and pain. In the lumbar spine, the sciatic nerve just happens to be an adjacent nerve. So, when a herniated disc occurs at this point on the spine, it may lead to sciatica.
Lumbar Herniated Disc & Sciatica Symptoms
It is not uncommon for a herniated lumbar disc to put stress upon or inflame nearby nerves, leading to pain radiating along the length of the nerve. In fact, the most common cause of sciatica is a lumbar herniated disc.
These are some general characteristics of how a lumbar herniated disc may feel:
- Leg Pain: The leg pain associated with sciatica and lumbar herniated discs is much worse than the accompanying lower back pain. If the pain radiates along the sciatic nerve, then doctors call this condition sciatica.
- Variable List of Symptoms: A lot of factors determine the symptoms associated with both lumbar herniated discs and sciatica. This list includes the severity of the herniation, as well as other symptoms present in the back, buttock front/back of the thigh, calves, foot, and toes. Typically, however, the symptoms just affect one side of the body.
- Nerve Pain: Nerve pain from both conditions is very noticeable. Patients describe this kind of pain as searing, sharp, radiating, or piercing.
- Foot Drop: Foot drop is a condition that occurs when the patient has difficulty lifting the foot when walking, or perhaps when they stand on the ball of their foot. This is a neurological symptom that may occur with either condition.
- Neurological Symptoms: “Pins-and-needles” sensations, weakness, and tingling are all associated with both conditions.
- Quick Onset: Symptoms of lumbar herniated discs usually have a quick onset, but there are some cases in which symptoms develop gradually.
- Movement Pain:Sitting, standing, leaning forward, coughing, sitting for prolonged periods of time. All of these become painful with sciatica and lumbar herniated discs.
- Lower Back Pain:Lower back pain is sometimes present, but not with all cases. Aside from lower back pain, both conditions may result in stiffness, muscle spasms, and throbbing.
Rarer Symptoms of Sciatica & Lower Herniated Discs
Loss of bladder/bowel control, numbness in the saddle region, lower back pain, and weakness in the extremities are all signs of a condition known as cauda equina syndrome. This syndrome is quite rare, but if you believe you have it then you should seek medical attention immediately.
The stress and swelling of the nerves at the end of the spine may lead to paralysis and other lifelong impairments if you do not seek treatment immediately. Always, always seek out medical attention promptly if you believe you have cauda equina syndrome.
Causes & Risk Factors of Lumbar Herniated Discs with Sciatica
Lumbar herniated disc and sciatic pain may have a sudden onset, but usually, the condition comes on more gradually. Spinal discs have high water content, which helps these discs stay flexible to absorb the daily shock that the spine undergoes. Over time, these structures dry out, which leaves the disc’s tough outer shell more brittle and susceptible to cracking or tearing.
Less common causes of herniated discs include traumatic injuries, which could involve anything from a car accident to a fall. An injury may put so much pressure on the discs in the lower back that they herniate.
Here are some common risk factors for developing sciatica and lumbar herniated discs:
- Gender: Men are at twice the risk for developing lumbar herniated discs, which also increases their chance of developing sciatica that much more.
- Age: The most common age group for developing lumbar herniated discs is ages 35-50. After age 80, the condition usually does not cause symptoms.
- Physically demanding or repetitive work: Jobs that require heavy lifting or other such physical labor will put patients at a greater risk of developing lumbar herniated discs, and thereby sciatica. This is especially true for twisting actions.
- Obesity: When the spine has to support more weight, it is put under more stress. This only makes sense. Obese patients are 12 times more likely to have the same disc herniate twice. Doctors call this phenomenon recurrent disc herniation.
- Family History: People with a family history of disc herniation are much more likely to have their discs herniate than others.
- Smoking: Nicotine limits the blood flow to the discs, which exacerbates disc herniation and dampens healing. Degenerated discs are much more likely to tear and crack, leading to herniation.
Lumbar Disc Herniation & Sciatica Treatment
Most doctors will exhaust conservative options before considering surgery. Most cases of lumbar disc herniation resolve themselves within six weeks, so doctors urge patients to try more conservative options first. This does not work for everyone, however.
Here is a list of conservative options that many patients use to achieve herniated disc relief:
- Medications: Usually consists of muscle relaxants and NSAIDs. This is also great for sciatica patients.
- Ice Application: Good for initial inflammation and muscle spasms that occur with lumbar herniated discs. This will also help with muscle spasms associated with sciatica.
- Heat Therapy: After the first 48 hours, heat may also help reduce muscle spasms that occur with both conditions.
- Physical Therapy: Certain stretching exercises are great for treating both conditions. Your doctor will be able to give you information pertaining to your specific needs.
- Epidural Injections: In cases where normal medications are not enough, your doctor may recommend steroid injections. The effects of this treatment, however, vary.
Two minimally invasive procedures are typically used for sciatica and lumbar herniated discs. Most commonly, this includes a microdiscectomy or an endoscopic microdiscectomy. These procedures relieve the pressure on the nerve root and allow for a better healing environment.
Typically, the doctor removes only a small portion of the disc that is pressing against the nerve. The majority of the disc is left alone, structurally speaking. The doctor will use small incisions in a microdiscectomy.
For an endoscopic microdiscectomy, the doctor also uses endoscopic guidance. That really is the main difference. The doctor inserts the implements through a tiny tube to minimize damage to surrounding tissues. A small camera is also inserted through the tube to allow guidance for the performing surgeon.
Both surgeries are minimally invasive and performed on an outpatient basis.
If you are experiencing symptoms of either lumbar disc herniation or sciatica, please contact our spine doctors at (855) 853-6542. Our team is passionate about finding an individualized care plan that will work for you. Contact us today!
