Ulnar tunnel syndrome is a fairly common problem, especially when it comes to professional athletes, factory workers and representatives of some other professions. The disease is accompanied by constant discomfort and pain, which significantly impairs the quality of human life.
Of course, people who are faced with such an ailment are interested in any information. What is ulnar tunnel syndrome? Symptoms, treatment, causes, possible complications - these are the points that must be considered.
What is an affliction?
Compression neuropathy of the right ulnar/radial nerves (tunnel syndrome of the elbow and wrist, respectively) is a fairly common problem. But first, of course, you should read the general information.
The ulnar nerve is one of the largest mixed nerves in the upper limb. It starts from the medial bundle of the brachial plexus and ends in the cubital canal.
Tunnel syndrome of the ulnar nerve is associated withcompression of the latter. In most cases, compression of the nerve pathways is due to trauma, pinching or damage to the elbow.
Main causes of disease development
Why does ulnar tunnel syndrome develop? The treatment of the disease is directly related to the causes, so it is worth studying the list of risk factors in more detail.
The ulnar nerve runs in the canal of the bone, so it is well protected from various external influences. But deformation of the walls of the bone canal can lead to its compression and the development of the so-called tunnel syndrome.
Risk factors include prolonged overexertion of the ligaments and tendons, as this leads to a temporary disruption of the blood supply to the tissues. A long-term deficiency of nutrients and trace elements affects the condition of the bone walls - they thicken or, conversely, loosen. Thus, the space in the bone tunnel is reduced, which creates additional pressure on the nerve.
In addition, deformation can be the result of prolonged loads on the elbow part - professional athletes often suffer from such an ailment.
Culnar tunnel syndrome can sometimes be the result of swelling of the nerve itself. The reasons in this case include intoxication of the body with hazardous substances, in particular, s alts of heavy metals, arsenic, mercury.
Risk factors also include severe bruises of the elbow, fractures of the forearm or shoulder, the appearance of bone spurs, cysts, intra-elbow osteophytes.
Who is at risk?
Definitely carpal tunnelof the ulnar nerve in most cases is associated with constant physical exertion and bone deformities. However, some people are more prone to conditions such as ulnar tunnel syndrome. The reasons may be associated with professional activities or hereditary diseases. The list of risk groups is as follows.
- People whose profession is associated with constant flexion-extension actions (tennis players, violinists, painters, hairdressers).
- The risk group includes people over 50 years old, since the aging process is inevitably accompanied by changes in bone tissue.
- People suffering from pathologies of the endocrine system, such as diseases of the pituitary gland, thyroid gland, diabetes. Against the background of such diseases, the regenerative abilities of the body weaken.
- Tunnel syndrome often affects people who are engaged in heavy physical labor, as well as athletes.
- The risk group includes people suffering from autoimmune diseases.
- There is also a genetic predisposition. People with various hereditary diseases of the musculoskeletal system, such as arthritis, osteochondrosis, arthrosis, are more prone to this disease.
Which symptoms to look out for?
What are the symptoms of ulnar tunnel syndrome? Symptoms and their severity directly depend on the degree of development of the disease. For example, in the initial stages, some disturbances in well-being and completelymay be missing. But as the space in the bone canal narrows, the symptoms become more pronounced. The clinical picture is as follows:
- periodically appears pain in the elbow, which intensifies after physical exertion;
- some patients complain of numbness in their hands or fingers;
- when a joint or ligament is sprained, the pain syndrome intensifies (tapping on the affected area is also accompanied by discomfort);
- as the disease progresses, stiffness appears when moving in the affected joint;
- gradually the muscles in the area of the affected nerve begin to weaken, gradually atrophy.
It is worth noting that with such a pathology, pain can spread to the forearm, shoulder, shoulder blade and even back, which often complicates the diagnostic process.
Diagnostic measures
Usually, a history and a thorough physical examination are sufficient to suspect ulnar tunnel syndrome. Treatment largely depends on the stage of development of the disease and the cause of its occurrence, which can be found out in the diagnostic process. For this purpose, the following methods are used:
- electroneuromyography - allows you to evaluate the functions of the shoulder muscles, determine the speed of impulse transmission along the nerve and the level of pressure on the nerve fibers;
- electromyography - a study that gives the doctor the opportunity to evaluate the work of the muscles of the forearm, shoulder and hand;
- x-ray, ultrasound, MRI are also used in the diagnostic process, especially if there is a suspicionfor trauma, fracture, arthritis, gout and other diseases.
Treatment of carpal tunnel with medication
What should a patient diagnosed with ulnar tunnel syndrome do? Treatment methods depend on the degree of compression of the nerve and the presence of certain symptoms. If we are talking about the initial stages of the development of the disease, then conservative therapy will be effective.
