Ulnar nerve neuropraxia after extracorporeal shock wave lithotripsy: a case report

A case is presented that illustrates and discusses the clinical presentation, diagnosis and chiropractic management of a 50-year-old male presenting with a case of ulnar neuropraxia following extracorporal shockwave lithotripsy. Onset is believed to be due to the patient's arm position in full abduction and external rotation during the lithotripsy procedure. Motor abnormalities related to the ulnar nerve were noted in the absence of distinct sensory findings. Chiropractic treatment focused on relief of the patient's pain during the course of the condition. Treatment may have helped in the rapid and complete resolution of his symptoms in this case. Poor patient positioning on hard surfaces, for extended periods may place pressure on superficial nerves resulting in nerve injury. In this case, the outcome was excellent, with complete resolution of symptoms less than one week later. The prognosis for this type of neuropraxia is usually good with conservative management. The patient history and chronological clinical course strongly suggest a causal association between the patient's position during the procedure and the development of the ulnar neuropraxia.