Cubital canal syndrome

Let's remember what happens if you hit your elbow hard on a hard object or surface? I believe that you don't even want to remember it, let alone experience it again. A piercing pain that spreads throughout the entire forearm and radiates to the tips of the smallest finger of the hand - the little finger, plunges us into excruciating suffering for some time and takes away the ability to move your fingers and the hand as a whole. But then everything returns to normal. This happens with short-term impact on the elbow, but if the situation is repeated often or the compression occurs on a permanent basis and is accompanied by painful symptoms, we can say that the person is developing cubital tunnel syndrome.

A little bit of anatomy

We know from our school biology course that in addition to liquid, our body consists of bones, skin, muscles, nerves and other "building" material. It is clear that the upper limbs, i.e. arms, are no exception.

Partial innervation of the forearm and hand is provided by the ulnar nerve, which runs from the brachial plexus to the tips of the 4th and 5th fingers. On its way, it runs along the humerus, bends around the internal epicondyle of the same bone, passes behind it, enters the cubital canal, and from there into the forearm, slipping between the heads of the ulnar flexor of the wrist.

Along the way, the central nerve branches out, providing innervation (nerve supply and connection with the central nervous system) to the muscles of the hand responsible for flexion of the wrist and fingers, and also responsible for the sensitivity of the wrist, palmar and dorsal part of the hand, partially 4 and completely 5 fingers of the hand.

It turns out that the nerve running along the elbow joint is responsible for both the motor function of the hand and its sensitivity. At the same time, in the cubital canal, the location of the motor and sensory bundles is such that the latter are located closer to the surface, which means that when mechanical action is exerted on nearby tissues and the nerve itself, sensitivity is first impaired, and then the motor function is lost.

Epidemiology

Research has shown that the symptoms of this pathology are typical for people whose professional activities involve active manual work. This includes athletes, drivers, loaders, typists, telephone operators, agricultural workers, etc.

Repetitive household work that requires frequent bending and unbending of the arms, in particular lifting heavy objects, can also cause the development of cubital syndrome.

Women who are emaciated and thin are more susceptible to developing the pathology than others.

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Causes cubital canal syndrome

It can be very difficult to determine the exact causes of cubital tunnel syndrome. It is only possible to determine the risk factors for the occurrence of this pathology. First of all, these are elbow injuries. Moreover, a one-time injury is unlikely to lead to such consequences. We are talking about frequently repeated injuries, and not isolated cases.

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

Drivers often suffer from cubital syndrome. This is due to the common habit among this category of the population of placing a bent arm on the slightly open glass of a car door, as a result of which the nerve is subject to compression for a long time.

But compression of the ulnar nerve does not necessarily have to occur only under external influence. When the arm is straightened, the dimensions of the cubital canal in a healthy person are considered sufficient for the normal functioning of the nerve. When the arm is bent at the elbow, the clearance is significantly reduced, leading to compression of the nerve. The situation is further aggravated if at that moment there was a heavy object in the hands, for example, when lifting a barbell or performing professional activities (loading raw materials or products).

Some types of professional activities (typists, telephone operators, etc.), as well as sports activities (gymnastics, javelin throwing, presses and lifting heavy sports equipment in weightlifting, etc.) can cause the development of symptoms of cubital tunnel syndrome. The pathological process in this case is the result of strong tension of the ulnar nerve with subsequent hemorrhages and partial disruption of the integrity of the fibers.

Cubital tunnel syndrome can develop as a result of a cystic formation on the nerve (a thickening in the form of a knot of nerve cells called a ganglion), pathological ossification of soft tissues along the nerve (ossification), formation of free bodies in the joint as a result of necrosis of cartilage or bone tissue. Symptoms of the syndrome can also be caused by snapping of the medial head of the triceps through the internal epicondyle with a parallel effect on the ulnar nerve. And, of course, congenital anomalies of the hand structure will not remain untouched by the problem.

It is clear that the development of cubital syndrome can also occur against the background of certain diseases that contribute to the disruption of 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 hand can be large neoplasms both on the nerve itself (nerve neuroma or neurinoma) and near it (for example, hemangioma or lipoma). Oddly enough, but the symptoms of the syndrome can even be caused by hormonal disruptions, for example, during pregnancy.

