Treatment of upper extremity neuropathy

To relieve pain and inflammation, non-steroidal anti-inflammatory drugs are usually prescribed: Indomethacin, Meloxicam, Nimesulide.

Indomethacin is a non-selective cyclooxygenase inhibitor, has a powerful anti-inflammatory effect, relieves pain well, but also has strong side effects characteristic of this group of drugs (ulcerogenic, hepato- and nephrotoxic effects, causes allergic reactions). The drug is taken orally after meals. A single dose is 25 to 50 mg, twice or three times a day. Therefore, more modern drugs are used more often.

For example, Meloxicam, which is also quite effective, but acts selectively on cyclooxygenase-2, that is, directly on the inflammation site, and, due to this, is much better tolerated and does not so often cause side effects from the gastrointestinal tract and kidneys. At first, it is usually prescribed intramuscularly at 2 ml once a day, after achieving a therapeutic effect, they switch to tablet form. Tablets are taken once or twice a day at a dose of 7.5 mg, regardless of food intake.

If a patient with tunnel syndrome (carpal, cubital tunnel) does not stop experiencing severe pain, the treatment includes the introduction of Diprospan (Hydrocortisone) (50 or 100 U) with Novocaine (Lidocaine) into the tunnels. Usually, even a single procedure leads to a noticeable improvement in the patient's condition, sometimes the pain intensifies during the first two days, however, later its intensity decreases and then the pain stops bothering at all. In cases of recurrence of the pain syndrome, the procedure is repeated at intervals of two weeks two more times. If there is no effect, surgical treatment is indicated.

In case of inflammatory processes in the joints that have caused a pinched nerve, oral corticosteroids may be prescribed, such as Methylprednisolone. It has high anti-inflammatory activity and, compared to prednisolone, is less likely to cause sodium retention in the body. However, it can still cause swelling, loss of calcium and potassium, suppresses the immune system and leads to the development of mental disorders. The dose is prescribed by a doctor, and the drug should be discontinued gradually with periodic dose reduction.

Prescriptions are made depending on the patient's condition. Pain syndrome in neuropathies can be quite severe. Various drugs from anesthetics to antidepressants are used to eliminate pain.

Daily compresses may be prescribed to relieve swelling, pain, and other symptoms of inflammation. The compress solution usually includes: the main anti-inflammatory component Hydrocortisone, the anesthetic Novocaine (Lidocaine), a conductor that also has a moderate ability to stop inflammation - Dimexide. The compress is made on a water basis, it is kept on the hand for about an hour.

In addition, diuretics Furosemide, Lasix, L-lysine aescinate, anticonvulsants (Gabapentin), muscle relaxants and vasodilators are used.

The use of the stimulator of nerve impulse conduction along peripheral nerve fibers Neuromidin allows restoring nerve conduction. It is used for various genesis of its disorders - as a result of injuries, intoxications, diseases. Stimulation of the central nervous system is moderate with manifestations of a calming effect, as well as pain relief and restoration of heart rhythm. The drug is considered hypoallergenic, does not have an immunotoxic effect and does not affect the endocrine system. Contraindicated for patients with peptic ulcer, bronchial asthma, severe heart disease, hyperkinetic disorders and epileptics.

Take one tablet two to three times a day. The duration of treatment is determined by the doctor.

Vitamins of group B are necessarily included in the treatment regimen, in any form - multivitamin complexes, injections (at the discretion of the doctor). In cases where neuropathy is caused by their deficiency, they eliminate this deficiency, and in this case such treatment can be limited. In other cases, their action also has a positive effect, helping to eliminate degenerative changes and restore the functioning of the peripheral nerve. Their neurotropic action is also accompanied by moderate pain relief, trophic effect and normalization of the hematopoiesis process.

Physiotherapeutic treatment in some mild cases can replace medicinal treatment: ozokerite and mud applications, magnetotherapy, diadynamics, electromyostimulation, acupuncture, and in addition to it - accelerate the recovery process. Medicinal electrophoresis with corticosteroids, NSAIDs, analgesics will help to quickly relieve swelling and reduce nerve compression, improve its nutrition.

Massage and exercise therapy are mandatory for neuropathy of the upper extremities. A set of therapeutic exercises is selected depending on the type of neuropathy, the loads are determined by the instructor and increase as recovery occurs. When performing therapeutic exercises, various devices are used to better develop the affected joint, and doing exercises in water also gives a good effect.

