What does drunkenness and being in love have in common? For some people it may result in an injury called radial neuropathy which produces a rather alarming condition known as wrist drop.
Nicknamed Saturday Night Palsy and Honeymooner’s Palsy, depending on the origin of the injury, a typical scenario is to wake up and find your hand is functionally as good as dead.
Wrist drop further confounds the mind as you may feel sensation in the hand, yet the mental determination of an Olympiad will not enable you to move your hand or fingers one millimeter.
What Causes Wrist Drop
Though the cause of wrist drop varies, radial neuropathy frequently results from a compression injury that involves damage or death of radial nerve cells in the arm.
Generally, pain is a warning sign before radial neuropathy develops as the arm bears pressure over an extended period. Yet, the pain may go unnoticed, or ignored, when one is in a chemical-induced stupor or in love.
One example is sleeping on your hyper-extended arm or with it swung over a chair following excess consumption of alcohol, hence the name Saturday Night Palsy. Another is when one lover falls asleep on the arm of the other and head pressure compresses and damages the radial nerve.
Even the common act of resting ones arm on the backseat of a chair at the movies can result in wrist drop. Young males in particular may recognize the pain but feel it’s wimpish or may hurt their date’s feelings to move the arm to a healthier position.
In the immortal mind of a teenager, who fears embarrassment over injury, the point is better made by asking how tough the young man will feel if his hand starts flopping around, in an exaggeratted fashion Hollywood attributes to male interior decorators.
Pain and tingling in the arm should therefore be respected.
Simulated Wrist Drop
To get an idea of what wrist drop is like; grab one arm with the opposite hand six or so inches above the wrist. Hold your arm at a 90 degree angle, towards the ceiling, and let your hand and fingers completely relax.
This represents the position of the hand affected by wrist drop.
Extend your arm in front of you, and imagine no resistance or control of your fingers is possible and you can see why the most benign tasks from dressing to typing are near impossible to perform.
Wrist Drop Diagnosis
The diagnosis of radial neuropathy may be made on the classic appearance of the hand and the circumstances preceding the injury, though an MRI or neurology consult may be necessary to assess damage and rule out other causes or co-existing conditions, such as carpal tunnel syndrome.
Recovery from Wrist Drop
Next to the fear of the symptoms, the unknowns about radial neuropathy can be unsettling. A doctor’s visit may not be reassuring as recovery can take days, weeks, months or as long as a year, a time frame often unknown to the physician. Though he may be able to provide an educated guess if recovery from wrist drop will be of shorter versus longer duration.
More commonly, wrist drop lasts days to weeks with no immediate improvement, and as the nerves heal gradual movement is restored. During the healing process the nerves that control the wrist may heal faster so wrist control occurs before finger control.
If nerve cells are destroyed rather than damaged the healing process is much longer as nerve cells must be regenerated.
Treatment for Wrist Drop
Unfortunately, no viable treatment exists for wrist drop. A hand splint with wrist support is helpful to encourage finger movement and offers a more useful position for the hand.
Daily brief flexing exercises, using the other hand to assist, may be recommended to keep the muscles and tendons from tightening and atrophy.
General healthy living such as a good diet, exercise and sleep can promote healing of cells.
Conclusion
While wrist drop is frightening to the patient, know that recovery will come with time. Often this occurs in days or weeks, even if no movement is possible the first few days. When healing begins and fingers can move as little as a couple of centimenters, the nerve cells may return to full function within several days.
