Nerve Compression (Cubital Tunnel Syndrome)

Nerve Compression at the Elbow (Ulnar Nerve Compression, Cubital tunnel syndrome)
There are three main nerves (ulnar, median and radial nerves) that originate from the neck and extend to the hand. The ulnar nerve is compressed in the cubital tunnel at the elbow. Rarely, compression can also occur in the wrist.
Cubital tunnel syndrome refers to compression or irritation of the ulnar nerve in the elbow region.
is a name.
Compression of the ulnar nerve causes numbness and pain in the elbow, wrist and fingers. Median nerve compression in the wrist is called Carpal Tunnel Syndrome, which I have already explained.

Elbow Region Anatomy
The bony prominence on the inside of the elbow is called the medial epicondyle. Behind the medial epicondyle is the cubital tunnel through which the ulnar nerve passes. When we place our hand on the medial epicondyle, the nerve passing through the tunnel can be felt very easily with the fingertips. Because it is located just under the skin.

Below the elbow or between the forearm and the wrist, the ulnar nerve travels inside the muscles. Near the wrist, it passes through a second tunnel called guyon’s canal and ends in the pinky and ring fingers. The ulnar nerve provides movement and sensation to the pinkie and ring fingers.

What Causes Nerve Compression in the Elbow?The cause of cubital tunnel syndrome is not known for certain.

In the elbow transition zone, the tunnel is narrow and there is little soft tissue protection. Common causes of impingement;
– The ulnar nerve is stretched when the elbow is bent. If it lasts for a long time, pain and tenderness occur in the elbow area. For example, some people sleep with their hand on their cheek while sleeping. The ulnar nerve is stretched and can result in finger numbness that wakes them up at night.
– In some people, when the elbow is bent, the nerve slips out of the tunnel and returns again. Over time, this leads to nerve damage.
– Lying on the elbow for a long time
– Swelling in the elbow (arthritis, rheumatism)
– May be seen during the healing period of elbow trauma or fracture

Who is more likely to have a pinched nerve in the elbow?
Old elbow fractures and dislocation
Osteoarthritis and bone spurs
Swelling in the elbow joint
Cysts around the elbow
Occupational risk factors leading to prolonged and repetitive bending of the elbow

What are the symptoms of a pinched nerve in the elbow?
– There is pain coming from the inside of the elbow. However, it is often characterized by pain and numbness radiating to the pinky and ring fingers.
– Numbness and tingling may increase when talking on the phone or driving.
• Initially transient in nature, it can become permanent over time.
• Numbness and tingling increase at night and decrease with shaking the hand.
• If the process is prolonged, weakness and atrophy of the forearm muscles develop. The critical period for treatment is usually 5-6 months.
If the critical period in nerve compression is exceeded and left untreated, irreversible nerve damage occurs.

What can I do at home to reduce pain?
•Do the following applications for a few weeks, if your complaints do not go away, you should consult your doctor.
– Do not bend your elbow for a long time
– If you use a computer for a long time, do not sit in a low chair.
– Do not rest the inside of your elbow on hard surfaces. For example, do not lean on the elbow while looking out of a window.
– Elbows should be kept straight while sleeping.

Diagnosis of a pinched nerve at the elbow
Special tests for diagnosis;
– When the nerve on the inside of the elbow and under the skin is irritated, there may be numbness or increased pain in the pinky fingers.
– Complaints may become more pronounced when the elbow is bent.
– The appearance of complaints with stretching of the hand and fingers is significant.

X-ray It gives detailed information about arthritis and bone spurs. It is important for differential diagnosis.
MRI: Provides clear information about the soft tissues in the elbow area.
EMG: Nerves are like electrical cables. EMG is a very valuable test that evaluates nerve conduction speed, function and compression in nerve compression. It should definitely be done..

Treatment of a pinched nerve in the elbow
Non-surgical methods should be applied in the initial stages. However, surgery should be planned for patients who do not respond to these methods.

Non-Surgical Treatment
– Medication: Anti-inflammatory and anti-edema drugs are used.
– Injection: Cortisone is given locally. Cortisone is a very effective anti-inflammatory drug and is effective.
•- Splint or Orthosis: A splint can be used to rest the elbow.
– Exercise: Stretching exercises are performed.

Surgery for a pinched nerve at the elbow
The pinched nerve can not only be released, but can also be transferred to a new pathway opened with a special technique in the forearm muscles to prevent recurrence after the release (transposition surgery).