Cubital Tunnel Syndrome: Is Surgery Needed?
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- Опубліковано 9 жов 2023
- To get the Active Care guide, The Secrets to Hand Numbness, go here: bit.ly/3hTNLlD
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CHAPTER 1: INTRODUCTION TO TREATING HAND NUMBNESS
Well, sorting through the treatment of hand numbness is a process, but that’s because of the variety of potential underlying causes for it which we have to review.
In this chapter, you’ll learn about the theory of how to comprehensively rehab and treat the symptoms of an ulnar nerve compression. HINT: This is the most important part for you to read.
Treatment of the ulnar nerve can be broken down into five parts:
Find the site of compression
Decrease local irritation (passively or actively)
Decrease activity creating compression (until under control)
Increase nerve’s ability to slide through
Improve postural control, breathing patterns, movement patterns, etc.
This will be worth your time. It’s only a 5 minute section before we go into the stretch and passive care you came to see.
1. Find the site of compression
Think of a nerve as a garden hose. Any kink in the hose will affect the water flow, regardless of its location. When considering ulnar nerve compression, it works much like the garden hose, but there are a few sites on the nerve that have high probability of becoming entrapped:
At the spine (the nerve root)
At the brachial plexus (the neck region)
At the brachial sleeve (the arm)
At the cubital tunnel (the elbow)
Within the forearm muscles
At the Tunnel of Guyon (the wrist)
There are also a few other underlying problems that can trigger “symptoms of an ulnar nerve compression.” Be warned, most of these are probably going to scare you; so seeing a doctor to confirm your specific cause is good prevention of unnecessary panic attacks.
I once had a patient experiencing numbness/pain in the ring and pinky fingers at night. In his case, the cause was a tumor in his spine.
Another young man came in and presented with bilateral (both sides) numbness and pain in his hands/fingers. This is one of the major signs (bilateral symptoms) of spinal cord compression.
The individuals involved in these cases both asked, “Hey, can you just treat it?” Of course, my answer was no. Cases like both of these must be referred out for further evaluation, treatment and care.
It’s sad and scary to hear horror stories like these, but the great news is if they are found early, then they can be corrected to some degree. Ignorance is only bliss for a period of time.
Moral of this story: you should know, with certainty, what is creating your symptoms. If you don’t, the muscles of the hand can end up wasting away, or even worse.
After we’ve screened out all the red flags, I often have my patients start to examine what changes their symptoms. To do this, I’ll have them keep all variables constant and only move ONE body region to a new position and hold it.
From center, does a tilt of the head to the opposite side increase or decrease symptoms?
From center, does dropping the chin to the chest change it?
How about a shoulder shrug?
Do you see what’s going on here? We are localizing the area that has the greatest effect on the hand numbness. Everyone is different, and sometimes it’s not a position change, but rather a “stiffening” of a region. We will get more into stabilization in the eBook.
2. Decrease local irritation
Decreasing irritation of the region of nerve compression can be helpful in decreasing “flare-ups.”
In most cases, people are pretty aware of what activities or motions will trigger their symptoms. I’m never one to encourage a mindset of “avoidance,” but in this case, while we attempt to fully address the reason for the nerve compression, holding off on those activities or motions might be a good idea.
If you’re thinking something along the lines of, “It happens when I drive. How can I not drive?” or some other activity that seems unlikely for you to stop entirely, then a little more effort is going to be necessary from you!
#CubitalTunnelSyndrome #california
Dommage il n y a pas de traduction francaise ........
thanks for sharing
For me it started with arm and fingers numbing, pain and needles. After changing some bad habits (sleeping with bent arms) it’s getting better, I didn’t have more numbness but I have heavy stiff wrists especially when sitting or laying down. I’m afraid to get back to the gym. Been resting for more than a month now.
Hey Monica, sorry to hear about that. The good news is a lot of people do get better with the right treatment. If you’d like us to prescribe some treatment for you just reach out as we see people virtually and in person for this with high success.
I have a ?.I am a complex case for sure.I had a cortisone shot 13 years ago in my wrist for carpal tunnel, emg confirmed it.Anyway the guy gave me a shot and almost immediately my pinky,ring finger and that whole side of my hand went numb.I talked to my primary about what happened and he said the nerve was clipped by the needle.The guy that gave me the shot said, oh the numbness should go away.He knew he screwed up but wasn't going to admit it!.Anyway fast forward 13 years later and my numbness has gotten real bad as it had gradually gotten worse since the shot!.Before i got the shot i never once had numbness in my ring and pinky finger or anywhere in that area.I get numbness behind my
Elbow aways and down my forearm.All these years the
Numbness was contained to my wrist area, but over last year it has been going down my forearm.I had i believe 3 emgs in the last 2 years to test for cubital tunnel and they all were negative?.I know i have it, i even have atrophy in the pad of my hand by my pinky!.My ? Is it possible for an emg to miss cubital tunnel because the damage to the nerve was caused by a needle?In other words, the damage didn't come from within the body, it came from the outside in.Please comment and let me know what you think,thanks!.
Gosh I’m sorry to hear about your situation. If you’d like to talk about it and see if we can help you call our office. 714-502-4243.
I have had cubital tunnel syndrome for 6 years or so - and I have now been told by two surgeons that about 20% of cases are missed by EMG, while carpal tunnel EMG is much more reliable(99% ish). There is a medical article about certain patients with normal EMG but ultrasound confirmed nerve swelling around the cubital tunnel. I hope you can find relief.
Good luck!
I have had trouble with this fir years.
Sorry to hear that!