Chủ Nhật, 12 tháng 1, 2014

Cubital Tunnel Syndrome

Cubital Tunnel Syndrome Cubital tunnel syndrome is a disorder affecting the ulnar nerve of the hands causing numbness. There will be tingling sensation in the forearm, fingers and parts of hand. The ulnar nerve originates from the medial brachial plexus and runs throughout the muscles of forearm and hand. Since it affects the nerves of the ulnar region this syndrome is also called ulnar neuropathy. Injury and increased pressure on the hand causes cubital tunnel syndrome and it can be controlled by medications and conservative treatments.

The ulnar nerve present in the elbow is damaged due to inflammation/pressure and it affects the nerves on the wrist. Very often it affects only the elbow causing compression on the ulnar nerve and this syndrome develops more in men than women.

Symptoms :

There will be numbness followed by pain in the elbow region. Some people will have tingling sensation in the little fingers and other fingers. In severe cases, the hands and fingers become weak and the person will not be able to pinch the thumb or little finger. The hand will lose gripping ability due to ulnar nerve damage. For some people it can cause claw like abnormality in the hand.

The extent and intensity of pain or numbness depends on the extent of ulnar nerve damage. Pain can be felt in the cupital tunnel area along with tenderness. Some may feel it as stabbing pain or cutting pain on the back of the hand and the pain will be more than usual when one indulges in stretching his fingers. Prolonged compression of the ulnar nerve can cause wasting of the intrinsic muscles and even abduction of little finger.

Causes :

The major cause of cubital tunnel syndrome is the increase in pressure on the ulnar nerve lying on the elbow area. You can develop ulnar nerve pain when you are resting your elbow on hard surface for long time. It can happen when you are keeping the elbow in the bent position for sustained periods.

It can occur due to injury or bone tumors in the elbow and inflammation of the tissues and ligaments in the ulnar region. For some people, benign tumors (lipoma) can develop on the elbow region causing inflammation. Cubital tunnel syndrome can occur when there is abnormal growth of the bone of the elbow. It can occur if you are engaged in strenuous physical activity that puts great pressure on the ulnar nerve. People who are engaged in sports events like baseball may develop this disorder since delicate tissues are torn in the elbow.

Diagnoses :

Your doctor will physically examine your body and order for electromyography test in which two electrodes are inserted into the muscles for measuring the nerve cells function. He will identify the extent of nerve damage and also its severity with this test.

Treatment :

Very often the symptoms of cubital tunnel syndrome can be managed through conservative methods. You can control mild to moderate pain by giving complete rest to the elbow region and by avoiding any activities that cause extra pressure on the elbow. You can wear a protective padding on the elbow to minimize the pressure exerted on the ulnar nerve.

If you have severe pain you can use splint on the elbow during nighttime to get good relief from pain or numbness. You should not bend the elbow often and continue to wear splint in the daytime if you experience pain. You can manage pain by taking over the counter pain killers like Ibuprofen, Motrin etc.

Surgery :

For severe case of pain and if the patient does not respond to any other methods of treatment, surgery is done for releasing the pressure exerted on the ulnar nerve. Your surgeon will gently shift the ulnar nerve to the front area or move the nerve well inside the fat muscle so that pressure is not felt. He would trim the bumps seen on the inner portion of the elbow through which ulnar nerve is passing through.

After surgery you need to avoid engaging in activities that would harm the healing process. You have to follow the instructions given by your doctor for lifting and making any movement with your elbow. It takes enough time for complete healing and for some people it may take even several months. You may still feel some numbness for few days which will gradually reduce. You can practice regular stretching exercises to strengthen the bone after consulting your doctor.

Prognosis :

If you are not taking any treatment for numbness or pain in the forearm and fingers, it can lead to complete loss of sensation in your fingers.

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