Folk treatment of neuropathy of the upper extremities

It is unlikely that you will be able to get rid of neuropathy using folk remedies alone, unless it was caused by physical overexertion, this factor is eliminated and rest is provided to the affected part of the hand. If the dysfunction of the limb is based on some pathological process, then it should be treated, and folk methods can be used as additional measures if the attending physician allows them to be used.

A massage with mustard oil can help reduce swelling and increase blood flow to the sore spot, as well as restore the functionality of the hand. It is applied to the affected limb and rubbed in with light circular movements until completely absorbed into the skin. This procedure warms the skin surface, stimulates nerve endings and helps reduce paresthesia, and at the same time heals the skin surface deprived of innervation. It is recommended to do the massage daily for 15-20 minutes.

You can also use castor or lavender oil as a massage oil, or alternate all three.

It is also recommended to make turpentine baths for hands. Necessary ingredients:

• grated baby soap – 30g;
• distilled water (can be filtered) – 600 ml;
• industrial gum turpentine – 500 ml;
• camphor alcohol – 20 ml;
• salicylic acid – 3g.

To prepare the mixture, pour water into an enamel container and let it boil, add grated soap and salicylic acid and, stirring with a glass rod, continue to cook for another quarter of an hour. Then remove the container from the heat and gradually, continuing to stir the contents, pour in turpentine, then camphor alcohol.

For a small basin, 10 ml of the mixture is enough, which is dissolved in warm water (≈36-37℃). You need to lower the sore limb into the basin and gradually add hot water to it so that the temperature rises at a rate of one degree per minute. The procedure takes ten minutes. After that, you need to rest for two hours, it is better to lie down, keeping the sore limb warm and calm. You can take baths before bed. Contraindications to such procedures are intolerance to the ingredients; people with heart disease and respiratory organs should do it with caution.

The bath mixture is stored in a cool, dark place in a container with a lid, preferably not transparent. Stir before use.

Baths for neuropathy can also be made with pine needles and red hot pepper. First, prepare a pine decoction, for which measure out 600 g of needles, then chop and pour three liters of water. Bring to a boil and boil for half an hour. Turn off the heat and let it brew for about forty minutes. Then add two teaspoons of red ground pepper to the bowl with the decoction. Keep the limb in the bath for 20-30 minutes. Blot dry with a towel, and massage the problem area with nourishing hand cream.

It is recommended to take this vitamin mix daily on an empty stomach: mix 300 ml of kefir or sour milk with two tablespoons of sunflower seeds ground in a coffee grinder and ½ cup of finely chopped parsley, stir. You can have breakfast like this - it's easy and healthy.

The basis of folk medicine is herbal treatment. Neuropathy can also be treated using medicinal plants.

Massage and compress oil from St. John's wort with ginger. Fill a 0.5 l jar with chopped above-ground parts of freshly cut St. John's wort. Do not trample. Pour in sunflower oil heated to 50-60℃. Cover with a saucer and leave in a dark place for 20 days. Strain, add a tablespoon of dry ground ginger. Stir before use.

The following remedy will help restore the sensitivity of the limb: take four tablespoons of ginkgo biloba leaf powder and brew it for three hours in a liter thermos with boiling water. Then strain and drink it throughout the day in random portions. Treat until the condition improves.

Traditional medicine suggests treating demyelinating neuropathy with a decoction of dandelion roots: pour a full tablespoon of roots crushed into powder with 300 ml of boiling water and boil over low heat for a quarter of an hour and leave for the remaining ¾. Then strain and drink every day before breakfast, lunch and dinner.

For neuropathy of any genesis, it is recommended to prepare the following collection from dried plants:

• 10g each of peppermint leaves and chamomile flowers;
• 20g each of centaury herb and birch leaves;
• 30g each of blueberry leaves and immortelle flowers;
• 40g each of St. John's wort and knotweed.

Make a mixture and take four tablespoons of it. Pour a liter of settled and filtered water into an enamel bowl and leave for eight hours (or overnight). In the morning, put it on the fire, bring to a boil and simmer for five minutes. Turn off the heat and leave for a third of an hour. Strain and drink in random portions throughout the day.