Brachial Neuritis (BN) is a neuropathic condition (otherwise known as Parsonage-Turner syndrome or neuralgic amyotrophy) that affects nerves in the chest, shoulders, arms, and hands. This condition causes pain and loss of functionality in the nerves that act as messengers between the brain/spinal cord and the rest of the body. These nerves that run along the spinal cord, neck, and shoulders are what medical experts call the brachial plexus.
BN typically leads to terrible pain in the shoulders. After this episode expires, movement limitation then follows the extreme pain. BN is a rare disorder with a very quick onset and usually is at its worst during the night time.
There are two main types of BN: idiopathic and inherited. Idiopathic means that the cause of the condition is largely unknown, while inherited BN is passed down amongst family members. The former is much more common than the latter. Usually, the condition is the result of the patient’s immune system attacking the body’s nerves. Presently, medical experts do not exactly know how the nerve damage occurs in either idiopathic or inherited BN, but great strides in research are always being made.
Causes of Brachial Neuritis
It is not uncommon for BN to be the result of some sort of injury or trauma. Some injuries from contact sports, such as football or hockey, cause temporary weakness in the shoulder, as well as numbness and pain. More serious injuries from major trauma, such as a car accident or a harsh fall, lead to the same symptoms although their manifestation is much more persistent.
As stated previously, BN has to main causes: the patient either inherits it or the condition is idiopathic. The former is nowhere near as common as the idiopathic manifestation of the condition. As the name suggests, with inherited BN the parents of the patient pass down the ailment to their child. Idiopathic forms of BN are instead just forms of the condition where the cause is unknown. This version of BN is much more common than the inherited form.
A lot of the patients who have a sudden onset of BN have a few things in common. For one, many of them may say that they have just gotten over some other illness, disease, or germ. Others may say that they have just recently undergone some sort of test or treatment. This includes things such as spinal taps, injections, or other tests that utilize dyes. In addition to these treatments, some patients have a sudden onset of BN after receiving radiation treatment or surgery.
Symptoms of Brachial Neuritis
The condition almost always starts off with some level of pain, ultimately leading into periods of muscle weakness and lost functionality. The severity and persistence of these symptoms will depend on which phase of the condition the patient is going through, as well as the specifics of their case. While symptoms vary from person to person, a general list is as follows:
- Sudden onset of extreme shoulder pain (typically the right shoulder). Many patients describe this type of pain as an intense stabbing or burning.
- Symptoms of pain exacerbate when the patient attempts to move the affected shoulder.
- Only the most powerful painkillers have any effect on treating the pain, with it still remaining constant for long periods of time.
- Many patients describe a loss of function or temporary paralysis in the shoulder muscles after a painful episode.
- Loss of muscle mass in the affected shoulder (atrophy).
- Multiple areas of numbness develop in different areas of the arm and/or shoulder.
- Sometimes BN affects the diaphragmatic nerves, which may result in shortness of breath.
Again, these are just to name a few general symptoms of the condition. It will always depend on the severity of your case, as well as your individual chemical composition. For more information, you should always communicate thoroughly with your doctor and remember to always ask questions.
How Do Doctors Diagnose Brachial Neuritis?
A fair question–after all the most common of the two types of this condition is the idiopathic form (meaning unknown cause). Of course, knowing the cause of a condition and being able to identify that a patient has BN are two totally different things.
To begin, your doctor will ask you questions regarding the nature of your condition and will perform an examination to look for areas that cause pain. If your doctor suspects BN early on, they will almost immediately test your shoulder functionality and muscle strength. In many people, it will be apparent which shoulder to examine first, as the affected shoulder often sticks out more than normally. During this time, your doctor will likely test your reflexes for anything unusual.
Once your doctor has laid down some groundwork, he or she will likely order imaging tests such as MRIs, CT scans, or X-rays. In some cases, your doctor may order electrical tests (such as electromyography or nerve conduction study) that show if individual nerves are performing as they normally should. Additionally, if your doctor suspects any other underlying medical conditions, he or she may order blood tests to check for those as well.
Brachial Neuritis Treatments
Most often, doctors treat BN with a multifaceted approach involving medication and physical therapy. That being said, there are some instances where a doctor may feel it is necessary for the patient to have surgery. These cases, however, are few and far inbetween.
To begin, your doctor will prescribe you with some form of pain medication. Pain is the most immediate symptom, so doctors often address this first before anything else. Once the pain situation is brought down to manageable levels, your doctor will then began treatment to eliminate paralysis of the arm and regain functionality. In order for this to happen, your doctor will most likely set you up on a rehabilitative physical therapy program that may last up to eight weeks. The length of this program, as well as the nature of the exercises, will entirely depend on the needs of your case. Don’t worry too much though, as your doctor will set you up with a physical therapist to make this process very manageable.
Unfortunately, sometimes conservative treatments simply are not enough to get the job done. In such instances, your doctor may put you on the path of surgery. Usually, this only happens after two years of consistent failure from more conservative methods. Of course, you may be able to truncate this time period if you opt in for surgery earlier. For this, however, you will need to have an extensive conversation with your doctor.
Surgical treatment for BN usually involves repairing nerves via grafts from normally functioning nerves elsewhere in the body. If successful, this procedure will return function to the muscles affected by BN. Of course, surgical treatments do not just begin and end with grafts. It is also possible to perform tendon transfers if your doctor deems it necessary to restore function.
Do you have extreme shoulder pain that simply doesn’t fade no matter what you try to do about it? If so, you may want to give us a call at (855)-853-6542. Our spine doctors at the Orthopedic Laser and Spine Surgery will work tirelessly to find the treatment plan that is perfect for the needs of your case. When you come to our clinics, you will meet a team of caring people dedicated to your recovery. Contact us today.