- In most cases, patients are prescribed non-steroidal anti-inflammatory drugs, in particular, Diclofenac, Ibuprofen, Ortofen, Voltaren. These drugs are available in the form of tablets, injections, ointments for external use. Such remedies help to stop the inflammatory process and quickly eliminate pain.
- The course of therapy also includes B vitamins, which help normalize blood circulation and nerve conduction.
- In some cases, doctors prescribe intravenous calcium chloride solution to help relieve inflammation and stabilize the immune system.
- In the most severe cases, steroids (Hydrocortisone, Prednisolone) are included in the treatment regimen, which quickly relieve pain and inflammation. Sometimes a hormone solution is injected directly into the affected area of the limb.
Rehabilitation and recovery period
With the help of medicines, you can get rid of inflammation, normalize blood circulation and tissue trophism. Further, additional measures are introduced into the therapy regimen.
Bin particular, patients are often recommended therapeutic massage, which helps relieve muscle spasm, increase muscle tone, and improve blood flow.
In some cases, doctors prescribe the wearing of a special splint. It is especially important to wear this device at night - this reduces the risk of injury during sleep. Sometimes short-wave heating of the elbow area is also effective.
Most often, conservative treatment lasts about 1-2 months. If you follow all the doctor's recommendations, you can get rid of inflammation, relieve pressure on the ulnar nerve and restore mobility to the elbow joint.
Tunnel syndrome of the ulnar nerve: therapeutic exercises
An important component of the recovery process is therapeutic exercises. Of course, a set of exercises is selected individually by a physiotherapist depending on the patient's condition.
- Sit on a chair with your back straight. Stretch both hands forward. Now begin to alternately squeeze and unclench the brushes. The exercise should be repeated 10-15 times (for each hand).
- Keep the same position. Clench your fists and begin to rotate your wrists. Do 10 repetitions in both directions.
- The shoulder should be leaned on the back of the chair and fixed so that the arm hangs freely down. In this position, begin to make movements that imitate the pendulum. At the same time, try to bend and unbend the elbow joint as much as possible. Repeat the movement 10-15 times.
Such exercises complement the conservativetherapy. They are also indicated after surgery, as they help to gradually restore the functions of the elbow joint.
Tunnel syndrome of the ulnar nerve: treatment with folk remedies
Immediately it should be said that home remedies can only be used at home. Some folk healers recommend making warm compresses from sea buckthorn (fresh berries should be ground to a homogeneous gruel, heated in a water bath and applied to the affected joint).
Pumpkin compresses will also be useful. The pulp needs to be slightly warmed up, put on the joint and fixed with cling film.
Inside you can take decoctions of parsley root, bearberry herb and white birch leaves. These plants have a lot of valuable properties, including the removal of edema, which often accompanies carpal tunnel.
Surgical Treatment: Decompression
How to treat ulnar tunnel syndrome if conservative therapy does not give the desired effect? Unfortunately, sometimes it is simply impossible to do without surgery.
Quite often, the so-called simple decompression is performed. The essence of the procedure is to cut the tendons and remove thickenings that pinch the nerve. This is a fairly simple operation, during which it is possible to preserve the blood supply to the nerve. Yes, and the restoration of the functions of the upper limb pass quickly. To disadvantagesonly the risk of re-exacerbation can be attributed, although such cases are rarely recorded.
Nerve transposition: features of the procedure
Another procedure often performed by surgeons. During the operation, the pinched nerve is moved to a freer space (deep or forward of the muscles).
This technique has a number of advantages. Most often, the functioning of the limb can be restored completely. The risk of relapse is minimal. There are also disadvantages - cases of tissue scarring have been reported.
What is a medial epicondylectomy?
In some cases, patients are prescribed an epicondylectomy. This is a much more complex procedure, the essence of which is to remove part of the elbow joint. Such manipulations help to expand the channel through which the nerve passes, which helps relieve pressure.
It is worth noting that some of the functions of the hand are lost even with a properly conducted recovery period. The rehabilitation period after such an operation is long and quite painful. The procedure is also associated with other risks - bone growth, muscle weakening.
Prevention of complications
Even after successful treatment, there is a risk of re-development of the disease, especially if the tunnel syndrome is caused by the peculiarities of professional activity. In this case, doctors recommend not to forget about therapeutic exercises, which are aimed at normalizing the functioning of muscles and tendons.
Also importantmonitor the posture during sleep - the arms should be unbent at the elbows. For this purpose, experts recommend purchasing special rollers. If there is damage to the nerves of the elbow, shoulder or wrist, then it is worth minimizing the load on the diseased limb, abandoning potentially traumatic activities. In the event that the arm still has to be strained, it is worth getting a special elastic fixator, which practically does not limit mobility, but partially relieves the load on the muscles and tendons.
It should be understood that the sooner the disease is diagnosed, the faster and easier it will be treated. That is why it is important to see a doctor as soon as the first symptoms appear.
