Cubital Tunnel Syndrome
Cubital tunnel syndrome is a malfunction that manifests itself as insensibility, persevering paresthesia or aching in the elbow, shoulder, or fingers. These irritating sensations are provoked by the pinching of the ulnar nerve in the region of the elbow joint.
The canal through which the ulnar nerve goes is very narrow, so even the slightest stress affects it severely.
In the initial stages of the cubital tunnel syndrome, insensibility, aching and paresthesia are observed, as well as the stress on the elbow. Subsequently, all of these sensations are felt constantly, there is a loss of control over motor skills: for no reason, objects slip out of the hand, it is difficult to hold the kettle, and so on. If you do not start treatment on time, the cubital tunnel syndrome flows into an advanced stage: the hand loses weight, the muscles atrophy, and pits appear between the bones. If in the initial stages of the cubital tunnel syndrome traditional treatment has the desired effect, then in advanced cases it is necessary to surgically release the nerve. The period of complete recovery in the shoulder takes three-six months.
Cubital tunnel syndrome can be provoked by multiple aspects. The ulnar nerve can elongate when the elbow is bent for a long-lasting period of time. Direct stress on the elbow, frequent bending or vigorous physical activity can also irritate the ulnar nerve.
Surgical and Nonsurgical Treatment
In mild cases of the cubital tunnel syndrome, drug therapy, injections of anti-inflammatory, steroid drugs, or blockade are used. Sometimes physical therapy helps – ultrasound with medicated ointment, magnetic therapy, electrophoresis and other procedures that relieve swelling of the hand by releasing a pinched nerve. At night, you can use a special orthosis, which keeps the shoulder in the correct position and reduces pain. However, all of these methods have short-term effects. Operational treatment is required to completely decompress the ulnar nerve. It gives a long-term result – the ability to work normally and sleep peacefully again.
To release the nerve, either traditional surgical methods or a newer and less traumatic endoscopic treatment is used for the elbow. During the surgery, a small incision is made on the inner surface of the elbow, the canal is opened and the ulnar nerve is decompressed. After the operation, one must observe a careful regimen for a month. The endoscopic treatment is much easier and safer for the patient – a miniature endoscope is inserted through a small skin incision into the cubital canal – a video camera and microscopic surgical instruments, with the help of which the squeezed nerve is decompressed. Thus, the surrounding elbow tissues are preserved, a less painful postoperative period is provided, a faster recovery and restoration of working capacity, as well as a minimal cosmetic defect. A significant advantage of this method is easy wound treatment, which is especially important for patients with complicated wound healing (for instance, diseases of the circulatory system).The rehabilitation period after endoscopic surgery is much easier and shorter.
In the early stages of the disease, the only manifestation (apart from weakness in the muscles of the forearm) may be loss of sensation on the elbow side.
In some cases, it is necessary to conduct electroneuromyography (the speed of the impulse along the nerve). The pathological changes in the elbow that provoke the malfunction may also be determined using MRI, which is a more accurate and detailed method.