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- Soft-tissue Sarcoma – Wrist Drop Syndrome
Soft-tissue Sarcoma – Wrist Drop Syndrome
David- I was diagnosed with a soft-tissue sarcoma in my left arm five years ago. My cancer recovery is going well, sounds like yours is too.
My treatment included:
- tumor resection,
- chemotherapy, and
- radiation.
About a year after radiation ended I experienced wrist drop syndrome, which was treated with hand therapy and eventually scar tissue surgery.
Over the next year I regained about 75% usage in my left arm and hand, and I would describe my current state as dealing with daily stiffness rather than pain.
My major concern is that my neuropathy does not worsen. What steps I can take to possibly improve my situation (I have plateaued with hand therapy/exercises). Thank you for your very informative video! Tim
Hi Tim-
I am sorry to learn of your soft-tissue sarcoma and resulting wrist drop syndrome. Of course complete remission is your first priority and managing possible side effects is your second priority. It sounds as though you are managing both issues pretty well.
While researching wrist drop syndrome in general and your question specifically I learned a few things. First and foremost, peripheral neuropathy (your wrist drop) can be caused either/or- your surgery, chemotherapy or radiation.
Because you say that you experienced wrist drop “about a year after radiation” I am going to assume that you sustained nerve damage from your radiation therapy aka you experienced a late stage side effect.
And based on your post, you seem to be satisfied with your rehabilitation. If I read you correctly, you would like to make an effort to reduce your risks of worsening peripheral neuropathy and perhaps continue your Improvement.
I would like to add to the therapies mentioned in the research below. In addition to
- Transcutaneous electrical nerve stimulation (TENS therapy-a therapy that applies a gentle electric current to the muscles and may help reduce pain)
- acupuncture
- massage
I would add anti-inflammatory nutritional therapies such as:
- omega-3 fatty acids
- curcumin
- hyperbaric oxygen therapy
Keep in mind that wrist drop syndrome seems to be relatively rare and therefore not well understood in my experience. I admit to being somewhat jaded where conventional oncology is responsible for causing a side effect like both of our peripheral neuropathy.
I encourage you to ask me any and all questions that you would like.
Sincerely,
David Emerson
- Cancer Survivor
- Cancer Coach
- Director PeopleBeatingCancer
I’ve researched and written about the damage caused by radiation for years now.
- Chemotherapy-induced Peripheral Neuropathy aka Nerve Damage
- Home Remedies for Neuropathy from Chemo aka CIPN
- Chemotherapy-induced Peripheral Neuropathy-Female
- Multiple Myeloma – Velcade- Nerve Damage
- Chemo-induced, Radiation-induced muscle atrophy
Wrist drop
“Wrist drop is a medical condition in which the wrist and the fingers cannot extend at the metacarpophalangeal joints. The wrist remains partially flexed due to an opposing action of flexor muscles of the forearm. As a result, the extensor muscles in the posterior compartment remain paralyzed…
Diagnosis[edit]
The workup for wrist drop frequently includes nerve conduction velocity studies to isolate and confirm the radial nerve as the source of the problem. Other screening tests include the inability to extend the thumb into a “hitchhiker’s sign”.[4] Plain films can help identify bone spurs and fractures that may have injured the nerve. Sometimes MRI imaging is required to differentiate subtle causes.
Treatment[edit]
Initial treatment includes splinting of the wrist for support, along with osteopathic medicine, physiotherapy and occupational therapy. In some cases, surgical removal of bone spurs or other anatomical defects that may be impinging on the nerve might be warranted. If the injury was the result of pressure from prolonged use of improperly fitted crutches or other similar mechanisms of injury, then the symptoms of wrist drop will most likely resolve spontaneously within 8–12 weeks.[5]
Is wrist drop neurological?
“Wrist (with finger) drops are usually due to a peripheral neuropathy affecting the radial nerve, often as it runs in the radial groove of the humerus (“Saturday night palsy”).”
What Can Cause a Wrist Drop?
“Injury to the radial nerves or radial nerve palsy of the wrist can cause a wrist drop.
The radial nerves are responsible for:
- Backward bending of the wrists.
- Movement and sensation of the wrist and fingers…
Radial nerve palsy can be caused by several conditions that include:
- Fracture of the humerus bone (the long bone of the upper arm)
- Growths such as tumors or cysts in the arm area..
- Severe systemic nutritional deficiencies such as thiamine deficiencies
What are the treatment options for a wrist drop?
Treatment of a wrist drop depends on the underlying cause. In some cases, the wrist drop may be temporary and goes away when the underlying cause is corrected. In the majority of cases, the wrist drop gets corrected with conservative treatment.
Treatment of a wrist drop and radial nerve palsy may include:
- Medication
- Anti-inflammatories
- Pain medicines
- Physical therapy to strengthen muscles and increase the range of motion
- Splint or cast
- Transcutaneous electrical nerve stimulation (a therapy that applies a gentle electric current to the muscles and may help reduce pain)
- Surgery that aims to
- Repair a broken bone
- Repair the nerve
- Remove a tumor or cyst
Surgery aims to repair any damage to the nerve or relieve the entrapped nerve and subsequent pressure on the nerve.
Recovery depends on the severity of the injury and may take weeks or months for a nerve to heal after treatment…”
Nerve Problems or Neuropathy
“Your nerves help you sense, feel, and move your body. Your nervous system has 2 parts: the central nervous system and the peripheral nervous system. The central nervous system is made up of your brain and spinal cord, a thick cord of nerves inside your spine. The peripheral nervous system is made up of all your other nerves. They send information between your brain and your body.
Doctors call damage to these nerves “peripheral neuropathy.” It can cause problems related to sensing, feeling, and moving. Cancer or its treatment can cause peripheral neuropathy…and not getting enough vitamin B12 or other nutrients…
Cancer and peripheral neuropathy (updated 07/2020)
You have some risk of peripheral neuropathy if you have cancer. Certain factors raise your risk of getting it from cancer or its treatment. These include:
- Where the tumor is. A tumor might press on or grow into a nerve. This could cause nerve damage.
- Some chemotherapy drugs. Some chemotherapy drugs can damage your nerves, especially in high doses
- Radiation therapy. Radiation therapy might damage nerves. It might be years before you notice signs of nerve damage.
- Surgery. Lung or breast surgery can cause nerve problems. So can removing an arm or leg.
Treatments for nerve problems (peripheral neuropathy) (updated 09/2022)
- Better nutrition-
- Physical or occupational therapy-
- Acupuncture-
- Massage-