Backpack palsy (BPP) — or rucksack palsy or rucksack paralysis — is a type of brachial plexus injury associated with carrying a heavy backpack or similar load with excessive compression of the shoulder areas by straps. It is a known hazard for ruckmarching soldiers and for certain outdoor recreationalists (hikers, trekkers, mountaineers, etc) and certain labors (e.g., those carrying sandbags). A particular risk factor is bearing heavy backpack loads without any waist support (i.e., all the weight borne by the shoulders). Typical upper extremity symptoms are paresis (i.e., weakness of voluntary movement, or partial loss of voluntary movement or impaired movement), numbness, and paresthesias (“pins and needles” sensation) after carrying a heavy load with shoulder-straps of a backpack, or similar burden. The syndrome is generally painless. Neuralgic pain, as seen with other acute brachial neuropathies (see Parsonage–Turner syndrome), is not a feature. The long thoracic nerve is often the critically affected organ.

(In this case the serratus anterior muscle is palsied and a "winged scapula" may be the result.[1]) The shoulder girdle and elbow flexors are usually the most severely affected. Sensory disturbances can occur in the lateral shoulder and arm region and in forearm and hand (especially the radial aspects). Atrophy of the affected muscles may develop long term in a minority of cases. Prognosis is not well understood: about two-thirds of victims recover completely, or mostly, within 6 months; for the remainder, the duration of prolonged recovery is unknown. Backpack palsy can be prevented by making change in backpack design. If the straps design in the way that be less concentrated on shoulder, then the pressure will be decreased on shoulder and can be helpful in decreasing the chance of backpack palsy.Brachial plexopathy occurs when there is damage to the brachial plexus - the bundle of nerve which exit your spinal cord at the base of the neck, between the C5 and T1 vertebrae. Brachial plexopathy is a form of peripheral neuropathy caused by damage to the brachial plexus.

This bundle of nerves exits the spinal column between the C5 and T1 vertebrae and then course down to the shoulder and several pass through the arm and into the hand. Damage to the brachial plexus can be either traumatic through a sudden injury to the area, or more chronic, either through poor posture, carrying heavy bags or illnesses such as viruses or tumours in the area. It may not always be clear what has caused the injury, especially in the case of viral illnesses. Injury when carrying heavy bags over the shoulder, especially on one shoulder only, is sometimes called Backpack Palsy. Brachial plexopathy can often be determined by a therapist using the history of the injury and symptoms present. If further tests are required, these may include: Treatment of brachial plexopathy should be aimed at correcting what has caused the problem, easing pain and enabling the patient to use their hand and arm as much as possible in the short-term. In many cases, the symptoms are only temporary.

In acute injuries, it may be swelling compressing the nerve, rather than injury to the nerve axon itself, which is causing the symptoms.backpack limit borderlands 2 Depending on the cause of your injury and the extent of the problem, anti-convulsants and anti-depressants may be prescribed by your Doctor.rezo backpack Physical therapy may be helpful for those who have postural problems contributing to the injury (such as desk workers and backpack palsy sufferers) or where a traumatic injury has caused muscle weakness / tightness.redmax backpack blowers for sale Education regarding posture, workplace desk set-up and how to carry bags may be necessary.um21 backpack

Surgery is rarely recommended in such cases, although may be required for those with tumours or nerve compression.stihl br600 backpack blower parts In cases of nerve damage from a traumatic injury where a nerve is severed (partially or fully), the nerves will eventually repair themselves.lucas backpack expandable Human nerve growth rates can reach up to 5mm a day in large nerves (less in smaller ones). best backpack for marathon des sablesElectrical stimulation may promote the healing rate.Please, wait while we are validating your browserA healthy 18-year-old man with no significant medical history presented with right shoulder weakness and pain that had been present for one week. He had recently started a daily intensive physical fitness regimen similar to military boot camp.

The week before his symptoms began, he had a particularly grueling workout session that involved multiple repetitions of push-ups, inchworms, and bear crawls that the patient found difficult to complete.He had weakness in his right arm and could not lift it over his head, and he had dull, achy pain in his right shoulder. He had no numbness or tingling. He noticed that his right shoulder blade was protruding compared with the left side.The examination revealed an obvious deformity (Figure 1). He was unable to abduct his arm above 90 degrees without assistance. He had full passive range of motion. Otherwise, his musculoskeletal and neurologic examination findings were normal, except for 4/5 strength in shoulder abduction.QuestionBased on the patient's history and physical examination findings, which one of the following is the most likely diagnosis?A. Amyotrophic lateral sclerosis.DiscussionThe answer is C: hereditary neuropathy with liability to pressure palsies. This is a rare autosomal dominant neuropathy characterized by recurrent mononeuropathies that are typically associated with compression or minor trauma.

In this case, the patient had carried two large duffel bags over his shoulders and participated in intensive workouts prior to the symptoms. The patient had a total palsy of the right long thoracic nerve, which accounted for the significant scapular winging seen on examination. Electromyography and nerve conduction studies also found slowed conduction in multiple nerves bilaterally without an apparent clinical manifestation, which is common with this disorder.This hereditary neuropathy is usually associated with a deletion in the gene encoding peripheral myelin protein 22, although the pathophysiology is not completely understood. Typical sites of focal nerve block are identified with nerve entrapment. However, mild slowing of nerve conduction velocities, prolonged distal motor latencies, and reduced amplitudes in clinically unaffected nerves also occur. For most patients, the first mononeuropathy occurs before 40 years of age, and the typical pattern of abnormalities in nerve conduction studies is usually found in patients older than 15 years.1 Treatment focuses on avoiding repeated trauma to peripheral nerves, which may lead to additional mononeuropathies.1Amyotrophic lateral sclerosis is characterized by both upper and lower motor neuron dysfunction.

Clinical manifestations vary widely based on involvement of different motor neurons in the brain, brainstem, and spinal cord. One or more body regions may be affected by a combination of spasticity, decreased coordination, weakness, atrophy, fasciculations, and decreased reflexes. There is no pain or sensory disturbance.2Backpack palsy is typically associated with activities that involve wearing a backpack, such as hiking, mountaineering, and military duty, and affects the shoulder girdle and elbow flexors, with sensory disturbances in the lateral shoulder and upper arm and in the radial forearm and hand. Symptoms commonly include paresis, numbness, and paresthesias of the upper extremities. The long thoracic nerve is most often affected.3Monomelic amyotrophy typically presents in males in their late teens to early 20s. It has an insidious onset and leads to slow progression of unilateral weakness. There is atrophy of a distal upper extremity, most often the hand or forearm. Sensory disturbances, tendon reflex abnormalities, and upper motor neuron signs are rare.

Nerve conduction studies of clinically unaffected nerves may have abnormal results.4Neuralgic amyotrophy presents as acute, severe pain in the shoulder or arm that lasts for days to weeks. Weakness, atrophy, and sensory loss develop as the pain diminishes. Bilateral involvement of the brachial plexus occurs in 30% of patients, but clinical features are commonly asymmetric. Symptoms may be preceded by viral infections, immunizations, and strenuous exercise, or in the perioperative or peripartum period.5View/Print TableSummary TableAmyotrophic lateral sclerosisUpper and lower motor neuron dysfunction; combination of spasticity, decreased coordination, muscle weakness, atrophy, fasciculations, and decreased reflexesBackpack palsyAffects the shoulder girdle and elbow flexors, with sensory disturbances in the lateral shoulder and upper arm and in the radial forearm and hand; paresis, numbness, and paresthesias of the upper extremities after carrying a heavy backpackHereditary neuropathy with liability to pressure palsiesMononeuropathy;