Cubital tunnel syndrome (ulnar nerve compression syndrome) develops when the ulnar nerve is compressed in the cubital tunnel. Nerves are designed to conduct impulses throughout the body, they begin with the brain and spinal cord and end with all organs of the human system. Due to the fact that the nervous system signals about all changes in the body, being responsible for movement and sensitivity, a person can see a doctor in time and prevent the development of many diseases. If the nerve is compressed, its full-fledged work will be disrupted.
Anatomy
The ulnar nerve begins in the neck, where the roots exit the spinal region. These nerve roots emerge from holes in the spine. When they are connected, three main nerves are formed that descend along the arm to the hand. One of these nerves is called the ulna. It passes through the cubital canal, located behind the internal ulnar region. Next nervedescends along the forearm to the area of the hand. This channel is formed by a combination of muscles, ligaments and bone. If you straighten your arm and rub the hollow on the inside of your elbow, you can feel the cubital canal.
Due to the ulnar nerve, a person feels the sensitivity of the little finger, half of the ring finger, and can also control some muscles in the hand.
Causes of the syndrome
The disease can develop for unknown reasons. It proceeds differently for each patient. But usually the development of the cubital canal syndrome is preceded by an injury in this department, or by frequent and sharp movements of the hand, for example, during exercise. With tension in the elbow joint, compression of the nerve can occur, which occurs due to muscle tension. If you actively move this muscle, an inflammatory process will develop, thickening of the tendons will occur, and the nerve will begin to hurt badly.
Sometimes the disease develops due to prolonged pressure on the elbow, for example, when lying in one position, or when lifting a barbell. Another reason may be the habit of putting your hand on the glass of the car in the door area.
The syndrome develops due to changes in the anatomy in the cubital canal, which occurs due to the formation of bone spurs. This can happen in the following situations:
- fractured elbow;
- with a fracture of the shoulder joint;
- due to cyst formation;
- when bone spurs appear;
- bruise in the elbow.
Whatprofessions are more prone to cubital syndrome
In addition to athletes who have a constant load on the elbow joint, representatives of other professions are also affected by this disease, namely:
- loaders;
- drivers, mostly truckers;
- hairdressers;
- rural workers.
Cubital canal syndrome according to ICD-10 code G56.0.
Symptoms
The earliest sign of cubital syndrome is numbness on the inside of the hand. The ring finger and little finger also go numb. As the cubital tunnel syndrome develops, numbness develops into pain. The arm may become numb due to prolonged stay in a bent position. For example, when a person speaks for a long time on the phone, or during sleep. There is clumsiness in the movements of the hand and thumb. This happens due to the defeat of the corresponding muscles.
If a push or blow is made in the area of the cubital canal, then the person immediately feels pain or numbness in the little finger. This condition in medicine is called Tinel's symptom.
Symptoms of cubital tunnel syndrome are also called tennis elbow condition or median epicondylitis. In this condition, pain is felt in the region of the inner condyle of the elbow.
Complications and consequences
If the treatment of the cubital canal syndrome is not started in time, then later will developcomplications. The most common of these is partial paralysis of the arm and subsequent loss of its ability to work.
As the disease develops, atrophy of the muscle tissue of the hand appears with the gaps between the bones sinking.
After the first symptoms of the disease appear, it is necessary to immediately begin treatment. If therapy is started after 3-4 months, then all measures by doctors will not bring the desired effect. Often, such people have to change their professional activities, or even apply for a disability of the 3rd degree.
Diagnosis
If you suspect cubital canal syndrome, the doctor should first examine the patient and listen to his complaints.
- When the elbow is pressed, the doctor detects the level of nerve compression.
- Testing is being done to maintain the sensitivity of the fingers and motor abilities of the hand.
- The presence of a tunnel syndrome of the cubital canal is revealed), when a person feels pain when tapping on the elbow bend. This is a mandatory diagnostic event.
All these actions on the part of the doctor are called palpation. This procedure can be painful, as the doctor needs to identify the affected area in the area of the nerve endings. The patient will have to be patient, because this procedure is an important part of the diagnostic measures.
