Chronic Pain

Everything You Should Know about Ulnar Nerve Entrapment (Cubital Tunnel Syndrome)

 

Cubital Tunnel Syndrome

It happens quite often that people experience symptoms and either simply ignore them (at least in the first phase of the development of the particular medical condition they suffer from) or they believe that it is something else that they are suffering from.

With the Cubital Tunnel Syndrome (or  “ulnar nerve entrapment”) the first symptoms may be misleading and they may make the patient think that it is nothing serious to worry about.

However, in its later development, this syndrome can seriously affect the state of the patient. If you are interested in finding out more about this medical condition, then do read on.

Causes of the Cubital Tunnel Syndrome

The medical explanation behind the Cubital Tunnel Syndrome is related to the ulnar nerve. This nerve is located very close to the bone and when pressure is put on this bone, the nerve will be pressured as well.

This can happen in many ways: if you lean against a table with your elbow, if you fall on it and even if you fall asleep with your elbow bent and you keep it like that for an extended period of time.

Furthermore, repetitive bends and straightening of the elbow can also lead to the development of the so-called “ulnar nerve entrapment”.

You cannot develop the Cubital Tunnel Syndrome just by bending your elbow for a longer time, but if that happens repetitively and if the pressure on the elbow is significant enough, the ulnar nerve can get quite irritated and this can lead to the development of this syndrome. What Do You Know About Ulnar Nerve Compression?

Symptoms and Diagnosis of the Cubital Tunnel Syndrome

Basically, there are three main symptoms patients who develop this syndrome show in the first stage: numbness, tingling and pain (especially at the level of the little fingers and at that of the ring finger). Common causes numbness and tingling in my finger?

Furthermore, the pain is usually felt when there is pressure on the ulnar nerve (for example, when the patient sits on his/her elbow, when he/she repetitively bends and straightens the arm, when he/she talks on the phone for extended periods of time, and so on.).

Further on, the patient can experience weakness in the fingers and even the tendency to drop the things he/she is trying to hold. In the latest stage of the development (the very severe cases), all sensation can be lost and the patient can simply become unable to use his/her hand due to the weakness felt in it.

Furthermore, in very severe cases the patient may feel that he/she has lost the ability to coordinate his/her fingers (especially in activities such as playing an instrument and typing).

Many people are worried that the nerve lesion that caused the development of the Cubital Nerve Syndrome are worried that it may be difficult for a medical professional to diagnose their medical condition. Can this syndrome be diagnosed though?

In short, yes, the Cubital Tunnel Syndrome can be diagnosed. However, you should bear in mind the fact that it can become quite confusing even for a professional to determine whether or not you have started developing this syndrome (especially in the very early stages of development).

The physician will be able to put a clear diagnosis after a series of test. In the first phase, the medical professional will have to assess the symptoms and clear them out together with the patient.

Further on, tests such as electromyography (EMG) or nerve conduction studies (NCS) may have to be done in order to see exactly whether the patient suffers from the Cubital Tunnel Syndrome or not.

The same tests can be used to see the stage of the development of the disease (in case the diagnose settles for it).

Other tests that may be conducted are those related to diabetes and to thyroid diseases.

Furthermore, the physician may have to make a differential diagnosis. The Cubital Tunnel Syndrome can look very much like other syndromes and medical conditions, but simple tests can detect the exact diagnosis.

For instance, in a first phase it can be mistaken to the Carpal Tunnel Syndrome. This latter syndrome is triggered by the compression of the median nerve and it is characterized by numbness in the index, thumb, middle finger and partly in the ring finger.

Furthermore, when the radial nerve is compressed, another syndrome can develop and the patients suffering from it will show the same symptoms in the thumb and on the back of their hand (however, this kind of syndrome is very rare).

To determine whether the patient suffers from one syndrome or the other, a simple test such as asking the patient to bend the hand into a fist can be very helpful.

In the case of those patients who suffer from lesions to the median nerve, they will not be able to flex the middle finger and the index finger.

However, in the case of those patients suffering from ulnar nerve lesions, they will not be able to unflex the pinky and the ring fingers.

