Cubital canal syndrome (ulnar compression syndrome) develops at the moment when the ulnar nerve is compressed in the cubital canal. Nerves are designed to conduct impulses throughout the body, they begin with the brain and spinal cord and end with all the organs of the human system. Due to the fact that the nervous system signals all changes in the body, responsible for movement and sensitivity, a person can consult a doctor in time and prevent the development of many diseases. When squeezing a nerve, its full-fledged work will be disrupted.
Anatomy
The ulnar nerve begins in the neck, where the roots exit the vertebral region. These nerve roots come out of the holes in the spine. When they join, three main nerves are formed, descending along the hand to the hand. One of these nerves is called ulnar. It passes through the cubital canal located behind the inner elbow. Next, the nerve descends along the forearm to the area of the hand. This channel is formed by a combination of muscles, ligaments and bones. If you straighten your hand and rub the hollow from the inside of the elbow, you can feel the cubital channel.
Due to the ulnar nerve, a person feels the sensitivity of the little finger, half of the ring finger, and can also control some muscles on the wrist.
Causes of the Syndrome
A disease can develop for unknown reasons. It occurs in each patient in different ways. But usually the development of cubital channel syndrome is preceded by an injury in this department, or frequent and sharp movements of the hand, for example, during physical exercises. When the elbow joint is stressed, nerve compression can occur, which occurs due to muscle tension. If you actively move this muscle, then the inflammatory process will develop, tendon thickening will occur, and the nerve will begin to hurt greatly.
Sometimes the disease develops due to prolonged pressure on the elbow, for example, when lying in the same position, or when lifting the barbell. Another reason may be the habit of putting your hand on the car glass in the door area.
The syndrome develops due to changes in the anatomy in the cubital canal, which is due to the formation of bone spurs. This can happen in the following situations:
- with a fracture of the elbow;
- with a fracture of the shoulder joint;
- due to the formation of a cyst;
- with the appearance of bone spurs;
- bruise in the elbow.
Which professions are more prone to cubital syndrome
In addition to athletes who have a constant load on the elbow joint, representatives of other professions are also affected by this disease, namely:
- movers;
- drivers, mainly truckers;
- hairdressers;
- rural workers.
The syndrome of the cubital channel according to ICD-10 has the code G56.0.
Symptoms
The earliest sign of cubital syndrome is numbness on the inside of the hand. The ring finger and little finger are also numb. As the cubital channel syndrome develops, numbness develops into pain. The hand may become numb due to prolonged stay in a bent position. For example, when a person speaks on the phone for a long time, or during sleep. There is clumsiness in the movements of the hand and thumb. This happens due to damage to the corresponding muscles.
If a push or blow is made to the area of the cubital channel, then the person immediately feels soreness or numbness in the little finger. This condition is called a symptom of Tinel in medicine.
Symptoms of the cubital canal syndrome are also called the condition of the "tennis elbow" or median epicondylitis. In this condition, pain is felt in the region of the internal condyle of the elbow.
Complications and consequences
If treatment of the cubital canal syndrome is not started on time, then complications will develop in the future. The most common of them is a partial paralysis of the hand and the subsequent loss of its working capacity.
As the disease progresses, atrophy of the muscle tissue of the hand appears, with the gaps between the bones sagging.
After the first symptoms of the disease appeared, treatment should be started immediately. If therapy is started after 3-4 months, then all measures by the doctors will not bring the desired effect. Often, such people have to change their professional activities, or even register a degree 3 disability.
Diagnostics
If you suspect a syndrome of the cubital canal, the doctor should initially examine the patient and listen to his complaints.
- When you click on the elbow bend, the doctor reveals the level of compression of the nerve.
- Testing is being done to maintain the sensitivity of the fingers and motor abilities of the hand.
- The presence of tunnel syndrome of the cubital canal is detected), when a person feels soreness when tapping on the elbow bend. This is a required diagnostic measure.
All these actions by the doctor are called palpation. This procedure can be painful, since the doctor needs to identify the affected area in the area of nerve endings. The patient will have to endure, because this procedure is an important part of diagnostic measures.
