the cubital canal syndrome: symptoms, treatment and prevention
Causes and treatment of the syndrome of the cubital channel
Task nerves – conduct impulses from the brain (brain and spinal cord) throughout the body. Among other things, the nerve impulses responsible for the muscle movement and skin sensitivity.
When compressed nerve its normal function is disturbed and the pulse passes the worse, the more compressed the nerve.
If you hit his elbow on something hard, followed by backache in the finger and sharp pain. This is a response of the ulnar nerve on a hit on it. In the case when the ulnar nerve is not the goal but a constant pressure, a so-called neuropathy, that is, violation of nervous impulse.
Compression of the ulnar nerve in the cubital area of the channel is called the syndrome of the cubital channel.
Anatomy of a syndrome
Beginning in the cervical nervous plexus, the ulnar nerve runs along the arm to the fingers. Through the elbow the ulnar nerve passes through the cubital canal.
This channel is formed by the tendons, bone (ulnar bone and into the inner epicondyle) and ligament.
The area of responsibility of the ulnar nerve is the sensitivity of the little finger and ring finger (one half). In addition, it controls some of the muscles of the hand.
Therefore, if you damage the ulnar nerve, grip the brush will be difficult.
Causes of the syndrome
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The reasons why the development of the syndrome of the cubital channel, there are several:
- It is considered that the most common of these is multiple trauma. For example, the monotonic and frequent movements of bending-unbending of the elbow during their professional activities or sports. Because of this inflamed tendon arc, the edges become thicker and the space of the channel is narrowing.
- The next reason is a fracture of the olecranon or the lower portion of the humerus, which can change the anatomy of the cubital channel. Similar result can cause the formation of bone spurs and cysts. The cubital canal syndrome can develop due to strong elbow.
- Another cause is prolonged pressure on the elbow. For example, if while driving the car to lean his elbow on the door. Or if you long to sit at the table with emphasis on the elbow.
Indicates what syndrome?
The following are symptoms of which syndrome of the cubital channel is manifested most often, and not necessarily to present all at once:
- a feeling of numbness, pain and stiffness, it covers the little finger and half the ring finger;
- pain when bending-unbending of the fingers, weakness of grip;
- drawing pain in the region of the elbow.
All of these problems appear gradually and progress in the future. Clearly the symptoms are in the morning, as in a dream the long elbow is in a bent position without movement.
There are difficulties in the movements of the brush, hard to write, to print, something to hold in your hand.
As a rule, the intensity of the symptoms decreases after a few hours. However, if you do not start timely treatment, the problem could become more serious.
The doctor should be contacted in the case when the above mentioned symptoms persist for months.
At the initial examination the physician must determine the level at which the ulnar nerve is pinched.
Is determined by the ability to make brush some of the movements, and the fingers are checked for sensitivity.
Established presence symptom Tinnila (when tapping on the cubital canal symptoms increase).
Patient medical examination can be very unpleasant, but required for proper diagnosis.
Mainly for diagnosis is sufficient only to survey.
If a particular case raises doubts, may be held an additional examination. It is intended to identify unusual cause of shoulder impingement syndrome of the ulnar nerve.
This may be assigned:
- The x-rays. Designed to to see the bone;
- CT (computed tomography). Can also be used to show bones, only with a lot of details;
- Ultrasound (ultrasonography);
- MRI (magnetic resonance imaging). Designed to to see soft tissue. These include muscles, cartilage, ligaments, etc.;
- AMG (electromyoneurography). Test, measuring the speed of transmission of nerve impulses.
The complex of therapeutic methods
In the case of diagnosing a syndrome of the cubital channel is assigned conservative treatment or surgery performed.
The aim of conservative treatment in the initial stage of the syndrome is the causes of the onset of symptoms. You need to seriously limit load, and the athletes to stop exercising.
Also with the symptoms will help to manage the reception of non-steroidal anti-inflammatory drugs.
All monotone, many times repetitive motion should be deleted. We need to abandon the habit to lean his elbow on the door in the car, etc.
But most importantly – to exclude the execution of those movements that provoke pain. If the execution of these movements required to perform tasks in the framework of professional activities, though, you need to maximize the number of interruptions.
If the patient is sitting at the computer, to make sure that his elbow is not hanging down and not leaned on the edge of the table. In General, when working at a Desk, elbow you need to put something soft.
Also good with a bandage to attach to the crook of the elbow folded towel. So the hand will be less to bend. It is especially useful to do for those who sleep, bending the arm and putting it under his head.
Another important aspect of conservative treatment is the use of anti-inflammatory non-steroidal drugs.
For example, it can be voltaren gel. Smear the elbow they need, regardless of what the pain is or it is not. In addition to analgesic, these drugs have anti-inflammatory action.
Namely, the inflammation of the soft tissues of the walls of the cubital channel is the cause of nerve compression.
Also well-proven vitamin B6.
Treatment conservative treatment usually lasts about a month. If it had no effect, you can continue up to three months. If during this time did not come the result, then schedule the surgery.
The aim of surgery is decompression (getting rid of compression) of the ulnar nerve in the cubital canal. There are several varieties of the operation.
The first surgery is to dissect the tendinous arc and removed part of the walls of the channel. In some cases, this involves the partial removal of the epicondyle of the humerus.
The second type of operation is a transposition of the ulnar nerve. In this case, a completely new channel, in which the transplanted nerve.
Which of these two methods of operation is preferable, it is difficult to say, because statistics show that they have the same effectiveness.
The operation is performed either under local or under General anesthesia.
What is needed for effective rehabilitation
If the conservative treatment was successful, improvement will come in 1-1. 5 months. It is possible that patient will have is at night elbow pillow.
Will also need to monitor the movement of the hands. Repetitive and monotonous movements of the arms and hands should be curtailed, and the elbow should not long be in a bent position.
How will the postoperative recovery depends on the surgery itself. After removal of the patient epicondyle around the elbow will be imposed gauze bandage.
Recovery after this type of surgery is fast. During rehabilitation are assumed to be motor exercises.
After transposition, recovery is slower. It is not excluded that this process will take several months. At the elbow, patients will have the splint will have to wear for 3 weeks.
After removing the tire patient shows physical therapy ranging from passive movements to active power load.
Complications are rare. If they do happen, are a damage to the medial collateral ligament and/or medial cutaneous nerve.
It is also possible, when perineural will be involved in the scarring process.
The goal of prevention is to avoid elbow injuries
Any special preventive measures does not exist. You just need to exclude the possibility of trauma to the elbow.
If the operation is performed correctly, then the positive effect will be necessary, though, and to wait sometimes several months. This term is due to the fact that there is a restoration of nerve cells, and they do it slowly.
Also I must say that the improvement comes gradually, not abruptly and at the last moment.