Crutch palsy

Crutch Palsy is a medical condition primarily affecting the radial nerve that is often associated with the prolonged use of crutches. This condition is characterized by a loss of function and/or sensation in the arm, wrist, and hand, which can significantly impact a person's ability to perform daily activities. The radial nerve, which runs along the underside of the arm, is responsible for controlling movement and sensation in the arm and hand. When pressure is applied to this nerve for an extended period, as can happen with crutch use, it can lead to nerve damage known as crutch palsy.

Causes

Crutch palsy is most commonly caused by the improper use or fitting of crutches, where excessive pressure is placed on the radial nerve. This pressure can occur in the armpit area when crutches are used for mobility over a long period, especially if they are not adjusted correctly or if the individual leans heavily on them. Other causes may include direct trauma to the nerve, compression from prolonged bed rest, or other conditions that lead to nerve compression.

Symptoms

The symptoms of crutch palsy can vary depending on the severity of the nerve damage. Common symptoms include:

• Weakness in the wrist and hand, leading to a condition known as "wrist drop" where the individual is unable to lift the wrist or fingers.
• Numbness, tingling, or loss of sensation in the back of the hand and fingers.
• Difficulty with finger coordination and movement.
• Pain or discomfort in the arm, wrist, or hand.

Diagnosis

Diagnosis of crutch palsy typically involves a physical examination and a review of the patient's medical history, including their use of crutches. Additional tests, such as nerve conduction studies or electromyography (EMG), may be conducted to assess the extent of the nerve damage and to rule out other conditions.

Treatment

Treatment for crutch palsy focuses on relieving pressure on the radial nerve and restoring function to the affected arm and hand. This may include:

• Adjusting or discontinuing the use of crutches.
• Physical therapy to strengthen and improve flexibility in the arm, wrist, and hand.
• Occupational therapy to help with daily activities and to adapt to any limitations.
• In severe cases, surgery may be required to decompress the nerve or repair nerve damage.

Prevention

Preventing crutch palsy involves proper fitting and use of crutches, including:

• Ensuring crutches are the correct height and that the handgrips are properly positioned.
• Avoiding putting weight on the armpits by supporting weight on the hands.
• Taking breaks from crutch use to reduce pressure on the arms and nerves.
• Strengthening exercises for the arms and hands to reduce the risk of muscle weakness.

See Also

• Nerve compression syndrome
• Peripheral neuropathy
• Rehabilitation