Instrumental diagnostics
Most often, palpation diagnosis is enough to make a diagnosis of cubital ulnar nerve syndrome. But if the doctor has doubts, then he directs the patient to an instrumental examination:
- radiography;
- ultrasonography;
- CT or MRI;
- electroneurography - the study determines the speed with which impulses travel through the nerve channels.
Treatment
If an unpleasant sensation occurs in a person only after squeezing the elbow, then conservative treatment is performed. The load on the cubital channel is reduced, including in the form of bends in this section, which contributes to the rapid restoration of its work.
To completely eliminate the load, at night the arm is fixed so that it does not bend at all in the elbow. For example, a bent or twisted towel is attached to the elbow bend with a bandage, which prevents the arm from bending.
When working with a computer, you will also need to hold your elbow, and when driving, straighten your arms as much as possible.
In order for the symptoms of the disease to disappear soon, external anti-inflammatory drugs will have to be used. In this case, the Voltaren gel helps well, which is applied to the affected area up to 3-4 times a day. Such drugs can relieve pain and swelling, which often becomes the cause of the development of cubital canal syndrome.
NSAIDs are an important treatment measure for cubital canal syndrome. If they do not help, then the doctor may prescribe stronger drugs corticosteroids. For example, a hydrocortisone injection in combination with an anesthetic has a good effect.
Sometimes doctors prescribe vitamin B6 for quick recovery, but it is worth remembering that you can not take it yourself. Only a doctor can determine the appropriateness of his appointment and the necessary dosage.
Such conservative treatment can last up to a month. In some cases, it may be delayed. But if the numbness in the elbow persists, then the doctor may decide on surgical intervention.
Surgery
Surgery for cubital canal syndrome involves eliminating the causes of squeezing the ulnar nerve. It is carried out in case of failure of conservative therapy. So, if after drug treatment within a month there is no improvement, then you should wait up to three months. If no changes have occurred, then an operation is prescribed.
After the surgery is performed, the patient for a certain time will have to abandon physical activity on this joint.
Types of operations
With prolonged numbness, as well as with fractures, doctors carry out an operation, which can be of two types:
- Simple decompression. A part of the thickened walls that compress the nerves is cleansed, and a dissection is made in the tendon arch. The operation does not belong to the category of complex, but its disadvantage is the unstable effect.
- Transposition of the nerve. During the operation, doctors try to move the pinched nerve from the cubital canal slightly forward. It is moved into the space between the muscles and subcutaneous fat. This operation is called anterior subcutaneous transposition. Sometimes the nerve is moved deeper into the axilla. In this case, the operation is called "anterior axillary transposition."
Alternative treatment
Traditional medicine for the syndrome of the cubital canal will be effective only in combination with drug therapy and compliance with the rules for handling a sick hand. In addition, grandmother's methods of therapy help with pain and swelling, but they cannot eradicate the causes of this condition.
Alternative therapy of the cubital channel syndrome involves the use of rubbing and compresses.
- To relieve swelling, cabbage leaves, burdock or horseradish leaves are often used. It is enough to attach the plant to a sore spot and leave it for a certain time.
- You can use cool dough, which is made from vinegar and red clay. A cake is formed from such a mixture, which is applied to the elbow at night. The procedure is repeated for 3 days.
- It helps with edema and pain in the elbow, the bacon, which grease the affected area. The course of treatment lasts 1 month.
- In the pharmacy you can buy a solution of "Bishofit", it is also used as a grind, compresses or bathtubs. This is done every other day, 10-12 procedures are enough.
- Compresses can be used from an alcohol-honey composition, mustard grinding is also recommended.
- To strengthen the body and relieve inflammation, decoctions are prepared on the basis of herbs, such as chamomile, St. John's wort, oregano, fireweed, raspberries. They are recommended to drink during the day instead of tea.
Finally
If you follow all the doctor’s recommendations, provided that therapy is started on time, then improvement will come in 1-1.5 months. Perhaps for a certain amount of time the doctor will recommend putting on an elbow pillow for the night. Subsequently, the patient is also advised to constantly monitor hand movements. Constant and monotonous movements in the elbow and the long bent position of the elbow are limited.