In very rare cases, patients can suffer from multiple types of nerve lesions, which obviously makes the diagnosis very difficult to make.

Prevention of the Cubital Tunnel Syndrome

While the Cubital Tunnel Syndrome is quite thoroughly known in the medical world, there is very little known about the way one can prevent its development.

In most of the cases, the syndrome is not even diagnosed until the first symptoms appear.

Since there is little known about the prevention of this medical condition, there is nothing you can actually do to make sure you will not develop it (such as in the case of other medical conditions out there).

However, there are general things on which the medical specialists have agreed that they will help with the prevention of the development of the Cubital Tunnel Syndrome.

First of all, you should know the fact that obesity can influence the development of this syndrome.

Being severely overweight can influence every aspect of your health and every single part of your body can be harshly affected by this condition.

Thus, changing your lifestyle to a healthier one and starting to lose weight up to a healthy point will help with the prevention of the ulnar nerve entrapment.

Secondly, if you work in a position that requires you to keep your elbow bent for extended periods of time, you may want to change the position of your arm from time to time.

Simple exercises can prevent the ulnar nerve to be affected and thus they can prevent the development of the syndrome related to it.

One example of such a job is that of being a call center agent, where you may have to hold a phone with your elbow bent for a longer period of time than normally.

Also, if you use vibrating tools or if you bend or straighten the elbow repetitively for a longer period of time can be a risk factor in the case Cubital Tunnel Syndrome (baseball players can be a good example in this case).

Furthermore, you should know that those people who suffer from diabetes mellitus are more prone to develop various types of peripheral neuropathy (including the entrapment of the ulnar nerve and other similar syndromes).

Another risk factor is related to various types of injuries or deformities of the elbow and studies have shown that those people who already have this kind of medical conditions tend to develop the Cubital Tunnel Syndrome more easily.

Moreover, people who have already developed other types of nerve entrapments in the arm (and even in the shoulder) are also more prone to develop this syndrome.

Other studies show that large-breasted women who wear bras can develop an ulnar nerve entrapment syndrome due to the fact that the bra strap tends to affect the soft tissue of the shoulder (which can eventually lead to injuries to the ulnar nerve).

Cubital Tunnel Syndrome

Home Remedies in Case of Ulnar Nerve Entrapment

In case you have started experienced the symptoms described earlier (and if you were diagnosed by a physician), you should also know that there is a series of home remedies that will help you get through the symptoms better.

Do bear in mind the fact that these home remedies may not treat completely your issue, but that they are meant to make the pain and the other symptoms feel less intense.

One of the things you should do to make your situation less painful and less uncomfortable is avoiding those positions that require you to keep your elbows bent.

If you frequently work at the computer, do make sure you do not rest your elbows on the desk and that your chair is not too low (since this will cause an uncomfortable position of your arms and elbows and it may worsen your situation).

Furthermore, if you frequently drive and rest the elbow on the window, make sure you avoid this as well, since this can be considered to be an uncomfortable position for your arm as well.

Also, if you know that you keep your elbow bent while sleeping, remind yourself to keep it as straight as possible.

This may be difficult for you during the sleep, so you can wrap a towel around the elbow to keep it straight and to remind you to keep it this way and not to bend it.

Treatment and Surgery for Transposition of the Nerve at the ElbowPain Relieving Roll

Many people out there may be worried that the ulnar nerve entrapment is a permanent condition, although in most of the cases it is not so.

There are both surgical and non-surgical ways of treating this medical conditions and it is only in special cases that it cannot be treated.

If the tests conducted by the physician professional (the EMG and the NCS tests mentioned before) show that there is quite a small amount of pressure on the ulnar nerve, non-surgical treatment can be applied with success.

Non-steroidal anti-inflammatory drugs may be prescribed and in some cases the doctor steroid injections may be given as well.

Furthermore, the doctor will recommend a series of nerve gliding exercises. Also, the medical professional may also recommend braces and pads to help with the recovery of the patient.

There are certain cases however when the doctor will recommend surgery. For example, when the non-surgical treatment has not yet given any result, when the nerve is very pressured and when the muscle weakness has already installed, surgery will be the best method of treatment in the case of the Cubital Tunnel Syndrome.

