For patients suffering from cubital tunnel syndrome, performing some simple everyday tasks might prove impossible. Fortunately, physicians can offer both conservative and surgical hand treatment options on an outpatient basis to achieve relief.
Overview of This Disorder
The American Society for Surgery of the Hand describes this problem as one caused by pressure on or stretching of the ulnar nerve. Another name for it is ulnar nerve entrapment. People commonly refer to this nerve as the funny bone nerve. It runs down the arm, on the inner side of the elbow, and provides feeling to half the ring finger plus the little finger.
When the nerve undergoes compression behind the inside portion of an elbow, this syndrome can occur. The most common causes of compression are keeping an elbow bent for extended periods, patient anatomy, leaning on the joint for long periods, fluid buildup within the elbow, or trauma to it.
The American Academy of Orthopaedic Surgeons cites these risk factors linked to a predisposition:
- Previous elbow dislocation or fracture
- Elbow arthritis or bone spurs
- Swelling in the joint
- Cysts near the elbow joint
- Activities that cause an elbow to remain flexed or bent repetitively or for long periods
Symptoms vary greatly in severity among patients, but most occur in the hand. The most common include:
- Numbness or tingling affecting the little finger and the ring finger
- A sensation of “falling asleep” in these digits, particularly when the elbow is bent
- Difficulty coordinating fingers for activities like typing
- A weakened grip
- Hand muscle wasting or clawing when compression is severe
Hand Treatment Options
Florida Hand Center patients undergo a comprehensive physical exam that includes a discussion of symptoms and a health history. Tingling or numbness in the little finger raises suspicion of this disorder. The physician often tests the function of the ulnar nerve.
For patients diagnosed with mild or intermittent ulnar nerve entrapment, the first step toward relief is usually conservative treatment. It seeks to modify physical activity and avoid exerting pressure on the nerve. Patients need to become aware of when to keep their arms straight, often when sleeping or driving with the window down, and how to position their arms when using computers. Other nonsurgical options include non-steroidal anti-inflammatory drugs, splinting or bracing, and special exercises.
When these methods fail to cause improvement, the physician might recommend outpatient surgery. Several types of surgery are available. The procedure of choice for many Florida Hand Center patients is a minimally invasive technique known as endoscopic ulnar nerve decompression.
The surgeon utilizes an endoscope inserted through a small incision as a guide while freeing the ulnar nerve from any adhesions. Use of general anesthesia is typically unnecessary. The recovery period depends on the severity of compression but is brief when compared to that for other procedures.