The following mixture has a beneficial effect on the peripheral nervous system and helps in its restoration: mix equal volumes of crushed dried plant components - succession grass, cleavers, verbena, cocklebur and dead nettle, burdock and licorice roots, elder flowers, hop cones and birch leaves. Pour two tablespoons of the herbal mixture into a thermos and pour 800 ml of boiling water over it for three hours. Strain and drink in random portions before evening instead of tea.

You need to treat yourself with herbal infusions and decoctions for at least two decades, then take a break.

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Homeopathy

In the treatment of hand paresthesia and loss of sensitivity, substances of various origins are used - mineral: Magnesia phosphorica (Magnesium phosphate), Baryta and Calcarea carbonica (Barium and calcium carbonates), Causticum (multicomponent preparation), Graphites (Graphite), Zincum (Zinc); animal: Ambra grisea (substance from the intestines of a sperm whale), Apis (Honey bee), Aranea diadema (Cross spider), Crotalus (Rattlesnake); plant: Aconitum (Aconite), Lycopodium (Club moss), Pulsatilla (Meadow pasqueflower) and many others.

To treat neuropathy of the upper extremities with homeopathic remedies, you need to consult a homeopathic doctor. The arsenal of drugs used to eliminate such pathology is very large, so only a specialist in this field can select an effective drug.

Official medicine uses homeopathic preparations produced by the pharmaceutical industry.

One of the complex homeopathic preparations that can be prescribed for neuropathies, complications in the form of intense pain (causalgia), for the regeneration of nerve fibers and the restoration of their nutrition is Galium-Heel. The effect of its use is determined by the combined action of the components contained in the composition. The drug is indicated for the treatment of degenerative-dystrophic changes in peripheral nerves and causalgia, as well as many pathologies that cause such damage. It has a pronounced analgesic effect and is able to activate the body's immune defense. Mainly consists of substances of plant origin:

Galium Aparine (Cleavers) – diuretic and anesthetic;

Galium Album (White Bedstraw) – antispasmodic and sedative action;

Sempervivum Tectorium (Terrestrial Bugleweed) – burning pain;

Sedum Acre (Sedum Acre) – muscle relaxant and diuretic;

Thuja (Thuja) – hypothyroidism, metabolic disorders, loss of sensitivity, osteochondrosis, neuralgia, paresthesia;

Clematis (Clematis) – neuralgia;

Caltha Palustris (Marsh Marigold) – relieves cramps, inflammation, pain; all the above-described drugs are also used for oncological diseases;

Echinacea angustifolia (Echinacea) – immunostimulant, intoxication, lymphadenitis, injuries with tissue damage and the threat of sepsis;

Hedera Helix (Common Ivy) – has anti-inflammatory properties;

Juniperus Communis (Common Juniper) – diseases of the urinary system;

Saponaria (Soap root) – neuralgia;

Urtica (Stinging nettle) – neuritis, articular rheumatism, diuretic and other herbal components will help get rid of neuropathy of any origin;

Ononis Spinose (Spiny Horsetail) – used for kidney diseases and as an antirheumatic agent.

The composition also includes another organic component – Pyrogenium (a product of septic decomposition) as an antiseptic.

Inorganic substances are:

Phosphorus (Phosphorus) – prescribed for neuralgia, neuritis and nervous weakness, for diabetics, liver diseases, intoxication, including alcohol, paralysis, paresis and nerve atrophy;

Argentum (Silver) – contractures, paresthesia, osteochondrosis, diabetes insipidus, polyarthritis, intoxication;

Acidum Nitricum (Nitric acid) – arthritis and neuralgia;

No side effects of the drug have been identified.

A single dose is 10 drops. To relieve acute discomfort, take it every quarter or half an hour for the first 48 hours, then three times a day. You can dilute it in a tablespoon of water or just drop it under your tongue. Take it before meals, hold it in your mouth before swallowing. You can eat a quarter of an hour after taking it.

In case of neuropathies of traumatic origin, Traumeel C can be prescribed, which is not inferior in effectiveness to non-steroidal anti-inflammatory drugs. It is available in drops and tablets, ampoules for injections, in the form of ointment and gel. The therapeutic effect is provided by calcium compounds, Hamamelis virginiána (Witch hazel), Hypericum perfoliatum (St. John's wort), Millefolium (Yarrow), Aconitum (Aconite) and (Arnica montana) Arnica - capable of strengthening the walls of blood vessels, relieving swelling, pain, inflammation, and intoxication. Homeopathic dilutions of mercury compounds complement the effects of plant substances.

