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Published in: Archives of Orthopaedic and Trauma Surgery 7/2007

01-09-2007 | Basic Science

Peripheral paresthesia in patients with subacromial impingement syndrome

Authors: Manoj Sivan, Balachandran Venkateswaran, Hannan Mullett, Tirtza Even, Saleem Khan, Steven Copeland, Ofer Levy

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 7/2007

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Abstract

Introduction

Some patients presenting with subacromial impingement syndrome complain of tingling and numbness radiating to hand. In the current literature, there is no description of such paresthesia being a part of the clinical picture of impingement syndrome.

Objective

This observational study aimed at looking whether these symptoms resolve with successful arthroscopic decompression of the impingement.

Material and methods

One hundred consecutive patients undergoing arthroscopic surgery were enlisted for the study.

Results

Fifty-four percent reported paresthesia during the course of the shoulder problem (63% of them had radial sided symptoms, 29.6% ulnar-sided symptoms and 7.4% involving all fingers). Significant association was observed between the occurrence of paresthesia and worst pain levels (P = 0.0053), age of the patient (P = 0.0104) and the acromial impingement grade (P = 0.0377). Nerve conduction studies done in seven patients (with paresthesia) selected by systematic random sampling did not show any significant attributable entrapment neuropathy. Up to 12 months follow-up, 48 of 54 (88%) had complete relief of pain and paresthesia and 50 (92.5%) were satisfied.

Conclusion

Some patients with subacromial impingement syndrome report associated peripheral paresthesia radiating to hand, which is strongly associated with the age, pain level and the grade of impingement. In most (88%) of such cases, these symptoms are relieved after treatment of the impingment lesion. The incidence and aetiology of such paresthesia is the subject of further studies.
Literature
1.
go back to reference Abe M, Shimamura T, Nishida J et al (1997) Diagnosis and treatment of thoracic outlet syndrome. J Orthop Sci 2:119–127CrossRef Abe M, Shimamura T, Nishida J et al (1997) Diagnosis and treatment of thoracic outlet syndrome. J Orthop Sci 2:119–127CrossRef
2.
go back to reference Chauhan SK, Peckham T, Turner R (2003) Impingement syndrome associated with whiplash injury. J Bone Joint Surg Br 85(B):408–410PubMedCrossRef Chauhan SK, Peckham T, Turner R (2003) Impingement syndrome associated with whiplash injury. J Bone Joint Surg Br 85(B):408–410PubMedCrossRef
3.
go back to reference Copeland SA (1995) Operative shoulder surgery. Churchill Livingstone, Edinburgh pp 141–150 Copeland SA (1995) Operative shoulder surgery. Churchill Livingstone, Edinburgh pp 141–150
4.
go back to reference Date ES, Gray LA (1996) Electro diagnostic evidence for cervical radiculopathy and suprascapular neuropathy in shoulder pain. Electromyogr Clin Neurophysiol 36:333–339PubMed Date ES, Gray LA (1996) Electro diagnostic evidence for cervical radiculopathy and suprascapular neuropathy in shoulder pain. Electromyogr Clin Neurophysiol 36:333–339PubMed
5.
go back to reference Demondion X, Bacqueville E, Paul C, Duquesnoy B, Hachulla E, Cotten A (2003) Thoracic outlet: assessment with MR imaging in asymptomatic and symptomatic populations. Radiology 227(2):461–468PubMedCrossRef Demondion X, Bacqueville E, Paul C, Duquesnoy B, Hachulla E, Cotten A (2003) Thoracic outlet: assessment with MR imaging in asymptomatic and symptomatic populations. Radiology 227(2):461–468PubMedCrossRef
6.
go back to reference Gorski JM, Schwartz LH (2003) Shoulder impingment presenting as neck pain. J Bone Joint Surg 85(A):635–638PubMed Gorski JM, Schwartz LH (2003) Shoulder impingment presenting as neck pain. J Bone Joint Surg 85(A):635–638PubMed
7.
8.
go back to reference Jaeger SH, Read R, Smullens S et al (1984) Thoracic outlet syndrome. Diagnosis and treatment. In: Hunter J, Schneider L, Mackin E et al (eds) Rehabilitation of the Hand. St Louis, CV Mosby pp 378–390 Jaeger SH, Read R, Smullens S et al (1984) Thoracic outlet syndrome. Diagnosis and treatment. In: Hunter J, Schneider L, Mackin E et al (eds) Rehabilitation of the Hand. St Louis, CV Mosby pp 378–390
9.
go back to reference Leffert RD, Gumley G (1987) The relationship between dead arm syndrome and thoracic outlet syndrome. Clin Orthop 223:20–31PubMed Leffert RD, Gumley G (1987) The relationship between dead arm syndrome and thoracic outlet syndrome. Clin Orthop 223:20–31PubMed
10.
go back to reference Levy O, Sforza G, Ron M Dodenhoff, Copeland SA (2000) Arthroscopic evaluation of the impingement lesion: pathoanatomy & classification. JBJS (B) Supp III:233 Levy O, Sforza G, Ron M Dodenhoff, Copeland SA (2000) Arthroscopic evaluation of the impingement lesion: pathoanatomy & classification. JBJS (B) Supp III:233
11.
go back to reference McComas AJ, Jorgensen PB, Upton ARM (1974) The neuropraxia lesion: a clinical contribution to the study of trophic mechanisms. Can J Neurol Sci 1:170PubMed McComas AJ, Jorgensen PB, Upton ARM (1974) The neuropraxia lesion: a clinical contribution to the study of trophic mechanisms. Can J Neurol Sci 1:170PubMed
12.
go back to reference Morrison DS, Frogameni AD, Woodworth P (1997) Non-operative treatment of subacromial impingement syndrome. J Bone Joint Surg Am 79-A:732–737 Morrison DS, Frogameni AD, Woodworth P (1997) Non-operative treatment of subacromial impingement syndrome. J Bone Joint Surg Am 79-A:732–737
13.
go back to reference Neer CS, Welsh RP (1977) The shoulder in sports. Orthop Clin North Am 8:583–591PubMed Neer CS, Welsh RP (1977) The shoulder in sports. Orthop Clin North Am 8:583–591PubMed
14.
go back to reference SAS Release 8.2 SAS Institite Inc. (2001) Cary, NC, USA SAS Release 8.2 SAS Institite Inc. (2001) Cary, NC, USA
15.
go back to reference Upton ARM, McComas AJ (1973) The double crush in nerve entrapment syndromes. Lancet II:359–362CrossRef Upton ARM, McComas AJ (1973) The double crush in nerve entrapment syndromes. Lancet II:359–362CrossRef
16.
go back to reference Wright IS (1945) The neurovascular syndrome produced by hyperabduction of the arm. Am Heart J 29:1–19CrossRef Wright IS (1945) The neurovascular syndrome produced by hyperabduction of the arm. Am Heart J 29:1–19CrossRef
Metadata
Title
Peripheral paresthesia in patients with subacromial impingement syndrome
Authors
Manoj Sivan
Balachandran Venkateswaran
Hannan Mullett
Tirtza Even
Saleem Khan
Steven Copeland
Ofer Levy
Publication date
01-09-2007
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 7/2007
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-007-0409-5

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