Cubital channel syndrome

Let's remember what happens if you hit hard on an object or surface with your elbow. I believe that I do not even want to remember that, not to experience it again. A piercing pain that spreads all over the forearm and gives to the tips of the smallest finger of the little finger's hand, for some time immerses us in painful suffering and takes away the ability to move the fingers and the hand as a whole. But after everything returns to normal. This occurs with a short-term exposure to the elbow, but if the situation is often repeated or the squeezing occurs on an ongoing basis and is accompanied by painful symptoms, it can be said that a person develops a syndrome of the cubital canal.

A little anatomy

Even from the school course of biology, we know that, apart from the liquid, our body consists of bones, skin, muscles, nerves and other "building" material. It is clear that the upper limbs, ie hands, are no exception.

Partial innervation of the forearm and hand provides the ulnar nerve passing from the brachial plexus to the very tips of fingers 4 and 5. On its way it passes along the humerus, bends around the inner epicondyle of the same bone, passing behind it, enters the cubital canal, and from it already in the forearm, slipping between the head of the ulnar flexor of the wrist.

Along the way, the central nerve branches, providing innervation (nerves and connection to the CNS) of the muscles of the hand responsible for flexing the hand and fingers, as well as answering for the sensitivity of the wrist, palmar and back of the hand, partially 4 and totally 5 fingers of the hand.

It turns out that the nerve, passing along the elbow joint, is responsible both for the motor function of the hand, and for its sensitivity. At the same time, in the cubital channel the arrangement of the motor and sensitive bundles is such that the latter are located closer to the surface, and therefore, when the mechanical influence on the nearby tissues and the nerve itself, sensitivity is first of all broken, and then the motor function is lost.

Epidemiology

Studies have shown that the appearance of the symptoms of this pathology is peculiar to people whose professional activity is associated with active work by hands. We are talking about athletes, drivers, loaders, typists, telephonists, agricultural workers, etc.

Calling the development of the cubital syndrome can also be repeated household work, requiring frequent flexion-extension of the hands, in particular, lifting weights.

The exhausted women of a lean physique are more prone to the development of pathology.

[1], [2],

Causes of the syndrome of the cube channel

It is very difficult to determine exactly the causes of the development of the syndrome of the cubital canal. You can determine only the risk factors for this pathology. First of all, this is an elbow injury. And one-time injuries are unlikely to lead to such consequences. These are often recurring injuries, not single cases.

What happens with injuries of the elbow and why does the ulnar nerve suffer? During the impact, blood vessels burst, in places where the integrity of the vessel walls is disturbed, microscopic hemorrhages appear, which in turn lead to the formation of adhesions that impede the normal movement of the nerve, disturbing its microcirculation and performing its functions. The location of the nerve near the surface only increases the likelihood of an unpleasant event.

Often the drivers suffer from the syndrome. This is due to the habit of placing a hand bent in the elbow on the open door of the car, which causes the nerve to be compressed for a long time.

But squeezing the ulnar nerve does not necessarily have to come only when exposed externally. When the arm is unbent, the dimensions of the cubital canal in a healthy person are considered sufficient for the normal functioning of the nerve. When bending the arm at the elbow, the lumen decreases significantly, leading to a squeezing of the nerve. The situation is further aggravated if at that moment a heavy object was in hand, for example, when lifting a bar or performing professional activities (loading of raw materials or products).

Some kinds of professional activity (work of typists, telephone operators, etc.), as well as sports activities (performing gymnastic exercises, throwing javelins, pressurizing heavy sports equipment in weightlifting, etc.) can cause the development of symptoms of the syndrome of the cubital canal . The pathological process in this case is the result of a strong tension of the ulnar nerve with subsequent hemorrhages and partial violations of the integrity of the fibers.

