title: Peripheral paresthesia in patients with subacromial impingement syndrome.
abstract: BACKGROUND
  Some patients presenting with subacromial impingement syndrome complain of tingling and numbness radiating to hand. In the current literature, there is no description of such paresthesia being a part of the clinical picture of impingement syndrome.
  
  
  OBJECTIVE
  This observational study aimed at looking whether these symptoms resolve with successful arthroscopic decompression of the impingement.
  
  
  METHODS
  One hundred consecutive patients undergoing arthroscopic surgery were enlisted for the study.
  
  
  RESULTS
  Fifty-four percent reported paresthesia during the course of the shoulder problem (63% of them had radial sided symptoms, 29.6% ulnar-sided symptoms and 7.4% involving all fingers). Significant association was observed between the occurrence of paresthesia and worst pain levels (P = 0.0053), age of the patient (P = 0.0104) and the acromial impingement grade (P = 0.0377). Nerve conduction studies done in seven patients (with paresthesia) selected by systematic random sampling did not show any significant attributable entrapment neuropathy. Up to 12 months follow-up, 48 of 54 (88%) had complete relief of pain and paresthesia and 50 (92.5%) were satisfied.
  
  
  CONCLUSIONS
  Some patients with subacromial impingement syndrome report associated peripheral paresthesia radiating to hand, which is strongly associated with the age, pain level and the grade of impingement. In most (88%) of such cases, these symptoms are relieved after treatment of the impingment lesion. The incidence and aetiology of such paresthesia is the subject of further studies.
authors.affiliation: Reading Shoulder Unit (RSU), Royal Berkshire Hospital, Reading, UK. drmanojsivan@yahoo.com
authors.forename: Manoj
authors.initials: M
authors.lastname: Sivan
authors.forename: Balachandran
authors.initials: B
authors.lastname: Venkateswaran
authors.forename: Hannan
authors.initials: H
authors.lastname: Mullett
authors.forename: Tirtza
authors.initials: T
authors.lastname: Even
authors.forename: Saleem
authors.initials: S
authors.lastname: Khan
authors.forename: Steven
authors.initials: S
authors.lastname: Copeland
authors.forename: Ofer
authors.initials: O
authors.lastname: Levy
mesh_terms: D000174:Acromion / Q000601:surgery*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D010292:Paresthesia / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D019534:Shoulder Impingement Syndrome / Q000150:complications / Q000601:surgery*