There are three main types of surgery the patient may have to undergo. The first one (which is also the most common one as well) involved the transposition of the ulnar nerve.

In this case, the nerve will be moved from the back of the median epicondyle to a place in front of it. The nerve can be placed on top of the muscle, within the muscle or underneath it.

Another type of surgery one may have to undergo when suffering from the Cubital Tunnel Syndrome is that of the Cubital Tunnel release.

Basically, in this case, the Cubital Tunnel will be cut and divided, so that it becomes larger and the pressure on the nerve is diminished.

This kind of surgery is usually recommended when the compression put on the nerve is not very high (rather mild) and when the nerve hasn’t slide out from its place when the patient bends his/her elbow.

The third type of surgery is related to removing part of the medial epicondyle. This type of surgery prevents the nerve to be caught in a wrong place and its effect is quite similar to that of the Cubital Tunnel release one.

Most of the times, the surgeries performed to treat the Cubital Tunnel Syndrome are effective and the patient fully recovers.

However, you should know that in the severe cases, the nerve may recover with more difficulty (nerves usually recover with difficulty) and certain symptoms may still stay with the patient after the surgery is performed.

Each of the three types of surgery the patient may have to undergo for the treatment of the ulnar nerve entrapment shows a different level of success rate, but in general, the patients can feel much better (if not completely cured) after going under the hands of the surgeon.

Another thing you may want to know is the fact that those patients who show an advanced level of disease (muscular atrophy or weakness, for example) usually show permanent nerve damage and in their case the treatment may not be completely successful.

While surgery may release most of their symptoms (or at least diminish their intensity), some of the symptoms may also remain with the patient, since the nerve will not recover completely (and the surgery will stop it from getting worse).

However, in the other cases, where atrophy has not yet installed itself, the patients will experience full recovery.

In the case of the patients with mild (and even sporadic) symptoms, the pain and the numbness may disappear even without treatment (still, you should go visit a doctor even if the symptoms you experience are mild).

Both in the case of Cubital Tunnel Syndrome and in the case of other medical conditions it is highly essential that you appoint yourself to a medical specialist if you see that the symptoms do not disappear within a few days (or if they are recurrent and if they do not completely disappear for extended periods of time).

Only a physician will be able to tell if you suffer from any kind of disease or syndrome and you should make sure to get the right diagnosis.

This can save your situation (and even your life, in some of the cases out there), since the right diagnosis is the first step you can make towards treatment and recovery.

As mentioned before, home remedies may work when the situation is very mild and when you do not experience intense symptoms.

However, you should bear in mind that it is only medical professional who can prescribe you real and effective treatment.

If you are discovered to suffer from this syndrome and you have to undergo surgery though, keep in mind the fact that the rate of success in the case of the patients who suffer from ulnar nerve entrapment is very high.

The sooner you are properly diagnosed, the better your recovery will go and you may not even have to go under the knife, since the non-surgical treatment can work perfectly fine as well.

The Cubital Tunnel Syndrome is not a life-threatening disease, but, as mentioned before as well, it can be influenced a lot by other medical conditions you may suffer from (obesity, for example).

Take your doctor’s advice with you and follow it religiously, since it is only this way that you will increase your chances of complete recovery and you will not have to suffer from the symptoms of this syndrome any longer.

Most importantly, keep a positive attitude: the Cubital Tunnel Syndrome is a medical condition that is well known and treatable and there is a high chance you will recover sooner, rather than later.

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2 Comments

  • Very nice post…definitely gonna help me..m too suffering from right sided mild ulnar neuropathy n have been on conservetive management since 7-8 months…keep on getting intermittent pain..doctors adviced if the pain gets irritating further then wil go for an ulnar nerve release…i need to keep up wd posotove attitude..thank u so much…

  • when i was little i had an accident lead to damage my ulner nerve and its been a long time (9 years) the symptoms are visible the part between my thumb and forefinger is sunken and i have problem in maintaining grip while holding some objects is there any treatment to recover please reply

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