The syndrome of the cubital canal can develop due to cystic nerve formation (thickening in the form of a nerve cell called ganglia), pathological ossification of soft tissues along the nerve pathway (ossification), the formation of free bodies in the joint as a result of necrosis of the cartilaginous or bone tissue. Symptomatic syndrome can cause and perekchelkivanie medial head of the triceps through the internal epicondyle with a parallel effect on the ulnar nerve. And, of course, the congenital anomalies of the arm structure will not be left out of the problem.

It is clear that the development of the cubital syndrome can occur against the backdrop of certain diseases that contribute to the structure and functioning of cartilage, bones and joints. Such pathologies include diabetes mellitus, gout, arthritis, rheumatism, etc.

The cause of impaired sensitivity and motor activity of the arm may be large neoplasms both on the nerve itself (neuroma of the nerve or neurinoma) and near it (eg, hemangioma or lipoma). Strangely enough, but the symptoms of the syndrome can cause even hormonal failures, for example, during pregnancy.

[3], [4]

Pathogenesis

Squeezing of the ulnar nerve in the elbow region for various reasons can occur in several places. The physical sensations and consequences of such compression will depend on the strength and duration of the effect. But in general, the picture is as follows: compression (compression) causes an inflammatory reaction in the ulnar nerve, as a result of which it swells and becomes thicker, causing a violation of its own blood supply followed by degeneration. In this case, the sensitive side first suffers, and then the impaired motor functions begin.

If the nerve compression occurs on a regular or permanent basis, the symptoms also differ relative constancy, and the doctor with a high degree of probability can diagnose the development of the syndrome of the cubital canal.

[5], [6]

Symptoms of the syndrome of the cube channel

As a disease, neither name, but its causes and manifestations will remain the same. So in the case of the syndrome of the cubital canal, which has many equivalent names. The cumulative tunnel syndrome, or late ulnar-cubital traumatic paralysis, or, for example, compression-ischemic neuropathy of the dorsal branch of the ulnar nerve - all this is one and the same pathology requiring special attention.

Well, of course, it all begins with the banal numbness of the limb. Periodically recurring episodes of loss of sensitivity of the little finger and ring finger from the elbow are the first signs of the onset of the cubital syndrome. They can appear in the form of numbness, tingling, or "goose bumps", "activity" which is strengthened by flexing the arm at the elbow. All these symptoms often increase at night, when a person does not control their movements. This leads to sleep disorders, such as difficulties with falling asleep, frequent awakenings, insomnia.

If such manifestations are left unheeded and the treatment of pathology is not started in time, a complete loss of sensitivity of the fingers, palms and hands ("asleep hands") may occur.

Following a sensitivity disorder, motor impairments also occur, which ultimately lead to a decrease in muscle activity (paralysis). And it all starts seemingly innocuous: with awkward movements and some awkwardness. A person can not hold a mobile phone in his bent hand, experiences certain difficulties in using a pen, a screwdriver, an ordinary or can opener, and so on.

At the early stage of the development of the pathological process, all of the above symptoms are not permanent and usually occur when the arm is bent. In later stages, the weakness of the hands is observed on an ongoing basis, accompanied by an unnatural position of 4 and 5 fingers. They can relax in a relaxed state in a half-bent state, resembling a claw of an animal. And in some cases, the half-bent little finger is set aside and, as it were, "freezes" in this position.

With the syndrome of the cubital canal, a person experiences severe difficulties during flexing of the hand, as well as of the ring finger and little finger, and the mixing-dilution of these fingers becomes simply impossible. In the area of the elbow and hand, strong painful sensations are observed, especially if the elbow has been in a bent state for a long time (for example, after awakening those who like to sleep with a folded arm under the pillow).

Complications and consequences

If you do not start treating the disease in time, you may develop unpleasant complications, such as partial paralysis of the hand with disability. At the last stage of the disease, atrophy of the muscles of the hand occurs with the interstitial spaces occluded. Treatment of the syndrome of the cubital canal in later stages, 3-4 months after the appearance of the first signs is not always sufficiently effective, which leads to disastrous consequences: the need to change the type of work activity or the onset of disability (group 3).

