Nerve Entrapment at Elbow: CUBITAL TUNNEL SYNDROME

Let's get to know the ulnar nerve
Causes of ulnar nerve compression in the elbow?
What can i do?
Inspection and tests
Treatment

Most people know that electric shock-like feeling when you hit your elbow. The nerves are networked like the city's electrical wiring system. As these electrical cables come out of the spine and go towards our muscles, they are closer to the skin where they bend around the joints. Due to this proximity, when there is sudden contact with the nerve, we suddenly feel a sense of distortion, numbness extending to the ring and little fingers of our hand. The ulnar nerve is separated from the main nerve network from the cervical spine under the armpit and runs along the inner side of our arm and forearm to the 4th and 5th fingers by wrapping around the back of the protruding bone on the inside of the elbow. If you think of the nerves as a cable, the nerve wires on the outer wall of this cable are the sensation nerves related to hearing and feeling. The nerve wires that run through the middle of the cable are the motor cables that send orders from our brain to the muscles that move our hands. When a nerve is compressed, sensory nerves outside the cable are affected first, and when the compression continues, the motor cables in the middle of the cable begin to be affected. In other words, tingling, numbness and sometimes burning is felt in the ring and little fingers, then the hand feels weak and weak, and finally the hand, especially the muscles between the comb bones, melts and the bones begin to be seen clearly. This melting is irreversible, so it is important to see a doctor if there is numbness in the ring and little fingers for more than 6 weeks.

 Causes of ulnar nerve compression:
This nerve stretches about 2 cm when we bend and unbend our elbow. This stress is minimal when the elbow is at a 45 degree angle. As we continue to bend our elbow, the stretch increases gradually, especially above 90 degrees, the stretch increases significantly. People who work with bent elbow for a long time begin to feel numbness and then weakness since there is a constant tension in this nerve. Those who use the keyboard for long hours, women who knit at home, and those who use their phones in fixed positions for long periods are in the risk group. People who sleep with bent elbows at night may experience this syndrome.
 
When you notice this situation, you should take the following measures:
If you feel numbness in the ring and little fingers of your hand, take the following measures immediately:
• Do not keep your elbow bent for long periods while using the phone and keyboard.
• Do not sit for long periods of time with your elbow resting on a hard surface
• Do not travel with your elbow on the open window side while in the car
• keep your elbow open rather than bent while sleeping at night; A practical method for this is: wrap a thick towel around the elbow like a wrap and tape it, it will prevent the elbow from becoming bent after sleeping.

If complaints do not disappear despite these measures, consult a doctor.

Inspection and tests
After your doctor understands cubital tunnel syndrome easily, he / she wants to understand the motor strength state of your hand and whether a muscle melting has started. He does some strength tests for this. If there is a problem with force, he / she requests the following tests:
X-rays: X-rays do not show the nerve, but we see some bone protrusions, joint arthrosis that can put pressure on the nerve.
With EMG: nerve conduction tests, we learn the nerve tissue damage and the severity of the work, and we understand the need for surgery. Nerves are like electrical wires, carrying messages between the brain and muscles. When the nerve fails to function properly, these messages begin to be transmitted late instead. We test the points where the affected nerve passes and measure the message transmission rates. With this test, we can understand whether the nerve is affected enough to cause muscle wasting.

Treatment
In addition to the measures taken in the daily life described above, if it is not sufficient to wrap a towel, night splints that keep the elbow in a certain position are used. Some exercises for the elbow and wrist can also work. At first, we give short-term ibuprofen tablets, sometimes steroid injections are made around the nerve.
Surgery: If muscle wasting has started or if the complaints do not disappear despite all the precautions and modifications taken, the problem is solved with surgery. There are different surgical techniques. When we change the way the nerve passes behind the elbow and transfer the nerve to the front of the elbow, a very rapid relief is achieved and the danger of muscle wasting is eliminated. It is possible to be discharged from the hospital on the same day. There is no restriction after surgery.