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Dr. Khalid is a physician, a researcher, a health writer, and holds a Ph.D. in clinical research.


What is Acroparesthesia?

Acroparesthesia manifests through stiffness, numbness, burning sensation, and tingling across toes, fingers, feet, and hands. The severe form of acroparesthesia triggers severe episodic pain in the affected patients.

Clinical History

  1. The patients experience morning stiffness and weakness and tend to drop objects while undertaking their day-to-day activities. They appear careless from the movements of their hands and fingers.
  2. The affected extremities of the acroparesthesia patients develop burning pain and sensation during nighttime.
  3. The day-to-day activities that lead to brachial plexus compression trigger the acroparesthesia symptoms across the affected extremities. The patients experience sleeping disturbances and find it difficult to deliver their hundred percent at work.
  4. Middle-aged women have an increased tendency for acroparesthesia compared to males.
  5. The predisposing factors of acroparesthesia include carpal tunnel syndrome, scaphoid fracture/malunion, rheumatoid arthritis, Colle’s fracture, and tenosynovitis.
  6. Patients with myxedema or acromegaly also experience a high predisposition to acroparesthesia.
  7. People with a family history of acroparesthesia also have the risk of developing the disease in their lifetime.

Clinical Examination

  1. Patients with acroparesthesia often develop Hoffmann-Tinel sign or carpal tunnel syndrome.
  2. The subclavian artery compression reduces the vascular supply to the digits that trigger their coldness and cyanosis.
  3. The reduced sensibility of the cutaneous nerve in acroparesthesia patients increases their risk of sensory loss.
  4. The weakness and tenderness of muscles cause substantial discomfort and add to the extremity pain in acroparesthesia patients. The reduction in muscle power reduces their overall strength and endurance.
  5. The brachial plexus compression in acroparesthesia patients leads to the wasting of their muscles.
  6. The thenar eminence of the acroparesthesia patients appears degenerated on physical examination.
  7. The tenderness in the adductor, thenar and extensor muscles proves to be the primary manifestation of acroparesthesia.

Differential Assessment

  1. The subacute cord degeneration and disseminated sclerosis include the abnormal physical manifestations of the spinal cord that the physician must rule out to confirm acroparesthesia.
  2. The paraesthesia and pain in digits might also develop under the impact of fibrosis and osteophytes development or cervical spondylosis.
  3. The cervical disk protrusion often restricts neck movements that trigger stiffness and pain resembling acroparesthesia.
  4. Polyneuritis manifestations need exclusion before confirming the diagnosis of acroparesthesia.
  5. The tingling of digits due to vitamin D deficiency may also trigger symptomatology similar to acroparesthesia.

Medical Management

  1. Surgical intervention for acroparesthesia relies on wrist splinting or bifurcation of the volar retinaculum.
  2. The adjuvant therapy for acroparesthesia relies on administering pain relievers or analgesics.
  3. The general tonic treatment or massage therapy helps minimize the symptoms of acroparesthesia in most patients.
  4. The administration of procaine injection (05%) across the extensor muscles provides symptomatic relief to numbness or tingling sensation in acroparesthesia.
  5. The complete bed rest and arm support help reduce the pain and numbness in digits of acroparesthesia patients to a considerable extent.

Diagnostic Interventions

  1. The electromyography and nerve conduction studies often guide the diagnosis of acroparesthesia, particularly when the physical examination fails to retrieve conclusive findings.
  2. The reflection of the cervical rib or downward protrusion of the clavicle’s outer end sometimes also indicates the development of acroparesthesia.

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2021 Dr Khalid Rahman

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