Tunnel ulnar nerve syndrome: causes, symptoms, treatment methods
Tunnel ulnar nerve syndrome is a fairly common problem, especially when it comes to professional athletes, plant workers and representatives of some other professions. The disease is accompanied by constant discomfort and soreness, which significantly worsens the quality of human life.
Of course, people who encounter such a disease are interested in any information. What is tunnel ulnar nerve 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 is worth 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.
Tunnel ulnar nerve syndrome is associated with compression of the latter. In most cases, the compression of the nerve tract is caused by trauma, infringement or damage to the elbow.
The main causes of the development of the disease
Why develop tunnel syndrome of the ulnar nerve? Treatment of the disease is directly related to the causes, so it is worth more detailed study of the list of risk factors.
The ulnar nerve passes through the bone canal, so it is well protected from various external influences. But deformation of the walls of the bone can lead to its squeezing and development of the so-called tunnel syndrome.
Risk factors include prolonged overstrain of ligaments and tendons, as this leads to a temporary disruption of blood supply to tissues. Prolonged deficiency of nutrients and microelements affects the condition of the bone walls - they thicken or, conversely, loosen. Thus, the space in the bone tunnel decreases, which creates additional pressure on the nerve.
In addition, deformation can be the result of prolonged stress on the ulnar part - from this ailment often suffer professional athletes.
The tunnel syndrome of the ulnar nerve can sometimes be the result of the edema of the nerve itself. To the reasons in this case it is possible to carry an intoxication of an organism with dangerous substances, in particular, salts of heavy metals, arsenic, mercury.
Severe contusion of the ulnar part, fractures of the forearm or shoulder, the appearance of bone spurs, cysts, and intralateral osteophytes are also considered risk factors.
Who is at risk?
Certainly, tunnel syndrome of the ulnar nerve is in most cases associated with persistent physical stress and bone deformities. Nevertheless, some people are more prone to such a pathology as ulnar nerve 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-extensibility( tennis players, violinists, painters, hairdressers).
- The risk group includes people over 50 years old, because aging processes are inevitably accompanied by changes in bone tissue.
- People suffering from pathology of the endocrine system, for example, pituitary diseases, thyroid gland, diabetes mellitus. Against the background of such diseases, the regenerative capacity of the body is weakened.
- Tunnel syndrome often affects people who are engaged in heavy physical labor, as well as athletes.
- The risk group includes people who suffer from autoimmune diseases.
- There is also a genetic predisposition. To this disease people with different hereditary diseases of the musculoskeletal system are more likely, for example, arthritis, osteochondrosis, arthrosis. What symptoms should I pay attention to?
What signs are accompanied by tunnel syndrome of the ulnar nerve? Symptoms and their severity directly depend on the degree of development of the disease. For example, at the initial stages, any disturbance of well-being may be absent altogether. But as the space in the bone channel narrows, the symptoms become more pronounced. The clinical picture is as follows:
- occasionally appears pain in the elbow, which is strengthened after physical exertion;
- , some patients complain of numbness in the palms or fingers;
- when the joint or ligaments are stretched, the pain syndrome increases( tapping on the affected area is also accompanied by discomfort);
- , as the disease develops, stiffness appears when moving in the affected joint;
- gradually muscles in the affected nerve begin to weaken, gradually atrophy.
It should be noted that with this pathology the pain can spread to the forearm, shoulder, shoulder blade and even back, which often complicates the diagnostic process.
As a rule, the collection of anamnesis and a thorough physical examination is sufficient to suspect tunnel syndrome of the ulnar nerve. Treatment largely depends on the stage of development of the disease and the cause of its appearance, which can be clarified during the diagnosis. To this end, the following techniques are used:
- electroneuromyography - allows you to assess the function of the shoulder muscles, determine the rate of momentum transfer along the nerve and the level of pressure on nerve fibers;
- electromyography is a study that gives the physician 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.
Treatment of tunnel syndrome with medications
What should I do for a patient diagnosed with tunnel ulnar nerve syndrome? 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, Orthofen, Voltaren. These drugs are available in the form of tablets, injection solutions, ointments for external use. Such drugs help to stop the inflammatory process and quickly eliminate pain.