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Pathogenesis

Compression of the ulnar nerve in the elbow area can occur in several places for various reasons. The physical sensations and consequences of such compression will depend on the strength and duration of the impact. But in general, the picture is as follows: compression (squeezing) causes an inflammatory reaction in the ulnar nerve, as a result of which it swells and becomes thicker, causing a disruption of its own blood supply with subsequent degeneration. In this case, the sensitive side suffers first, and then a disruption of motor functions occurs.

If the nerve compression occurs on a regular or ongoing basis, the symptoms will also be relatively constant, and the doctor may be more likely to diagnose cubital tunnel syndrome.

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Symptoms cubital canal syndrome

Whatever the name of the disease, its causes and manifestations will remain the same. The same is true for cubital tunnel syndrome, which has many equivalent names. Cubital 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 the same pathology that requires special attention.

Well, of course, it all starts with banal numbness of the limb. Periodically recurring episodes of loss of sensitivity of the little finger and ring finger on the elbow side are the first signs of the onset of cubital syndrome. They can manifest themselves in the form of numbness, tingling, or "goosebumps", the "activity" of which increases when bending the arm at the elbow. All these symptoms often intensify at night, when a person does not control their movements. This leads to sleep disorders, such as difficulty falling asleep, frequent awakenings, insomnia.

If such manifestations are left unattended and treatment of the pathology is not started in time, complete loss of sensitivity of the fingers, palms and hands (“sleepy hands”) may occur.

Following the sensitivity disorders, motor disorders also occur, which eventually lead to decreased muscle activity (paralysis). And it all starts seemingly harmlessly: with awkward movements and some clumsiness. A person cannot hold a mobile phone in a bent arm, experiences certain difficulties in using a pen, a screwdriver, a regular or can opener, etc.

At an early stage of the development of the pathological process, all the above symptoms are not constant and usually occur when bending the arm. At later stages, weakness of the hands is observed on a permanent basis, accompanied by an unnatural position of the 4th and 5th fingers. They can remain in a relaxed state in a semi-bent position, resembling an animal's claw. And in some cases, the semi-bent little finger is moved to the side and seems to "freeze" in this position.

With cubital tunnel syndrome, a person experiences severe difficulties when bending the wrist, as well as the ring finger and little finger, and adduction and abduction of these fingers becomes simply impossible. There are severe pain sensations in the elbow and wrist area, especially if the elbow has been bent for a long time (for example, after waking up in those who like to sleep with their bent arm under the pillow).

Complications and consequences

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

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Diagnostics cubital canal syndrome

The difficulty in diagnosing cubital tunnel syndrome is 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, some cardiovascular diseases, such as angina, pregnancy and some other pathologies.

Symptoms of cubital tunnel syndrome can be felt when the ulnar nerve is compressed in the wrist or hand area (Guyon's canal syndrome). If they are accompanied by shoulder pain, thoracic outlet syndrome (compression of the neurovascular bundle of the arm) can be diagnosed. If, against the background of symptoms of cubital tunnel syndrome, there is difficulty in movement and pain in the neck area, this may indicate the development of C8 root radiculopathy.

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Differential diagnosis

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

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

Special tests are carried out, such as the "Timmel symptom", which is observed in the middle stages of the disease, when regeneration of nerve fibers is possible. To carry it out, the doctor gently hits the area of the "sick" elbow, as a result of which the pain and "goosebumps" in the area of the elbow bend and hand should increase significantly.

Another specific test that allows for a high degree of accuracy in diagnosing cubital tunnel syndrome is called the Wadsworth sign. It involves the subject holding their arm in the most bent position for 2 minutes. This should result in increased numbness in the area of the arm innervated by the ulnar nerve.

Test #3. Analogue of Phalen's symptom. The patient sharply bends his arm at the elbow, which results in increased numbness of the 4th and 5th fingers.

If the doctor has any doubts or there are some symptoms of other diseases, additional research methods may be needed. Here, instrumental diagnostics come into play, and X-ray examination comes to the forefront, allowing to identify fractures, displacements, hereditary deviations in the structure of the elbow joint, ossification and loose bodies, inflammatory processes. Sometimes, for the same purpose, a computer tomography is prescribed, which gives a more complete picture.

It would also be useful to do an ultrasound, the results of which will show whether the cause of the nerve compression was a tumor-like neoplasm 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 nerve tissue, whether the walls of the cubital canal itself are deformed. An ultrasound examination, among other things, will help to determine the level at which pathological changes in the nerve are observed.

