Tunnel ulnar syndrome is a fairly common problem, especially when it comes to professional athletes, factory workers and representatives of some other professions. The disease is accompanied by constant discomfort and pain, which significantly impairs the quality of human life.
Of course, people who are faced with a similar ailment are interested in any information. What is ulnar tunnel syndrome? Symptoms, treatment, causes, possible complications are those moments that must be considered.
What is an ailment?
Compression neuropathy of the right ulnar / radial nerves (tunnel syndrome of the elbow and wrist, respectively) is a fairly common problem. But for starters, of course, it's worth getting familiar with the general information.
The ulnar nerve is one of the largest mixed nerves of the upper limb. It starts from the medial bundle of the brachial plexus and ends in the cubital canal.
Ulnar tunnel syndrome is associated with compression of the latter. In most cases, compression of the nerve pathways is caused by injuries, pinching or damage to the elbow.
The main causes of the development of the disease
Why does ulnar tunnel syndrome develop? Treatment of the disease is directly related to the causes, so it is worthwhile to study the list of risk factors in more detail.
The ulnar nerve passes in the canal of the bone, therefore it is well protected from various influences from the outside. But the deformation of the walls of the bone canal can lead to its compression and the development of the so-called tunnel syndrome.
Risk factors include prolonged overstrain of the ligaments and tendons, as this leads to a temporary disruption of the blood supply to the tissues. Long-term deficiency of nutrients and microelements affects the condition of the bone walls - they thicken or, conversely, loosen. Thus, the space in the bone tunnel is reduced, which creates additional pressure on the nerve.
In addition, deformation may be the result of prolonged stress on the elbow - professional athletes often suffer from such an ailment.
Tunnel ulnar syndrome can sometimes be the result of edema of the nerve itself. The reasons in this case include intoxication of the body with hazardous substances, in particular, salts of heavy metals, arsenic, and mercury.
Risk factors also include severe bruising of the elbow, fractures of the forearm or shoulder, the appearance of bone spurs, cysts, and ulnar osteophytes.
Who is at risk?
Of course, tunnel ulnar syndrome in most cases is associated with constant physical activity and bone deformities. Nevertheless, some people are more prone to a pathology such as ulnar tunnel syndrome. The reasons may be associated with professional activities or hereditary diseases. The list of risk groups is as follows.
- People whose profession is associated with constant flexion and extensor actions (tennis players, violinists, painters, hairdressers).
- The risk group includes people older than 50 years, as the aging process is inevitably accompanied by changes in bone tissue.
- People suffering from pathologies of the endocrine system, for example, diseases of the pituitary gland, thyroid gland, diabetes mellitus. Against the background of such diseases, the regenerative abilities of the body are weakening.
- Tunnel syndrome often affects people who engage in heavy physical labor, as well as athletes.
- The risk group includes people suffering from autoimmune diseases.
- There is also a genetic predisposition. People with various hereditary diseases of the musculoskeletal system, for example, arthritis, osteochondrosis, arthrosis, are more prone to this ailment.
What symptoms should I look for?
What are the signs of ulnar tunnel syndrome? Symptoms and their severity directly depend on the degree of development of the disease. For example, in the initial stages, some disturbances in well-being may even be absent. But as the space in the bone canal narrows, the symptoms become more pronounced. The clinical picture is as follows:
- periodically there is pain in the elbow, which intensifies after physical exertion;
- some patients complain of numbness of the palms or fingers;
- when the joint or ligaments are stretched, the pain syndrome intensifies (tapping the affected area is also accompanied by discomfort);
- as the disease develops, stiffness appears during movements in the affected joint;
- gradually the muscles in the affected nerve begin to weaken, gradually atrophy.
It is worth noting that with such a pathology, the pain can spread to the forearm, shoulder, shoulder blade and even the back, which often complicates the diagnostic process.
Diagnostic measures
As a rule, a medical history and a thorough physical examination are enough to suspect tunnel ulnar syndrome. Treatment largely depends on the stage of development of the ailment and the causes of its appearance, which can be clarified during the diagnosis. For this purpose, the following methods are used:
- electroneuromyography - allows you to evaluate the function of the muscles of the shoulder, to determine the speed of impulse transmission along the nerve and the level of pressure on the nerve fibers
- electromyography - a study that gives the doctor the opportunity to evaluate the work of the muscles of the forearm, shoulder and hand;
- X-ray, ultrasound, MRI are also used in the diagnostic process, especially if there is a suspicion of injury, fracture, arthritis, gout, and other diseases.
Medication for Tunnel Syndrome
What should be done to a patient diagnosed with ulnar tunnel syndrome? The methods of treatment depend on the degree of compression of the nerve and the presence of certain symptoms. If we are talking about the initial stages of the development of the disease, then conservative therapy will be effective.
