The Latin word “plexus” means a plexus of nerve structures. In essence, plexitis is an inflammation of nerve structures. The neck-shoulder and lumbosacral areas are most commonly affected. The reason for this may be their greater mobility. The shoulder plexus is most commonly affected by plexitis. It is more common in men than women. It is characterized by severe pain in the shoulder area, loss of sensation and weakness throughout the upper limb. Among the most common causes of shoulder plexitis is an inflammatory process or trauma.
Causes, types of plexitis and symptoms
The leading symptom is acute pain of constant magnitude and variable strength. It often occurs unilaterally, and its intensity increases with movement or pressure. The pain affects the paravertebral muscles, the shoulder area, the floor and the supraclavicular area, but can also affect lower areas. Impaired sensitivity, tingling and weakness in the limb accompany the pain in the clinical picture. There are also autonomic vasomotor symptoms such as sweating, redness, swelling. The symptoms depend on the type of infection: upper / C5-C6 /, lower C8-TH1 /, total / C5-Th1 /. The upper type is the most common, and the total type is the most severe, causing flaccid paralysis of the whole arm.
The etiology of plexitis of the shoulder plexus is related to:
- injuries – difficult birth, fall, removed shoulder, broken collarbone;
- compression – from anatomical anomalies / of the cervical vertebrae or additional cervical rib /; infectious or toxic substances.
Diagnosis and treatment
Differentiation in the diagnosis is made by the method of excluding other diagnoses / radiculitis, carpal tunnel syndrome, nosological units related to the shoulder, etc./ Accurate diagnosis in addition to history and clinical examination may include other imaging studies at the discretion of the therapist doctor. Radiography provides information about the condition of the cervical spine and bone abnormalities. Electromyography is informative about the sensory and speed of the impulse in the affected nerves.
The treatment consists of medication of non-steroidal anti-inflammatory drugs, physiotherapy, kinesitherapy, with an emphasis on postural control and strengthening the back muscles with analytical therapeutic gymnastics. This puts patients in an active position, requiring time, attention and patience.