Ulnar neuropathy also known as carpal tunnel syndrome is a disorder that causes excruciating pain, tingling numbness and weakness in the arms, hand and elbow.
You might have tenderness in the upper part of your arm, or you may experience sharp pain radiating down your arm. People often find that they can’t pinch the pinkie and the thumb together and they have difficulty gripping things.
Eventually someone might see atrophy, which is muscles wasting in the hands. This can make their hand, take the shape of a claw. I’ll explain what causes this to occur and available treatment options in the following paragraphs.
What’s Caused Me to Suffer?
Generally what happens is the ulnar nerve, which is the small nerve that lies just underneath the skin around the elbow is pinched.
Usually this is caused from a bone or possible soft tissue. This increased pressure against the nerve causes the pain to occur.
People who generally get this either lean on their elbows a lot, bend their elbows frequently, or for long periods of time.
Tennis players, golfers, baseball players and other activities that increase the pressure on the ulnar nerve might have some type of carpal tunnel. Sometime when a person’s bone don’t grow correctly, this can cause carpal tunnel.
Often your doctor can tell by your display of symptoms, what’s occurring. Sometimes they will order an electromyography to make sure. During this test, the doctor will send electrodes into your skin. This will tell him if there is nerve damage and the extent of the damage.
The doctor might suggest to minimize activities that will cause stress to the nerve. He may ask you to wear a pad on your elbow when you are doing activities and he might suggest using splints when you sleep. He might possible, ask you to wear splints during the day.
The doctor may prescribe a non-steroid anti-inflammatory agents like Motrin, or naproxen to reduce the pain and swelling in the area. He might order a topical NSAID cream.
Sometimes doctors will give their patents corticosteroid injections. This too relieve irritation on the ulnar nerve.
It will reduce the swelling, which reduces the pain. He may choose to do ultrasound therapy on the area.
Doctors might suggest a class to teach you ways to decrease the stress on the nerve. These classes will also teach you various exercises like stretching, strengthening and nerve glide exercise. He might suggest applying warm, moist heat or ice packs to the area.
Occasionally the damage is already so extreme that the doctor feels that surgery is the only option. This is especially true when a patient presents with lack of range of motion in the fingers, weakness, muscle atrophy and claw like hand.
Sometimes after being unsuccessful with the other options, the doctor could suggest surgery. The one he chooses depends on how severe your symptoms have become. Generally the doctor will choose the less evasive first. This the one we’ll begin with first.
The least evasive surgery is known as simple decompression. After numbing the area, the doctor will make a small incision into your skin.
Generally this cut is no bigger than the doctor feels necessary, usually an inch and a half. This small opening will release the built up pressure on your ulnar nerve.
This procedure usually is quicker than a routine office visit, a normal time for this procedure is half an hour.
The second option is known as a simple decompression with epicondylectomy. The doctor will numb the area. He will then make a one and a half inch incision into your skin, Next he will take out a small amount of your funny bone, the epicondyle.
Your doctor may choose to do a surgery known as subcutaneous transposition. The doctor has to make a larger incision with this option, usually four inches.
Once the built up pressure’s been reduced, he’ll then move the ulnar nerve in front of your elbow.
The biggest problem seen with this type of surgery is it leaves the nerve exposed, which increases the chance of it getting hurt in other types of trauma. Especially if the patient is underweight.
As the last possible option, when everything else has failed, the doctor may choose to do a surgery known as sub muscular transportation.
The doctor will place you under anesthesia. Once you’re asleep, the doctor will make a six inch incision into your skin. This will expose your muscle and various nerves.
He will then make a small incision in your muscle. There are six muscles than can trap the ulnar nerve. The doctor will decide which one is causing the damage when he can visualize the problem.
He will then move the nerve below the muscle. He might remove part of the funny bone at this time, if he sees that it might create a problem. He will then suture the muscle and then your skin.
Dressings and Healing Time
After simple decompression you will notice a small bandage. This only needs to stay on for three days. You will be able to use your arm for light work after surgery.
For the second and third mentioned surgery the area will be wrapped in an ace bandage. You will be asked to wear a sling for two weeks. After these two weeks you can do light work with it.
You’ll also be visiting a physical therapist for a month and a half to help regain your range of motion and muscle strength in your arm.
For the last one sub muscular the healing time is more intense. You will begin seeing a physical therapist three months prior to the surgery.
Reviewing the Facts
Carpal tunnel syndrome is caused by the ulnar nerve being pinched by either bone, or soft tissue.
Certain activities, leaning on your elbow and growth abnormalities can also cause this. Sometimes heat, cold, splints and elbow pads cures the problem, while others need surgery.