Resolution of PIN syndrome following Physiotherapy: A case report

Abstract

This case report highlights the use of physiotherapy as monotherapy for non-traumatic posterior interosseus nerve palsy, which is a rare compression neuropathy that usually gets referred to a surgeon and for which the patient may undergo surgical decompression. However, in a resource limited setting, patients are often not able to afford advanced radiographic modalities like high resolution ultrasound and MRI scans. Hence the standard pathway to surgery is uncertain and they often get referred to physiotherapy while awaiting surgery. In this case, the patient was referred for Physiotherapy and the palsy improved. This suggests there was no defined surgical lesion, as has been found in many patients who have undergone ultrasound. This case highlights the need for robust research on the role of physiotherapy for PIN palsy in resource limited settings and a possible treatment algorithm that reserves investigations and surgery for patients whose PIN palsy does not improve with physiotherapy and for whom surgery is not clearly indicated from the outset.