[7], [8], [9]

Diagnostics of the syndrome of the cube channel

Difficulties in diagnosing the syndrome of the cubital canal consist in the fact that its symptoms coincide with the manifestations of other diseases. This is especially true for numbness of the fingers, which is observed with cervical osteochondrosis, head, neck and upper limb injuries, migraines, certain diseases of the cardiovascular system, for example, with angina pectoris, pregnancy and some other pathologies.

Symptoms of the cubital syndrome can be felt by squeezing the ulnar nerve in the area of the wrist or hand (Guyon canal syndrome). If pain is attached to them in the shoulder, it is possible to diagnose the chest exit syndrome (compression of the neuromuscular bundle of the hand). If, against the background of symptoms of the syndrome of the cubital canal, there is difficulty in movement and pain in the neck region, this may indicate the development of radiculopathy of the root of the C8.

[10], [11]

Differential diagnosis

The doctor's task in differential diagnosis is to distinguish one pathology from another, or to identify their joint "living" in the body, comparing the existing symptoms. So, for example, with osteochondrosis, loss of sensitivity of the thumb and index finger is observed and discomfort is felt while moving the head, while with the development of the syndrome of the cubital canal, we note the numbness of 4 and 5 fingers, as well as pain and difficulty in moving the hand.

Sometimes it is enough for the doctor only to listen to the patient's complaints and carefully inspect his hand around the perimeter to make a final diagnosis. At the same time pay attention to the sensitivity of the fingers of the hand, as well as whether there are unpleasant or painful sensations after examination.

Special tests are carried out, such as the "Timmel symptom", which is observed at the middle stages of the disease, when regeneration of nerve fibers is possible. For his conduct, the doctor slightly strikes the area of the "sick" elbow, so that the pain and "goose bumps" in the area of the elbow and hand should significantly increase.

Another specific test that makes it possible to diagnose, with great accuracy, the syndrome of the cubital canal is called the Wadsworth symptom. Its carrying out is that the researched person should hold his hand for 2 minutes in the most bent position. As a result, the numbness of the arm should be strengthened, the innervation of which is the elbow nerve.

Test number 3. Analogue of the symptom of Phalen. The patient sharply bends the arm at the elbow, resulting in numbness of the 4 and 5 fingers.

If a doctor has any doubts or if there are some symptoms of other diseases, additional research methods may be needed. Here, instrumental diagnostics is included in the case, and an x-ray examination comes to the fore, which allows to identify fractures, displacements, hereditary deviations in the structure of the elbow joint, ossification and free bodies, inflammatory processes. Sometimes a computer tomography is assigned with the same purpose, giving a more complete picture.

It would be superfluous to make ultrasound, the results of which will show whether the neoplasm caused a tumor-like tumor on the nerve fibers or near the passage of the nerve. And also whether there is a thickening of the ulnar nerve in some part of it or other changes in the nervous tissue, whether the walls of the cubital canal itself are deformed. Among other things, ultrasound will help to determine the level at which pathological changes of the nerve are observed.

Determination of the level of compression of the ulnar nerve can be carried out using electroneuromyography (ENMG), and information on the state of soft tissues (muscles, ligaments and cartilages) is obtained from the results of MRI. If a patient is suspected of having heart disease, the patient may be referred to an ECG.

Additional tests, such as a general blood and urine test, may be necessary for the doctor in connection with the prescribed treatment to avoid the undesirable effects of taking certain drugs.

[12], [13],

Treatment of the syndrome of the cube channel

Therapy of the cubital syndrome is carried out based on the degree of development of the pathology and the severity of its symptoms. It should be borne in mind that even at an early stage of the syndrome development, only medications, no matter how effective, can not bring the desired relief if their reception is not accompanied by observance of certain rules of conduct in the home and at work.

First, it is necessary to limit the raising of massive heavy objects with a sick hand, and also to restrict sports activities, which resulted in the development of symptoms of the syndrome of the cubital canal.

