A medium radial paralysis is a paresis of the radial nerve. Paralysis occurs in the area of the distal upper arm and is usually the result of injury or other external factors. The middle radial paralysis is usually localized within the so-called radial sulcus.
What is medium radial paralysis?
The medium-sized radial paralysis causes the affected persons to have restrictions in the mobility of their arms, wrists and fingers. In the majority of cases, paralysis of the middle radialis is only seen on one side of the body. See nonprofitdictionary for Cruciate Ligament Tear (abbreviated as CLT).
Because a simultaneous occurrence of the underlying factors on both arms is rather rare. For example, the patients have difficulty stretching their wrists due to the medium radial paralysis. A medium radial paralysis disappears on its own in many cases.
As a rule, the treatment of this disease depends greatly on the cause. In many cases, resting the entire musculature can lead to a positive course of the disease. In some cases, however, surgical interventions are necessary to resolve the symptoms. It does not affect the life expectancy of the patient. If the nerves have been irreversibly damaged, in many cases treatment is no longer possible.
Causes
The causes that lead to the development of a medium-sized radial paralysis vary from individual to individual. In principle, various factors and influences are capable of triggering paralysis of the middle radial nerve. In many cases, this involves damage to the radial nerve that occurs in the distal section of the upper arm.
In many patients, median radial paralysis develops as a result of pressure being applied to the corresponding nerve. The pressure becomes a problem especially when it lasts for a long period of time. For example, if the arm has been in the same position, such as on a hard surface or the back of a chair, for an unusually long time. Sometimes the disease is therefore also referred to as so-called park bench paralysis.
Plaster casts that are too tight can also damage or irritate the radial nerve. In addition, a medium radial paralysis develops in some cases in connection with fractures in the bones of the upper arm (medical term humerus).
Symptoms, Ailments & Signs
The characteristic symptoms and signs of an intermediate radial paralysis are numerous. For example, the affected patients are impaired in their supination and the abduction of the radius and ulna. Sometimes the sick person is unable to stretch their wrist as usual due to the paralysis.
These disorders are primarily caused by irritation of certain muscles, for example the supinator muscle. The inability to stretch usually affects not only the joint of the hand, but also the finger joints. For this reason, doctors also call the symptoms drop hand or finger. Muscles such as the extensor indicis muscle fail as part of this symptom pattern.
Flexing the lower arm is also only possible to an insufficient extent as a result of the middle radial paralysis. In addition, the affected persons show a reduction in the radius periosteal reflex. Paralysis of the middle radial also leads to disturbances in sensitivity, which are primarily concentrated in the lower arm area. On the other hand, there are no comparable complaints on the upper arm. The triceps tendon reflex is largely maintained during mid-radial paralysis.
Diagnosis & course of disease
The diagnosis of medium radial paralysis must be made by a doctor. If such a paresis is suspected, medical advice should be sought immediately. Therapy may be necessary, and starting treatment early has a positive effect on the prognosis and quality of life of those affected.
The doctor usually begins the examination with an anamnesis. It is important to ask about the individual complaints and to obtain information about potential causes for the complaints. In many cases, conclusions about the disease can be drawn from this, so that the doctor can make a suspected diagnosis.
Neurological examinations are essential for a reliable diagnosis of medium radial paralysis. The doctor checks the patient’s ability to straighten and bend their lower arm. In addition, it is tested whether the stretching of hand and finger joints is possible. Other significant clues come from whether the triceps tendon and radial periosteal reflexes are still functioning.
In this way, it is also possible to find out where the damage to the radial nerve is located. This makes it possible to differentiate it from upper radial paralysis, which must be done in any case as part of the differential diagnosis. Electroneurography is suitable for confirming the diagnosis of medium radial paralysis.
Complications
The average radial paralysis severely restricts the patient’s everyday life. In most cases, the affected person can no longer fully extend their wrist. Disabilities occur in everyday life and in various types of work, which significantly reduce the quality of life. Radial paralysis can lead to developmental disorders, especially in children.
Not infrequently, the fingers can no longer be stretched or moved. Furthermore, in some cases, the paralysis also affects the entire arm, so that the affected person may be dependent on the help of other people in their everyday life. Due to the radial paralysis, the patient’s protective mechanism is also significantly restricted and reduced, so that various injuries can occur more easily.
When should you go to the doctor?
Persistent or sudden disturbances in the movement sequences indicate a health impairment that should be clarified by a doctor. If there is paralysis, motor irregularities or loss of muscle strength, a doctor is needed. Medium radial paralysis is characterized by disorders of the wrist.
