This occurs when the nerve in your arm is irritated from existing pressure. This causes tingling, numbness in your first and second fingers. You might experience tenderness in your upper forearm and occasionally sharp pains shooting down your arm.
If this condition’s left untreated a person will notice their hands becoming weaker and eventually they’ll have atrophy, or wasting away of the muscles in their hands. Suffers often find the pain is more severe at night, and times when they’re using their muscles a lot. This is due to the nerve being more irritated when it’s behind the elbow and between the biceps and triceps muscles.
How is it diagnosed?
Your neurologist will ask you for medical history, and give you a physical. Once completed, he’ll examine the nerves through various electronic shock waves.
Go Away, Pain
Once a diagnosis is made, the doctor will ask you to limit the use of your arm. This will reduce the chances of further irritation. He will probably advise you to wear a splint to bed. He might prescribe an elbow pad, to help cushion the area. The doctor will begin steroid injects around the elbow. This will reduce the pain and swelling associated with this disorder. If these treatment options aren’t effective, the doctor will probably suggest surgery. If the symptoms are consisting in the day and evening hours, or if you’re experiencing muscle weakness then you should strongly consider this option.
There are several different surgeries for this disorder. The one your doctor chooses will depend on the severity of your symptoms. I will explain a little about each, in the following paragraphs.
The first one is known as the simple decompression. The doctor will first numb the area with lidocaine. He will then make a 1 ½ inch incision into the skin. This small opening will release the pressure on the ulna nerve. This procedure takes less than a half hour to perform, and healing time is minimal. That’s why this surgery chosen first.
The second is simple decompression with epicondylectomy. This procedure is generally done if the ulnar nerve becomes dislocated when the person moves their arm. The doctor will make a 1 ½ incision to release the pressure. He will then remove a small portion of the medial epicondyle, or funny bone. Another type of surgery is the subcutaneous transposition. The doctor makes a 4 inch incision to reduce the pressure. He will then move the ulnar nerve to the front of the elbow. This surgery can leave the nerve susceptible to other types of trauma, especially if the patient is thin.
The last one is sub muscular transportation. This procedure is generally used as a last resort, when all of the above procedures have failed. With you under general anesthesia, the doctor will make an incision up to 6 inches in length. This will give him access to the nerve and muscles. He will then make an incision in the muscles near the elbow. The ulnar nerve is then moved below the muscle.The doctor will suture the incision with material that will be absorbed into the skin. So you won’t have to have the sutures removed.
The most commonly known complication with these surgeries is an infection at the incision site. This is rare, less than 2%. If this occurs, your doctor will prescribe antibiotics. A person might experience a little numbness for a short amount of time, usually less than a month, and is less likely in the first two surgeries. Although a small percentage has had numbness for an extended amount of time. Sometime there will be tenderness at the incision site, but this generally goes away within the first few months. Occasionally the surgery doesn’t completely solve the problem. This is due to the existing nerve damage. Rarely, less than 1% of people will experience nerve damage, muscle weakness and numbness after the surgery.
The Big Day
The doctor will advise you not to eat, or drink anything after midnight, the night before your surgery. Most will allow you to take morning medicines, with a small sip of water.
The doctor will ask you to arrive an hour before the surgery so he and the anesthesiologist.
The total time for the surgery is approximately half an hour, but the doctor will want to clean the wound and change your dressing one last time. So your time in the operating room will be about an hour.
You will then go to the recovery room where they will monitor your pulse, blood pressure and respirations for approximately an hour before they allow you to leave.
Time to Heal
For the simple decompression a small dressing is applied. It will need to stay intact for three days.You can shower, but try not to get the dressing wet. After the third day you’ll remove the bandage. Below that will be stickers, which will be removed on your follow up visit, in a week. You don’t have to worry about these stickers getting wet.
The doctor will tell you to start using your armfor light work only, to allow healing time.
If you experience pain usually an over the counter medicine will suffice. If the pain is severe, or if you experience excessive bleeding, you need to call your surgeon. A small amount of blood is normal.
The surgical area for the simple decompression with epicondylectomy and the subcutaneous transposition is covered with an ace bandage and placed in a sling for two weeks. Keep the bandage dry when you shower for the first week, until the surgeon changes your initial dressing on your weekly follow- up visit.
Use your arm for light work, for the first two weeks. You’ll then see a physical therapist for the next six weeks. You can resume normal activities after 8 weeks.
For sub-muscular the healing time is longer. A person will see a physical therapist after 3 months.