Secondly, to resolve the issue with the performance of professional duties that caused the disability, if after the expiration of the sick leave (about 1 month) mobility of the limb could not be restored. If possible, it is better to take care of changing activities inside or outside the enterprise.

Thirdly, to control hand movements in everyday life, trying to avoid bending the elbow, the more prolonged, while sleeping, talking on the phone (use headphones or - a Bluetooth headset), working behind a desk or a computer. Brush also better once again do not strain, bending and unbending it in the wrist. If it is difficult to control the movement of the hand in a dream, you can apply a special tire on it, which does not allow the arm to bend. Drivers better get rid of the "addiction" habit to put your elbow on the door of the car.

Effective treatment without surgery

Wisdom "strike the iron while hot" is especially relevant in the case of the syndrome of the cubital canal. If you want to avoid surgery on the elbow, you do not need to delay the trip to the doctor. Occurrence of periodically repeating discomfort in a hand during movement it should already guard, in fact this symptom in itself specifies necessity of medical consultation.

Since loss of sensitivity, swelling and pain indicate the development of an inflammatory process affecting the nervous tissue, first aid drugs are anti-inflammatory drugs. Preference is given to non-steroidal preparations in the form of tablets and ointments or gels (Nimesulide, Meloksikam, Voltaren, Ibuprofen, Orthofen, Diclac, Diclofenac, etc.).

"Nimesulide" is a non-steroid drug with a pronounced analgesic and anti-inflammatory effect. In principle, more for this pathology at an early stage of its development and not necessary.

The daily dose of the drug is 100-200 mg (1-2 tablets). It should be divided into 2 receptions. Take the drug is recommended after a meal. For patients with impaired renal function, the dosage should be minimal.

The medicine has quite a lot of side effects. Headaches, anxiety, nightmares, hyperhidrosis, various skin eruptions accompanied by itching, abnormalities in liver and kidney function, pain and bleeding in the digestive tract, development of gastritis, shortness of breath, falling blood pressure, increased heart rate and heart rate - these are incomplete list of undesirable manifestations. But this does not mean that all these unpleasant effects will be present when taking this medication, especially if its dosage is selected by a specialist taking into account an anamnesis of the patient.

Take the same "Nimesil" in powder, which is analogous to "Nimesulide." This popular anti-inflammatory drug is prescribed even by dentists, and few people complained about unpleasant side effects. The main thing is to take these funds for a short time and with minimal but effective doses.

Drugs are not prescribed:

• with ulcers and erosions in the digestive tract,
• bronchial asthma,
• various kinds of bleeding,
• with a violation of blood clotting,
• with diseases of the intestine,
• with severe pathologies of the liver and kidneys,
• heart failure in the stage of decompensation,
• increased concentration of potassium in the blood,
• pregnancy and breastfeeding,
• in children under 12 years of age,
• hypersensitivity to nimesulide preparations.

If the patient is not suitable drugs for oral administration, you can resort to external means in the form of gels.

"Diklak-gel" is a nonsteroidal greasy remedy with the same anti-inflammatory and analgesic effects, no less effective in treating the symptoms of the syndrome of the cubital canal. The active substance is diclofenac sodium.

The gel is intended for external use, and therefore does not have a negative effect on the digestive tract. For one application, no more than 2 g of the drug is used, which is applied to the area where inflammation and pain are observed, and lightly rubbed into the skin. This should be done 2 to 3 times a day.

When using the gel, such side effects can occur: increased sensitivity to sunlight with the appearance of allergic reactions, local reactions in the form of rashes, redness, swelling and itching.

Contraindicated drug:

• with increased sensitivity to this gel, acetylsalicylic acid or other NSAIDs, "aspirin" asthma,
• in the last 3 months of pregnancy (3rd trimester),
• at thoracal feeding,
• in children younger than 6 years.

If skin is in the area of application, there are wounds, lesions and foci of inflammation about the possibility of using Diclac gel or replacing the drug with another, talk with your doctor.