Instrumental diagnostics
Most often, palpation diagnosis is enough to make a diagnosis of syndromecubital canal of the ulnar nerve. But if the doctor has doubts, he sends the patient for an instrumental study:
- taking x-rays;
- ultrasound;
- CT or MRI;
- electromyoneurography - the study determines the speed at which impulses pass through the nerve channels.
Treatment
If a person experiences discomfort only after squeezing the elbow, then conservative treatment is carried out. The load on the cubital canal is reduced, including in the form of flexions in this section, which contributes to the rapid restoration of its work.
To completely eliminate the load, the arm is fixed at night in such a way that it does not bend at the elbow at all. For example, a bent or twisted towel is tied to the elbow with a bandage, which does not allow the arm to bend.
When working with a computer, you will also need to keep your elbow, and when driving vehicles, straighten your arms as much as possible.
In order for the symptoms of the disease to disappear as soon as possible, external anti-inflammatory drugs will have to be used. In this case, Voltaren gel helps well, which is applied to the affected area up to 3-4 times a day. Such drugs can relieve pain and swelling, which often causes the development of cubital tunnel syndrome.
NSAIDs are an important treatment measure for cubital tunnel syndrome. If they do not help, then the doctor may prescribe strongercorticosteroid preparations. For example, an injection of "Hydrocortisone" in combination with an anesthetic has a good effect.
Sometimes doctors prescribe vitamin B6 for quick recovery, but you should remember that you can’t take it on your own. Only a doctor will be able to determine the appropriateness of his appointment and the required dosage.
Such conservative treatment can last up to a month. In some cases, it may take longer. But if the numbness in the elbow persists, then the doctor may decide on a surgical intervention.
Surgical treatment
Surgery for cubital tunnel syndrome provides for the elimination of the causes of compression of the ulnar nerve. It is carried out in case of ineffectiveness of conservative therapy. So, if after drug treatment within a month there is no improvement, then you should wait up to three months. If no changes have occurred, then an operation is prescribed.
After the surgery is performed, the patient will have to give up physical activity on this joint for a certain time.
Types of transactions
With prolonged numbness, as well as fractures that have occurred, doctors perform an operation that can be of two types:
- Simple decompression. Part of the thickened walls that compress the nerves are cleansed, and a dissection is made in the area of the tendon arch. The operation is not classified as complex, but its disadvantage is the unstable effect.
- Nerve transposition. During surgery, doctors try to move the pinched nerve fromcubital canal slightly forward. It is moved into the space between the muscles and subcutaneous fat. This operation is called anterior subcutaneous transposition. Sometimes the nerve is moved deeper into the armpit. In this case, the operation is called "anterior axillary transposition".
Folk treatment
Traditional medicine for cubital canal syndrome will be effective only in combination with drug therapy and compliance with the rules for handling a sore hand. In addition, grandmother's methods of therapy help with pain and swelling, but they cannot eradicate the causes of this condition.
Folk therapy for cubital canal syndrome involves the use of rubbing and compresses.
- To relieve swelling, cabbage leaves, burdock or horseradish leaves are often used. It is enough to tie the plant to a sore spot and leave it for a certain time.
- You can use the steep dough, which is prepared from vinegar and red clay. A cake is formed from this mixture, which is applied to the elbow at night. The procedure is repeated for 3 days.
- It helps with swelling and pain in the elbow bend bear fat, which is used to lubricate the affected area. The course of treatment lasts 1 month.
- In the pharmacy you can buy a solution of "Bishofite", it is also used as a rubbing, compresses or baths. This is done every other day, 10-12 procedures are enough.
- Compresses can be used from an alcohol-honey composition, it is also recommendedmustard rub.
- For a general strengthening of the body and relieving inflammation, decoctions are prepared based on medicinal herbs such as chamomile, St. John's wort, oregano, fireweed, raspberry. It is recommended to drink them during the day instead of tea.
In closing
If you follow all the doctor's recommendations, provided that the therapy is started on time, then the improvement will come in 1-1.5 months. Perhaps, for a certain time, the doctor will recommend putting on an elbow pillow at night. Subsequently, the patient is also advised to constantly monitor hand movements. Constant and monotonous movements in the elbow part and a long bent position of the elbow are limited.