- The course of therapy also includes B vitamins that help normalize blood circulation and nerve conduction.
- In some cases, doctors prescribe intravenous calcium chloride solution - this helps to relieve inflammation and stabilize the immune system.
- In the most severe cases, the treatment regimen includes steroids( Hydrocortisone, Prednisolone), which quickly relieve pain and inflammation. Sometimes a solution of hormones 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. Then additional measures are introduced into the therapy scheme.
In particular, patients are often recommended therapeutic massage, which helps to relieve muscle spasm, improve their tone, improve blood flow.
In some cases, doctors designate wearing a special tire. It is especially important to wear this device at night - this reduces the risk of injury during sleep. Sometimes shortwave heating of the elbow area is also effective.
Most often, conservative treatment lasts about 1-2 months. If you follow all the recommendations of a doctor, you can get rid of inflammation, relieve pressure on the ulnar nerve and restore mobility to the elbow joint.
Tunnel ulnar nerve syndrome: therapeutic gymnastics
An important component of the recovery process is therapeutic gymnastics. Of course, the complex of exercises is selected individually by the physiotherapist depending on the patient's condition.
- Sit on a chair, straighten your back. Both hands pull forward. Now start alternately squeeze and unclench the brush. Exercise should be repeated 10-15 times( for each hand).
- Keep the same position. Squeeze your fists and start making rotational movements with your wrists. Do 10 repetitions in both directions.
- Shoulder should be leaned on the back of the chair and fixed so that the arm freely hangs down. In this position, start making movements that mimic a pendulum. Try to maximally bend and unbend the elbow joint. Repeat the movement 10-15 times.
Similar exercises are supplemented with conservative therapy. They are also shown after surgery, because they help to gradually restore the function of the elbow joint.
Tunnel ulnar nerve syndrome: treatment with folk remedies
Immediately it is worth mentioning that home remedies can only be used at home. Some folk medicine men recommend making warm compresses from sea-buckthorn( fresh berries must be grinded to the state of homogeneous mush, heated in a water bath and applied to the affected joint).
Pumpkin compresses will also be useful. The flesh should be slightly warmed, applied to the joint and fixed with food film.
Inside you can take decoctions from the root of parsley, herb bearberry and white birch leaves. These plants have a mass of valuable properties, including swelling, which is often accompanied by a tunnel syndrome.
Surgical treatment: decompression
How to treat tunnel syndrome of the ulnar nerve, if conservative therapy does not give the desired effect? Unfortunately, sometimes it's just impossible to do without an operation.
Quite often a so-called simple decompression is performed. The essence of the procedure is the dissection of the tendons and the removal of thickening, which pinches the nerve. This is a fairly simple operation, during which it is possible to preserve the blood supply to the nerve. And the restoration of the functions of the upper limb is fast. Among the shortcomings can be attributed except that the risk of repeated 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 or forward of the muscles).
This technique has several advantages. Most often, the limb can be fully restored. The risk of relapse is minimal. Disadvantages are also present - cases of tissue scarring have been reported.
What is the essence of medial epicondylectomy?
In some cases, patients are prescribed epicondylectomy. 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 to relieve pressure.
It is worth noting that some of the hand functions are lost even if the recovery period is correctly performed. The rehabilitation period after such an operation is long and rather painful. The procedure is also associated with other risks - the proliferation of bone tissue, muscle weakness.
Prevention of complications of
Even after successful treatment, there is a risk of re-development of the disease, especially if the tunnel syndrome is caused by peculiarities of professional activity. In this case, doctors recommend not to forget about curative gymnastics, which is aimed at normalizing the functioning of muscles and tendons.
It is also important to monitor the posture during sleep - the arms should be bent at the elbows. For this purpose, experts recommend buying special rollers. If there is damage to the nerves of the elbow, shoulder or wrist, it is worth minimizing the burden on the affected limb, abandoning the potentially traumatic activity. In the event that the hand still have to strain, it is worth to acquire a special elastic retainer, which practically does not limit mobility, but partially relieves the load from the muscles and tendons.
It should be understood that the earlier the disease is diagnosed, the faster and easier it will be to treat it. That is why it is important to consult a doctor immediately after the appearance of the first symptoms.