In addition, caution in the treatment of the drug should be observed in diseases of the liver and kidneys, ulcerative lesions of the gastrointestinal tract, heart failure, bronchial asthma, in old age and, of course, at any period of pregnancy.

With insufficient effectiveness of NSAIDs, doctors can resort to the help of corticosteroids. A good therapeutic effect is injected with "Hydrocortisone" in combination with an anesthetic.

To remove a strong pain syndrome when squeezing the nerve in the elbow area, you can use a plaster with a lepidocaine "Versatis" or a solution for external use called "Menovazin."

"Menovazin" is a budget variant of the local analgesic, which is quite effective in the syndrome of the cubital canal. The drug has a small number of contraindications and side effects, which expands the scope of its use.

"Menovazin" is released as a solution, which is applied directly to the skin in the affected area. Multiplicity of application - 2-3 times a day. The therapeutic course should not exceed 4 weeks, it is better if necessary to repeat it after a while.

The use of the solution may be accompanied by allergic reactions. Other side effects, such as dizziness and falling BP, are observed only with prolonged use of the drug.

The drug is not applied to damaged areas of the skin or if inflammation is visible on the skin. It is contraindicated during pregnancy, as well as breastfeeding due to insufficient knowledge of its effect on the child's body. For the same reason, "Menovazine" is not used to treat pain in patients under 18 years of age.

Diuretics such as "Cyclo-3 Fort" or "Lasix" will help to remove swelling in the syndrome of the cubital canal, and neuromidine can be used to improve nerve conduction.

"Neuromidin" is an expensive but effective drug for disorders of nerve conduction due to compression of the nerve, which we observe in the syndrome of the cubital canal. The preparation is produced in the form of tablets and solution for injections, intended for the therapy of patients over 18 years of age.

The form, method of application and dosage of the drug are determined by the physician individually in each specific case.

Tablets are taken in a dosage of 10 or 20 mg from 1 to 3 times a day for 1-2 months. In severe cases, Neuromedin may be given as a single injection (1-2 ml of a 1.5% solution), after which the treatment is continued with pills, but the single dose is already doubled with a multiplicity of 5 times a day.

Taking the drug may be accompanied by hyperhidrosis, increased salivation, nausea, pain in the stomach, cough with sputum, bronchospasm, lower pulse rate, headaches and allergic reactions.

The drug is contraindicated in such cases, if the patient is in parallel diagnosed with epilepsy, angina and bradycardia, bronchial asthma, ulcerative lesions of the gastrointestinal tract. And also if there are vestibular disorders, during pregnancy and lactation, with increased sensitivity to the components of the drug.

The drug contains lactose, so patients with intolerance to this component and lactase deficiency should be careful.

Irreplaceable in the treatment of the syndrome of the cubital canal are considered the vitamins of group B, the necessary dose of which is contained in the preparations "Neurovitan", "Milgamma", "Neurorubin", etc.

"Milgamma" is a vitamin preparation containing optimal doses of vitamins B1, B6, B12 plus ice-caffeine, so necessary for improving trophism of tissues and anesthesia.

"Milgamma" in the form of injections provides for a deep introduction of the drug into the muscle tissue. In severe pain syndrome, the drug is administered once a day (effective course from 5 to 10 days) in a dosage of 2 ml. When the pain subsides, the injection frequency drops to 2-3 per week by a therapeutic course of at least 2 and not more than 3 weeks. As an option, you can go to the tablet form of release.

Side effects when taking the drug are quite rare. These are headaches and dizziness, vomiting, convulsions, irritation at the injection site.

There are very few contraindications to the drug. This heart failure in the acute stage, pregnancy and lactation periods, as well as hypersensitivity to the components of the drug. The drug is not intended for use in pediatrics.

As with any abnormalities related to impaired peripheral nerve activity, drug therapy is performed in conjunction with physiotherapy. A set of measures to normalize the work of the nervous system and improve nerve conduction include:

• exposure to ultrasonic waves,
• electrophoresis with drugs,
• electrostimulation of muscular activity.