Determination of the level of compression of the ulnar nerve can be carried out using electroneuromyography (ENMG), and information about the condition of soft tissues (muscles, ligaments and cartilage) can be obtained from the results of MRI. If heart disease is suspected, the patient may be sent for an ECG.

Additional tests, such as a complete blood count and urine analysis, may be needed by your doctor in connection with the prescribed treatment to rule out unwanted effects from taking certain medications.

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Treatment cubital canal syndrome

Therapy for cubital syndrome is carried out based on the degree of development of the pathology and the severity of its symptoms. It should be taken into account that even at an early stage of the syndrome, medications alone, no matter how effective they are, will not be able to bring the desired relief if their use is not accompanied by compliance with certain rules of conduct at home and at work.

First, it is necessary to limit the lifting of massive heavy objects with the affected arm, as well as limit sports activities that resulted in the development of symptoms of cubital tunnel syndrome.

Secondly, resolve the issue of performing professional duties that caused the limitation of working capacity, if after the expiration of the sick leave (about 1 month) the 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, control your hand movements at home, trying to avoid bending your elbow, especially for a long time, during sleep, talking on the phone (use headphones or a Bluetooth headset), working at a desk or computer. It is also better not to strain your hand unnecessarily, bending and unbending it at the wrist. If it is difficult to control your hand movement during sleep, you can put a special splint on it that does not allow your hand to bend. Drivers should get rid of the “bad” habit of putting their elbow on the car door glass.

Effective treatment without surgery

The popular wisdom "strike while the iron is hot" is especially relevant in the case of cubital tunnel syndrome. If you want to avoid elbow surgery, you should not delay your visit to the doctor. The appearance of periodically recurring discomfort in the arm during movement should already be a warning sign, because this symptom in itself indicates the need for a doctor's consultation.

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

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

The daily dose of the drug is 100-200 mg (1-2 tablets). It should be divided into 2 doses. It is recommended to take the drug after meals. 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 rashes accompanied by itching, liver and kidney problems, pain and bleeding in the gastrointestinal tract, development of gastritis, shortness of breath, drop in blood pressure, increased heart rate and pulse rate - this is an incomplete list of undesirable manifestations. But this does not mean that all these unpleasant effects will be present when taking this drug, especially if its dosage is selected by a specialist taking into account the patient's medical history.

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

The following medications are not prescribed:

• for ulcers and erosions in the gastrointestinal tract,
• bronchial asthma,
• various types of bleeding,
• in case of blood clotting disorders,
• for intestinal diseases,
• in severe liver and kidney pathologies,
• heart failure in the decompensation stage,
• increased concentration of potassium in the blood,
• pregnancy and breastfeeding,
• in children under 12 years of age,
• hypersensitivity to nimesulide preparations.

If oral medications are not suitable for the patient, external agents in the form of gels can be used.

"Diclac-gel" is a non-steroidal ointment-like agent with the same anti-inflammatory and analgesic effects, no less effective in treating the symptoms of cubital tunnel syndrome. The active substance is sodium diclofenac.

The gel is intended for external use, which means it does not have a negative effect on the gastrointestinal tract. No more than 2 g of the drug is used per application, 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, the following side effects may be observed: increased sensitivity to sunlight with the occurrence of allergic reactions, local reactions in the form of rashes, redness, swelling and itching.

The drug is contraindicated:

• in case of hypersensitivity to this gel, acetylsalicylic acid or other NSAIDs, "aspirin" asthma,
• in the last 3 months of pregnancy (3rd trimester),
• during breastfeeding,
• in children under 6 years of age.

If there are wounds, damage or inflammation on the skin in the area of application, you should discuss the possibility of using Diclac Gel or replacing the drug with another with your doctor.

In addition, caution should be exercised when treating with the drug in cases of liver and kidney disease, ulcerative lesions of the gastrointestinal tract, heart failure, bronchial asthma, in old age and, of course, at any stage of pregnancy.

If NSAIDs are not effective enough, doctors may resort to corticosteroids. Hydrocortisone injections in combination with an anesthetic have a good therapeutic effect.

Severe pain caused by compression of a nerve in the elbow area can be relieved using a patch with lidocaine "Versatis" or a solution for external use called "Menovazin".

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

"Menovazin" is available as a solution that is applied directly to the skin in the affected area. Frequency of use - 2-3 times a day. The therapeutic course should not exceed 4 weeks, it is better to repeat it after some time if necessary.