Therefore, a visit to the doctor is recommended as soon as, for example, the stretching movements of the hand can no longer be carried out. If the person concerned is unable to move their hand, wrist or fingers as usual, they should see a doctor. As soon as everyday activities such as brushing teeth, washing or getting dressed can no longer be carried out without problems, it is advisable to seek a medical examination.
If the flexion of the lower arm can no longer be carried out completely, the symptoms need to be clarified. If the state of health deteriorates, everyday activities can no longer be managed or sensory disorders occur, a doctor should be consulted. If the person concerned is unable to carry out gripping movements, do paperwork, or if the symptoms lead to increased insecurities and minor accidents at home, medical help is required.
If there are emotional irregularities as well as physical irregularities, there is a need for action. In the case of mood swings, behavioral problems or deep despair, the support and help of a doctor can provide relief.
Treatment & Therapy
The measures taken to treat medium radial paralysis are primarily dependent on the triggering factors. In many cases, nerve paresis due to pressure damage does not require treatment. By resting the affected arm, the symptoms usually improve on their own and disappear again after a few days.
In this case, the prognosis for average radial paralysis is generally good. If the shaft of the upper arm is broken and the radial nerve is damaged as a result, surgical intervention is usually necessary. This also applies to so-called comminuted fractures, which are reconstructed as far as possible during operations.
Outlook & Forecast
In general, medium radial paralysis leads to a good prognosis. This is especially true if it was caused by a pressure lesion. Sick people usually do not need medical treatment. A protection is enough. The body has sufficient strength to bring about a healing after a few days. A reduction in quality of life is not to be expected. Average radial paralysis does not shorten lifespan.
The treatment of a comminuted fracture is significantly more complex. But even for this case, scientific medicine has developed sufficient therapeutic approaches to usually achieve complete elimination of the symptoms. The prospects can also be described as good. Early treatment is essential.
In principle, recovery also depends on the physical condition at the time of illness. In the case of elderly people and those with previous illnesses, healing takes significantly longer. They also suffer from increased mobility restrictions and pain after the initial therapy. Certain sports may no longer be allowed to be carried out or only under light loads. Restrictions may apply for lifting heavy objects.
Prevention
Preventive measures to avoid medium radial paralysis start with the triggering factors of the paresis. If possible, pressure damage to the corresponding nerve should be avoided and the arm should be spared.
Aftercare
Whether follow-up treatment is necessary for moderate radial paralysis depends on the specific case. In most cases, however, no investigations need to be carried out or further measures taken. The signs of the disease disappear by themselves without treatment. Therefore, as a rule, no check-up by a doctor is necessary.
In the case of long-lasting symptoms of medium radial paralysis or incomplete healing, it is usually necessary to continue treatment or take certain rehabilitation measures. The specific follow-up treatments that should be taken depend on the cause of the disease and the chosen therapeutic measures. In any case, regular check-ups by a specialist are necessary.
Basically, the most important measure for aftercare is extensive protection of the affected arm. If the middle radial paralysis is triggered by a fracture of the upper arm, surgical treatment usually follows. In the course of aftercare, it is particularly important for the surgical scar to heal.
For this reason, some medical examinations are necessary, which can usually be carried out on an outpatient basis. Furthermore, in most cases, physiotherapeutic treatment is advisable. This allows patients to regain mobility in the affected arm. If no serious complications occur, follow-up care for moderate radial paralysis is usually completed within a few months.
You can do that yourself
In order to reduce impairments of the muscles or nerve tracts in the organism, care should be taken with the posture that no vessels or fiber tracts are pinched. Stiff or rigid physical positions should not be held for long periods of time. In addition, no pressure should be exerted on the body by external influences. After a period of sitting or standing, balancing movements are important for a good functioning of the circulatory system and for supplying the organism with nutrients and messenger substances.
It is advisable for the patient to regularly engage in various sporting activities in order to maintain their health and exercise their mobility. At the same time, one-sided physical stress should be avoided in everyday life. In particular, the extremities must be protected from overload or excessive stress. Lifting and carrying heavy objects should be avoided to avoid damage to the nerve tracts.
If a moderate radial paralysis is diagnosed, the patient should rest his arm sufficiently and keep it still. In many cases, reducing physical activity for several days reduces the existing symptoms. Applying heat to the affected region also helps to improve the impairments. In addition, it protects against other diseases such as inflammation or irritation of the nerves.