With the syndrome of the cubital canal, you can not do without massage (according to the scheme: the fingers - the outer side of the hand - the inner side of the forearm, then the heat and rest for half an hour), acupuncture, and a complex of exercise therapy to restore lost muscle strength. Water procedures that relieve pain syndrome (immerse your hands in warm water, squeeze your fingers into a fist and make rotational movements for at least 10 minutes, then wipe it dry and wrap it warmly) will also be useful.

Alternative treatment of the cumulative syndrome

Before describing alternative recipes that patients suffering from symptoms of the syndrome of the cubital canal can use at home, it should be mentioned that even the most effective alternative means will not help to correct the situation if their reception is not combined with medical and physiotherapy, and also compliance with the rules of handling a sick hand. Alternative medications will help to remove inflammation, swelling, pain, but they can not eradicate the cause of the pathological condition.

The basis of alternative treatment are compresses and rubbing.

To remove swelling in the people at all times used fresh leaves of cabbage, horseradish, burdock, which must be reattached to a sore spot.

If there is no possibility to use the previous recipe, for the same purpose make a steep "dough" of vinegar and red clay. From the "test" make a flat cake, which is also attached to the elbow at night for 3 days.

If there is a bear's fat in the home reserves, then it is possible to remove inflammation and pain in the syndrome of the cubital canal, using it as rubbing. The course of treatment is 1 month.

To facilitate the condition of patients with this pathology, inexpensive mineral syrup "Bishofit", which is used every other day in the form of rubbing, compresses, baths (10-12 procedures) will help.

Among the compresses for relief of pain, alcoholic and honey compounds are good. The same effect is also provided by the flour with mustard.

Treatment with herbs with anti-inflammatory effect is also used in the case of a cubital syndrome. Most often use infusions and decoctions of herbs (chamomile, St. John's wort, oregano, kiprei, raspberry), which drink instead of tea.

[14], [15]

Homeopathy in Hand Tunnel Syndrome

In homeopathy there is no special medicine for the syndrome of the cubital canal. But there are many effective tools to help remove the unpleasant symptoms of tunnel syndromes of the upper limbs, such as pain, loss of sensitivity, discomfort in the hands.

For the removal of nerve pain in a cumulative syndrome, homeopaths recommend the following drugs:

Belladonna (belladonna) in 3 and 6 dilutions (effective for inflammation or pinching of the nerve). Relieves inflammation and pain.

Bryonia alba in 3, 6, 12 dilutions (a strong remedy for pain that is aggravated by various movements, in this case with flexion-extension of the arm at the elbow or wrist).

With neuralgic pain, Capisicum annuum (capsicum) helps in 3 and 6 dilutions. He is shown to people with excess weight.

The homeopathic composition of Chamomilla (chamomile, hen and uterine grass) helps relieve pain in patients too sensitive to it, who can not tolerate painful attacks easily. It is used in 3, 6 and 12 dilutions.

Improve the sensitivity of the syndrome of the cubital canal will help such homeopathic medicines:

• Rus toxicodendron in 6 dilutions (5 granules 2 times a day)
• Lachezis in 12 dilutions (3 pellets in the evening).

Despite the fact that homeopathic remedies have practically no contraindications and undesirable side effects, they should be applied strictly according to the doctor's prescription. This is due both to their sometimes unusual composition and the need to take into account the various physiological and psychological characteristics of the patient when prescribing an effective remedy.

When is the operation necessary?

If all possible methods of treatment are tried, but did not bring the expected result, surgical treatment is practiced. Indication for surgical intervention is considered and later recourse for help, when numbness is present on a permanent basis and there is a noticeable weakness of the muscles.