- In most cases, patients are prescribed non-steroidal anti-inflammatory drugs, in particular, “Diclofenac”, “Ibuprofen”, “Ortofen”, “Voltaren”. These drugs are available in the form of tablets, injectable solution, ointments for external use. Such remedies help to stop the inflammatory process and quickly eliminate pain.
- The course of therapy also includes B vitamins, which help normalize blood circulation and nerve conduction.
- In some cases, doctors prescribe an intravenous administration of a solution of calcium chloride - this helps relieve inflammation and stabilize the immune system.
- In the most severe cases, steroids ("Hydrocortisone", "Prednisolone") are included in the treatment regimen, which quickly relieve pain and inflammation. Sometimes a hormone solution is injected directly into the affected area of the limb.
Rehabilitation and recovery period
With the help of medications, you can get rid of inflammation, normalize blood circulation and trophic tissue. Further, additional measures are introduced into the treatment regimen.
In particular, patients are often recommended therapeutic massage, which helps relieve muscle spasm, increase their tone, improve blood flow.
In some cases, doctors prescribe wearing a special tire. It is especially important to wear this device at night - this reduces the risk of injuries during sleep. Sometimes short-wave heating of the elbow region is also effective.
Most often, conservative treatment lasts about 1-2 months. If you follow all the doctor’s recommendations, you can get rid of inflammation, relieve pressure on the ulnar nerve and restore mobility to the elbow joint.
Ulnar Tunnel Syndrome: Therapeutic Gymnastics
An important component of the recovery process is therapeutic exercises. Of course, a set of exercises is selected individually by a physiotherapist, depending on the condition of the patient.
- Sit on a chair, straighten your back. Pull both hands forward. Now begin to squeeze and unclench the brushes one by one. The exercise must be repeated 10-15 times (for each arm).
- Keep the same position. Clench your fists and begin to make rotational movements with your wrists. Repeat 10 times in both directions.
- The shoulder should be supported on the back of the chair and fixed so that the hand hangs down freely. In this position, begin to make movements that simulate a pendulum. At the same time, try to flex and unbend the elbow joint as much as possible. Repeat the movement 10-15 times.
Conservative therapy is supplemented by such exercises. They are also shown after surgery, as they help to gradually restore the functions of the elbow joint.
Tunnel ulnar syndrome: treatment with folk remedies
It’s worth mentioning right away that home remedies can only be used at home. Some folk healers recommend making warm compresses from sea buckthorn (fresh berries need to be ground to a state of homogeneous gruel, heated in a water bath and applied to the affected joint).
Pumpkin compresses will also be useful. The pulp needs to be slightly warmed up, applied to the joint and fixed with a food film.
Inside, you can take decoctions of parsley root, bearberry grass and white birch leaves. These plants have a lot of valuable properties, including relieve swelling, which is often accompanied by tunnel syndrome.
Surgical treatment: decompression
How to treat ulnar tunnel syndrome if conservative therapy does not produce the desired effect? Unfortunately, sometimes it is simply impossible to do without surgery.
Quite often, the so-called simple decompression is carried out. The essence of the procedure is to dissect the tendons and remove the thickenings that pinch the nerve. This is a fairly simple operation, during which it is possible to maintain blood supply to the nerve. Yes, and restoration of the functions of the upper limb pass quickly. The disadvantages include the risk of a second exacerbation, although such cases are rarely recorded.
Nerve Transposition: Features of the Procedure
Another procedure that is often performed by surgeons. During the operation, the pinched nerve is moved to a more free space (deep into or forward of the muscles).
This technique has several advantages. Most often, the functioning of a limb can be restored completely. The risk of relapse is minimal. Disadvantages also exist - cases of tissue scarring have been reported.
What is the essence of medial epicondyllectomy?
In some cases, patients are prescribed epicondyllectomy. This is a much more complicated procedure, the essence of which is to remove part of the elbow joint. Such manipulations help to expand the channel through which the nerve passes, which helps relieve pressure.
It is worth noting that part of the functions of the hand is lost even with a correctly conducted recovery period. The rehabilitation period after such an operation is long and rather painful. The procedure is associated with other risks - overgrowth of bone tissue, muscle weakness.
Prevention of Complications
Even after successful treatment, there is a risk of re-development of the disease, especially if the tunnel syndrome is caused by the characteristics of professional activity. In this case, doctors recommend not to forget about medical gymnastics, which focuses on normalizing the functioning of muscles and tendons.
It is also important to monitor posture during sleep - hands should be extended at the elbows. For this purpose, experts recommend purchasing special rollers. If there is damage to the nerves of the elbow, shoulder or wrist, then it is worth minimizing the load on the diseased limb, abandon the potentially traumatic activity. In the event that the arm still has to be strained, it is worth getting a special elastic retainer, which practically does not limit mobility, but partially removes the load from the muscles and tendons.
It is worthwhile to understand that the sooner a disease is diagnosed, the faster and easier its treatment will be. That is why it is important to consult a doctor immediately after the onset of the first symptoms.