The use of the solution may be accompanied by allergic reactions. Other side effects, such as dizziness and a drop in blood pressure, 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 also contraindicated during pregnancy and breastfeeding due to insufficient study of its effect on the child's body. For the same reason, "Menovazin" is not used to treat pain syndrome in patients under 18 years of age.

Diuretics such as Cyclo-3 Fort or Lasix will help relieve swelling associated with cubital tunnel syndrome, and Neuromidin is the best choice for improving nerve conduction.

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

The form, method of administration and dosage of the drug are determined by the doctor 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, Neuromidin may be prescribed as a single injection (1-2 ml of a 1.5% solution), after which treatment is continued with tablets, but the single dose is already doubled with a frequency of administration of 5 times a day.

Taking the drug may be accompanied by hyperhidrosis, increased salivation, nausea, stomach pain, cough with sputum, bronchospasms, decreased heart rate, headaches and allergic reactions.

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

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

Vitamins of group B are also considered indispensable in the treatment of cubital tunnel syndrome; the required dose of these is contained in the drugs Neurovitan, Milgamma, Neurorubin, etc.

"Milgamma" is a vitamin preparation containing optimal doses of vitamins B1, B6, B12 plus lidocaine, which are so necessary for improving tissue trophism and pain relief.

"Milgamma" in the form of injections involves deep administration of the drug into muscle tissue. In case of severe pain syndrome, the drug is administered once a day (an effective course is from 5 to 10 days) in a dosage of 2 ml. When the pain subsides, the frequency of injections is reduced to 2-3 per week with a therapeutic course of at least 2 and no more than 3 weeks. Alternatively, you can switch to a tablet form of release.

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

The drug has very few specific contraindications. These include acute heart failure, pregnancy and lactation periods, and hypersensitivity to the components of the drug. The drug is not intended for use in pediatrics.

As with any pathologies related to the disruption of peripheral nerves, drug therapy is carried out in combination with physiotherapy. The complex of measures to normalize the functioning of the nervous system and improve nerve conduction includes:

• exposure to ultrasonic waves,
• electrophoresis with drugs,
• electrical stimulation of muscle activity.

In case of cubital tunnel syndrome, you cannot do without massage (according to the scheme: fingers - outer side of the hand - inner side of the forearm, then warmth and rest for half an hour), acupuncture, as well as a set of exercise therapy to restore lost muscle strength. Water procedures that relieve pain will also be useful (immerse your hands in warm water, clench your fingers into a fist and make rotational movements with them for at least 10 minutes, then wipe dry and wrap up warmly).

Traditional treatment of cubital syndrome

Before describing folk recipes that patients suffering from the symptoms of cubital tunnel syndrome can use at home, it should be mentioned that even the most effective folk remedies will not help to correct the situation if their use is not combined with medication and physiotherapy, as well as compliance with the rules for handling the sore arm. Folk remedies will help relieve inflammation, swelling, pain, but they are not able to eradicate the cause of the pathological condition.

The basis of folk treatment is compresses and rubbing.

To relieve swelling, people have always used fresh cabbage, horseradish, and burdock leaves, which need to be tied to the sore spot.

If it is not possible to use the previous recipe, a tough "dough" is made from vinegar and red clay for the same purpose. A flat cake is made from the "dough", which is then applied to the elbow overnight for 3 days.

If you have bear fat in your home, you can relieve inflammation and pain in cubital tunnel syndrome with it, using it as a rub. The course of treatment is 1 month.

An inexpensive mineral syrup called “Bishofite” can also help alleviate the condition of patients with this pathology. It is used every other day in the form of rubbing, compresses, and baths (10-12 procedures).

Among the compresses for pain relief, alcohol and honey compositions are good. Rubbing with mustard has the same effect.

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

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Homeopathy for Carpal Tunnel Syndrome

There is no specific medicine for cubital tunnel syndrome in homeopathy. However, there are many effective remedies that help relieve the unpleasant symptoms of tunnel syndromes of the upper extremities, such as pain, loss of sensitivity, and discomfort in the hands.

To relieve nerve pain in cubital syndrome, homeopaths recommend the following medications:

Belladonna (belladonna) in 3 and 6 dilutions (effective for inflammation or pinched nerves). Relieves inflammation and pain.

Bryonia alba (bryony) in 3, 6, 12 dilutions (a strong remedy for pain that intensifies with various movements, in this case, when bending and straightening the arm at the elbow or wrist).