Chamomilla (Chamomile), Echinacea angustifolia (Echinacea), Calendula officinalis (Calendula), Symphytum officinalis (Comfrey), Hepar sulphur (Hepar sulphur) activate and normalize metabolic processes at the site of injury, promoting cellular renewal and restoration of normal tissue structure.

A single dose is 10 drops, in case of severe swelling it can be increased to 30 drops. Three times a day. They can be diluted in a tablespoon of water or simply dripped under the tongue. Take before meals, hold in the mouth before swallowing. You can eat a quarter of an hour after taking.

Keep the tablets under the tongue until completely dissolved, take one three times a day.

In the presence of joint diseases that have led to neuropathy, Traumeel can be combined with the complex remedy Ziel T, which alleviates the symptoms of these diseases - in particular pain syndrome, swelling, inflammation. The drug has a pronounced regenerating effect. Its formula includes 14-16 components (depending on the form) of plant - Arnica montana (Arnica), Rhus toxicodendron (Rhus toxicodendron, Bittersweet Nightshade), mineral (sulfur compounds, sodium, silicic acid), biological (placental, embryonic) origin. The combination of such active substances normalizes metabolic processes in tissues, restores their normal structure and activity.

The drug Ziel T is available in the form of sublingual tablets, ointment and ampoules with injection solution. Each dosage form comes with instructions for use in acute cases and during maintenance therapy. The drug is contraindicated in case of allergy to plants of the Asteraceae family or other components, although cases of hypersensitivity are extremely rare. In addition, the drug contains lactose, which should be taken into account in case of its intolerance. The injection solution and ointment are compatible with any drugs.

To eliminate the consequences of massive drug or alcohol intoxication, cleanse the body of toxins of infectious agents and the effects of other toxic substances, as well as strengthen the immune status, restore cellular respiration and nutrition in damaged tissues, you can use Lymphomyosot drops, in addition, use drugs that prevent hypoxic processes in tissues and metabolic disorders - Discus compositum, Ubiquinone compositum and Coenzyme compositum. These are injectable drugs, however, the contents of the ampoules can be used for oral administration. Doses and frequency of administration are prescribed by a doctor.

Surgical treatment

Indications for surgical intervention are constant intense pain and increasing negative symptoms - loss of motor functions, sensitivity, hypotrophic changes in the skin or persistence of symptoms for six months from the start of treatment. In most cases, surgeries allow to relieve the nerve from compression and create conditions that exclude its damage.

In case of traumatic nerve injuries, surgeries are also performed to restore its integrity; in case of neoplasms, the tumor compressing the nerve is removed or the hematoma after a bruise is drained.

Surgical treatment of neuropathy of the upper extremities is performed under local anesthesia using an open or endoscopic method. In the first case, the operation is performed through an incision approximately 5 cm long, in the second case, two or even one small incision up to 1.5 cm long is made.

Depending on the type of pathology, various operations are performed - dissection of the carpal ligament, canal plastic surgery and others, through which the nerve is released. After successful surgical treatment, in the recovery period, the patient's limb is immobilized for a while, medications and vitamins are prescribed for pain relief, removal of postoperative edema, improvement of trophism and nerve conduction. In addition, physiotherapy and exercise therapy are prescribed. Full recovery requires from three months to a year. This period depends on many factors, including the patient's age and the stage of the disease. Sometimes full recovery is impossible.

Laser treatment of upper limb neuropathy

Laser therapy is currently one of the newest methods of physiotherapeutic treatment and is not used everywhere. Low-intensity laser radiation (LILR) is used in the treatment of neuropathies. Its effect is still being studied, however, research data show its high efficiency, and at different stages of the disease of the peripheral nervous system. Patients with mild and moderate neuropathy respond especially well to laser therapy.

For example, laser acupuncture produces a pronounced clinical effect, which is manifested in a decrease in the intensity of pain and neurological symptoms – an increase in the speed of nerve impulses along the fibers responsible for motor skills, activation of blood flow in peripheral vessels, and an improvement in the basic criteria of immune status.

Positive results of LILI indicate stabilization of the condition of patients with neuropathy; their sensory-motor functions are restored approximately one and a half times faster.