Superficial Radial Nerve Lesion Clinical Trial
Official title:
Delto-Tricipital Compression Syndrome: A Randomized Treatment Comparison Trial of Dextrose Injection Versus Physical Therapy.
The posterior antebrachial cutaneous nerve (PACN) can be compressed between the deltoid and triceps, with resultant pain and dysfunction. The active treatment for this study will be injection of the point of compression and along the painful course of the sensory nerve with 5% dextrose. The control treatment will be physical therapy.
The PACN is a purely sensory nerve that originates in the midforearm, courses anterior to
the lateral epicondyle, and travels proximally until it dives between the posterior portion
of the V shaped insertion of the deltoid and the external? insertion of the triceps,
whereupon it joins with the radial nerve.
A proposed pathological explanation is that repetitive co-contraction produces irritation
and compression of the nerve at the delto-tricipital (D-T) fascial penetration point.
Clinically the patient experiences pain localized to that compression point, and traveling
distally along the course of some or all of the posterior femoral cutaneous nerve.
Perineural injection of dextrose has been previously reported for therapeutic use in chronic
pain associated with Achilles tendinopathy. Empirically,injection of D5W with a small needle
along the course of the PACN and at the D-T penetrator has been found to resolve both pain
and dysfunction (describe dysfunction).
Participants will be randomly assigned to either 1 month of physical therapy or to 0,1,2 and
3 week injection of D5W. The use of standardized measurement tools for pain (0-10 numerical
rating scale) and function (Quick DASH) will be utilized to determine baseline status and
status at 1 month. At 1 month, subjects receiving therapy will be allowed to cross over to
injection treatment and all participants will receive as needed treatment until the 1 year
period of follow-up. Thus only 1 month data is randomized but long term data will be
gathered.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment