COMPRESSION-ISCHEMIC NEUROPATHIES OF THE SHOULDER GIRDLE AND UPPER LIMBS AMONG LAW ENFORCEMENT PERSONNEL – CLINICAL PRESENTATION, DIAGNOSIS, TREATMENT

Abstract

Compression-ischemic neuropathies (CIN) are a prevalent cause of peripheral nervous system disorders, particularly in professions involving repetitive strain and physical load. This study investigates the clinical presentation, diagnosis, and treatment of CIN of the shoulder girdle and upper limbs among law enforcement personnel. The research involved 60 patients with CIN and 20 control subjects with cervical osteochondrosis without neurological manifestations. Diagnosis was confirmed through a combination of physical examination, nerve conduction studies (NCS), Doppler ultrasound of upper limb arteries, ultrasound of peripheral nerves, and MRI of the cervical spine. Patient assessments included the Visual Analog Scale (VAS), DN4 questionnaire, Neuropathy Impairment Score (NIS), and Hospital Anxiety and Depression Scale (HADS). The primary etiological factors were identified as prolonged forced positioning and repetitive movements under load, with 40% of cases co-occurring with cervical osteochondrosis. Clinical presentation was characterized by numbness (90%), reduced sensitivity (83.3%), pain (80%), and muscle weakness (75%). Following a comprehensive inpatient treatment course, significant improvements were observed in pain scores (VAS: 5.2 to 0.5), neuropathic symptoms (DN4: 4.8 to 0.7), motor function (NIS: 5.8 to 2.6), and objective parameters from NCS and Doppler ultrasound. Blood levels of insulin-like growth factor 1 (IGF-1) were found to be elevated, suggesting its potential role as a marker for nerve regeneration. The study concludes that a combined pharmacological and physiotherapeutic approach is effective for treating CIN in this high-risk group and highlights the need for optimized diagnostic, preventive, and therapeutic strategies.