Weak hands and involuntarily dropping objects

Introduction In patients with cervical rib syndrome, it is easy to fatigue when lifting the elbow, and the hand is weak and unconsciously throwing away the object.

Cause

For the cause of this disease, Chinese medicine and Western medicine have their own views:

1. Chinese medicine

The Chinese medicine understanding of this disease is roughly the same as that of the front scalene syndrome. Insufficient congenital endowment and cervical malformation are prerequisites for the occurrence of this disease. In addition, the internal causes such as weak liver and kidney weakness, weak muscle atrophy, and adulthood eventually become the disease. The etiology and pathogenesis of this disease should be recognized from the following two aspects.

(1) qi and blood stasis: congenital people with neck ribs, due to strain of neck and shoulder muscles, or long-term labor, can lead to local venous qi and blood stasis, muscles dying and causing pain.

(2) Liver and kidney deficiency: people with congenital deficiency and neck ribs, lack of function of liver and kidney sputum, leading to liver and kidney weakness, atrophy of bones and muscles, most of these patients feel the wind, cold and dampness, and obstruct the meridians, making the symptoms worse. .

2, Western medicine

The cervical rib is a deformed rib from the seventh cervical vertebra, which may be bilateral, and the distal end is connected to the first rib by a fiber band. The presence of the cervical ribs will cause the brachial plexus and the subclavian artery to rise, narrowing the thoracic outlet, and increasing the stretch of the vascular nerve to cause clinical symptoms. If there is a scapula with a sagging, a high sternum, and a high rib of the first rib, the symptoms are more obvious. People with cervical ribs do not have symptoms. This disease rarely occurs in people under the age of 30.

an examination

Related inspection

CT examination of bone and joint soft tissue

1, symptoms:

(1) Women who are born after the age of 40 have more right side than left side.

(2) Neck discomfort, toughness, neck and shoulder pain, and radiation to the elbow joint, the forearm ulnar side, the 4 fingers and 5 fingers of the hand, the pain accompanied by numbness, severe pain during the day, and relief at rest. Pain disappears or is relieved when the upper limb is raised; pain is exacerbated when the upper limb is pulled down.

(3) It is easy to fatigue when lifting the elbow, and the hand is weak and unconsciously throwing away the object.

(4) Repeated swelling, cold, pale, cyanosis or numbness in the hands and fingers are manifested by vascular involvement. In severe cases, gangrene between fingers can occur. Sometimes sympathetic symptoms are not easily distinguished from vascular symptoms.

2, signs

(1) The neck base is tender and the cervical vertebra activity is limited.

(2) Pressurization in the neck ribs can lead to local tenderness and radiation pain.

(3) In the supraclavicular area, the full beat can be touched and a tender mass can be reached. A murmur can be heard at the subclavian artery. The patient's hand is cold, and the radial artery beats weakly or even disappears. Bright skin, broken nails or ulcers between fingers. In severe cases, there are motor symptoms, weakness in the hands, muscle atrophy, and tremors in the muscles of the hands.

(4) When the ulnar nerve is compressed, the 4th and 5th fingers are hypersensitive and have atrophy of the interosseous muscle, the small intermuscular muscle and the female adductor muscle. The median nerve is affected by atrophy of the great intermuscular muscle, and sometimes the second, triceps and periosteal reflexes are reduced.

Differential diagnosis

Cervical rib syndrome occurs more than 30 years old, and its condition is similar to the onset and symptoms of cervical spondylosis. It needs to be identified clinically. In addition, the scapula sag, high sternum, first rib high, low brachial plexus and anterior oblique angle Muscle hypertrophy can cause symptoms similar to cervical ribs because they both compress the brachial plexus and the subclavian artery to produce symptoms. Clinically, it is also necessary to perform strict identification when making a diagnosis. Other diseases that need to be identified include cervical disc herniation, rib lock syndrome, excessive abduction syndrome, medullary cavity, spinal cord tumor, ulnar nerve carpal tunnel syndrome, and Raynaud's disease.

1, symptoms:

(1) Women who are born after the age of 40 have more right side than left side.

(2) Neck discomfort, toughness, neck and shoulder pain, and radiation to the elbow joint, the forearm ulnar side, the 4 fingers and 5 fingers of the hand, the pain accompanied by numbness, severe pain during the day, and relief at rest. Pain disappears or is relieved when the upper limb is raised; pain is exacerbated when the upper limb is pulled down.

(3) It is easy to fatigue when lifting the elbow, and the hand is weak and unconsciously throwing away the object.

(4) Repeated swelling, cold, pale, cyanosis or numbness in the hands and fingers are manifested by vascular involvement. In severe cases, gangrene between fingers can occur. Sometimes sympathetic symptoms are not easily distinguished from vascular symptoms.

2, signs

(1) The neck base is tender and the cervical vertebra activity is limited.

(2) Pressurization in the neck ribs can lead to local tenderness and radiation pain.

(3) In the supraclavicular area, the full beat can be touched and a tender mass can be reached. A murmur can be heard at the subclavian artery. The patient's hand is cold, and the radial artery beats weakly or even disappears. Bright skin, broken nails or ulcers between fingers. In severe cases, there are motor symptoms, weakness in the hands, muscle atrophy, and tremors in the muscles of the hands. (4) When the ulnar nerve is compressed, the 4th and 5th fingers are hypersensitive and have atrophy of the interosseous muscle, the small intermuscular muscle and the female adductor muscle. The median nerve is affected by atrophy of the great intermuscular muscle, and sometimes the second, triceps and periosteal reflexes are reduced.

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