The aim of the surgical operation in the syndrome of the cubital canal is to create conditions for the ulnar nerve that preclude its squeezing. This can be done in several ways:

• Decompression (simple decompression) is a surgical method of increasing space in the cubital canal and near it in order to release the nerve from the musculoskeletal "trap". Such an effect is achieved by dissecting the arch of the tendon or removing the canal walls, which for some reason cause its narrowing.
• Transposition of the nerve anteriorly. In other words, the nerve is displaced forward relative to the medial epicondyle. There are 2 types of transposition: the anterior subcutaneous (the nerve is placed between the subcutaneous fat layer and the muscles) and the anterior axillary (nerve anchoring in the depth under the muscle).
• Medial epicondylectomy is the removal of a part of the epicondyle to increase the space of the cubital canal.
• Nerve decompression according to the endoscopic method (an innovative method, the advantages of which are a small incision on the body, rapid symptom recovery and recovery, almost complete restoration of elbow mobility in more than 90% of patients).

Different methods differ in complexity, efficiency, and indications. The first method is used if the nerve compression is not strong. He has a big drawback - a significant probability of rapid relapse. Although much, of course, depends on the degree of neglect of pathology.

All operations are simple, but they assume a violation of the integrity of the skin and are conducted under anesthesia. Anesthesia can be both local and general.

After the operation, patients must strictly adhere to the doctor's recommendations during the rehabilitation period to prevent relapse of the disease. The rehabilitation period can differ significantly in time. For example, the endoscopic method involves the removal of symptoms within the first 24 hours after surgery and a short period of complete recovery.

After decompression for about 10 days, it is mandatory to wear a soft bandage that restricts the movement of the arm at the elbow, and perform exercises of exercise therapy under the supervision of a doctor. After this operation, it is even allowed to visit the pool as a rehabilitation procedure.

Transposition involves gentle immobilization for a period of 10 to 25 days, depending on the type of transposition and the patient's condition. To this end, a special gypsum tire is being put on the patient's arm. After the gypsum is removed, a series of test sessions are conducted, in which isometric (muscle tone is increased without joint mobility), passive (movements in the elbow joint with relaxed muscles), active (with muscle tension without load and with load) are examined.

With epicondylectomy it is recommended to immobilize the elbow joint for a period of no more than 3 days.

Again, you may need to take anti-inflammatory and analgesic drugs, physical therapy, medical massage.

Prevention

Prevention of the cubital syndrome is to prevent situations that cause this pathology. First of all, we should try to avoid injuries to the elbow and extremities in general. It is equally important during work to create comfortable conditions for the hands. For example, when working at a writing desk or a computer desk, one should try not to bend the elbow very much (the angle in the bend should be about 90 ^° ). Hands should be firmly resting on the table, and not hanging from it in the area of the elbow fold. By the way, it is better to choose a chair with armrests.

For drivers and passengers of the car, it is advisable not to put a hand bent at the elbow on the door glass. And anyway, do not place it on the glass.

Do not forget about nutrition. A full-fledged diet, replenishing the deficiency of vitamins and trace elements in the body, is a good prevention of the development of tunnel syndromes, a bright and equally unwanted representative of which is the syndrome of the cubital canal.

[16], [17], [18], [19]

Forecast

The period from the initiation of therapy to complete recovery is quite long. Most often it takes 3, or even 6 months. Even if the symptoms of the illness have subsided, the patient continues to take prescribed medications until they are canceled by the doctor. Independently to decide on the cancellation of certain drugs due to the fact that "I have nothing to hurt and I am completely healthy" means to expose myself to the risk of developing relapses, which are often much more difficult to treat than "fresh" pathologies.

The prognosis of the disease is directly dependent on the time of seeking help. In the syndrome of the cubital canal, a favorable prognosis is observed only at an early stage of the disease, when the symptoms do not differ by an enviable repetition rate. With the form of pathology started to rely on the full restoration of the functions of the hand, alas, it is not necessary. Most often, partial restoration of functions is observed, allowing to perform the usual actions, and in some cases a person is even given a disability with disability.

In one way or another, in most cases it is necessary to part with your favorite sport, to change a profession or type of activity to such that the hand will not experience unnecessary loads.

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