Capisicum annuum (capsicum) in 3 and 6 dilutions also helps with neuralgic pain. It is recommended for people with excess weight.

The homeopathic composition Chamomilla (chamomile, hen's-foot and uterine herb) helps relieve pain in patients who are too sensitive to it and who cannot calmly endure attacks of pain. It is used in 3, 6 and 12 dilutions.

The following homeopathic medicines can help improve sensitivity in cubital tunnel syndrome:

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

Despite the fact that homeopathic remedies have virtually no contraindications or undesirable side effects, they must be used strictly as prescribed by a doctor. This is due to both 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 surgery needed?

If all possible treatment methods have been tried but have not brought the expected result, surgical treatment is practiced. An indication for surgical intervention is also considered to be a late request for help, when numbness is present on a permanent basis and noticeable muscle weakness is observed.

The goal of surgery for cubital tunnel syndrome is to create conditions for the ulnar nerve that prevent it from being compressed. This can be accomplished in several ways:

• Decompression (simple decompression) is a surgical method of increasing the space in and around the cubital canal in order to free the nerve from the musculoskeletal "trap". This effect is achieved by cutting the tendon arch or removing the walls of the canal that, 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: anterior subcutaneous (the nerve is placed between the subcutaneous fat layer and the muscles) and anterior axillary (the nerve is secured deep under the muscle).
• Medial epicondylectomy is the removal of part of the epicondyle to increase the space of the cubital canal.
• Endoscopic nerve decompression (an innovative method, the advantages of which are a small incision on the body, rapid relief of symptoms and recovery, almost complete restoration of elbow mobility in more than 90% of patients).

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

All operations are simple, but involve breaking the integrity of the skin and are performed under anesthesia. Anesthesia can be either local or general.

After surgery, patients must strictly follow the doctor's recommendations during the rehabilitation period to prevent relapses of the disease. The rehabilitation period can vary significantly in time. For example, the endoscopic method involves the removal of symptoms within the first day after surgery and a short period of complete recovery.

After decompression, it is necessary to wear a soft bandage for about 10 days, limiting the movement of the arm at the elbow, and perform physiotherapy exercises under the supervision of a doctor. After this operation, even visiting the pool is allowed 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. For this purpose, a special plaster splint is applied to the patient's arm. After the plaster is removed, a series of test exercises are conducted, during which isometric (increased muscle tone without joint mobility), passive (elbow joint movements with relaxed muscles), and active (with muscle tension without load and with load) movements are examined.

In case of 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 pain-relieving medications, undergo physical therapy, and undergo therapeutic massage.

Prevention

Prevention of cubital syndrome consists of avoiding situations that cause this pathology. First of all, you should try to avoid elbow and limb injuries in general. It is equally important to create comfortable conditions for your hands during work. For example, when working at a desk or computer table, you should try not to bend your arm too much at the elbow (the angle at the bend should be about 90 ^o ). Your hands should lie firmly on the table, and not hang from it in the elbow bend area. By the way, it is better to choose a chair with armrests.

For drivers and passengers of the car, advice not to put your arm bent at the elbow on the door glass. And in general, it has no place on the glass.

Don't forget about nutrition. A complete diet in all respects, replenishing the body's deficiency of vitamins and microelements, is a good preventative measure against the development of tunnel syndromes, a striking and equally undesirable representative of which is the cubital tunnel syndrome.

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Forecast

The period from the beginning of therapy to complete recovery is quite long. Most often, it takes 3 or even 6 months. Even if the symptoms of the disease have subsided, the patient continues to take the prescribed drugs until the doctor cancels them. Deciding on your own to cancel certain drugs because “nothing hurts anymore and I am completely healthy” means exposing yourself to the risk of developing relapses, which are often much more difficult to treat than a “fresh” pathology.

The prognosis of the disease is directly dependent on the time of seeking help. With cubital canal syndrome, a favorable prognosis is observed only at an early stage of the disease, when the symptoms do not differ in an enviable frequency of repetitions. In the advanced form of the pathology, one cannot count on a complete restoration of hand functions, alas. Most often, partial restoration of functions is observed, allowing one to perform habitual actions, and in some cases, a person is even given a disability with limited ability to work.

One way or another, in most cases you have to give up your favorite sport, change your profession or type of activity to one in which your hand will not experience excessive stress.

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