Radial Nerve !

[emad]

Hi all;

Today visite me a young married woman 22 years , pregnant 6 months , with radial nerve palsy/compression/neuropraxia .

Her weakness begun since 8 days ,as pain in the middle of the arm and around the elbow joint area, she said now thus pain decreased but i feel my hand heavey to move .

assessment reveal :arrow:
fingers extension weak :arrow: grade +2
wrist extension :arrow: 2
thumb abduction :arrow: 2
thumb extension :arrow: 2

when i applied what i imagine ULTT for radial nerve was positive compose of ( shoulder adduction,internal rotation,elbow extension,supination,wrist flex,ulnar deviation,) she complained of more pain and very slight numbness along forearm posterior aspect .

ULTT :arrow: slight pain in anterior aspect of the elbow .


What are your views and suggesations for treatment . :?:
cheers
emad

[nari]

emad
Can you tell us more of her history and has she had any investigations into the problem?


Nari

[BB]

Hi Emad,

What are your findings at her shoulder and cervical spine?

How does she use the arm functionally? (occupation, recreation, etc.)

Cory

[emad]

Hi Nari &Cory:

No past complaints , or any past history of complaints.

No investigations performed !
Neck(cervical & Thoracic regions ) are absoultely free :arrow: no pain at all with her cervical motions.

Shoulder is absoultely free.

just i forget to write ,there is tenderness of the biceps tendon near the elbow joint .

about her funcational use of her upper limb , in her house activities , no job , no sports .


But , i put the hypothesis , she might lied on her upper limb , Or / she might let her husband sleep on her arm along all night :lol: :lol: :lol:

thus culture

I asked her if she let her husband lied on slept on her arm , but she was ashamed /shy to tell me .


Reflection On my past experience

Since one year visited me a young guy 30 years with signs of drop wrist ( radial nerve ) , i worked with him one week , then i noticed there are signs of facial palsy , really the signs were only on the mouth , i wrote my observations to the Doctor , who referred him to CT Scan , then we found Tumor in his Brain , he gone under surgey , then hemiparesis then physiotherapy .

So i will try to be cautauios. :? :?

cheers
emad

[emad]

Hi all :

Up to date regarding that case .

today she visits me .

Fingers extension is more better , but there some sign usually i meet with those cases of radial nerve weakness , when i ask the consumer to extend the wrist , it is weak extension with extended fingers , but with fingers flexed the wrist extension is very good :? :?

pain disappered ,which was through biceps brachi tendon .

thumb movement is more better .

cheers
emad

[BB]

Hi Emad,

She may be using her digit extensors to extend the wrist for compensation of weak wrist extensors.

With the fingers extended they are shortened and put at a decreased mechanical advantage to act at the wrist.

Cory

[emad]

Hi all:

This woman visited me today , very good outcome .

she said i am 95% more better , all pain and numbness disappeared and my hand is good .

Objectively:

i managed her for 16 days , 5 sessions of physio( composed of neural mobilis ,education , assurance )
she can extend her fingers ,wrist very good until grade 4 - ,but she says i am still not like before my probelm .

cheers
emad