Stuart Hinds - Treating Cubital Tunnel Syndrome
Cubital Tunnel Syndrome is the second most common peripheral nerve entrapment syndrome and is 5 times more common in men.
Cubital Tunnel Syndrome (ulnar neuropathy) is a condition that is caused by compression to the ulnar nerve often by connective tissue or bone. The ulnar nerve, one of the three main nerves in the arm, passes just under the skin’s surface close to the elbow or “funny bone”.
Any intense physical activity which adds pressure to this nerve can cause CTS, as can an abnormal bone growth in the elbow region.
What are the Symptoms of CTS?
In most cases, the pain develops slowly and gradually over weeks and months in the elbow area. It is less common for the symptoms to occur suddenly.
An aching pain or numbness may be felt in the inner elbow but most of the symptoms will be in the hand. The ring and little fingers may tingle too.
Some more severe symptoms may include:
• Difficulty coordinating fingers (e.g. if typing)
• Reduced ability to pinch the little finger and thumb together
• Wasting of hand muscles
• Reduction in gripping ability
• Finger numbness may wake some whilst sleeping
Who is Prone to CTS?
Anyone who participates in activities that require continuous periods of elbow flexion e.g from holding the telephone, especially when leaning against a hard surface, are more susceptible to this condition.
Baseball pitchers who repeatedly perform a twisting motion when throwing the ball have an increased risk of contracting CTS as this action can damage the elbow ligaments over time.
Obesity coupled with gripping something in a constant position whilst doing a repetitive action are considered major risk factors too.
Those who sleep with their arm bent under their pillow may also be more susceptible to CTS. When the elbow is bent, the nerve shifts outwards from behind the medial epicondyle. If this happens repeatedly over time, it may cause irritation to the nerve.
Differential Diagnosis - What Else Could It Be?
Here is an incomplete list of other conditions which can mimic CTS:
• Trauma (fracture)
• Problems with the radial head of the radius bone at the elbow joint
• Injury to the ulnar nerve (radial tunnel syndrome)
• Problems with the discs in the neck C6/7 neuropathy (cervical disc)
• Dysfunction to the triangular articular cartilage disc at the wrist
• Osteoarthritis of the inner side of the elbow joint
• Ulnar collateral ligament injury
• Guvon’s canal syndrome (ulnar nerve compression syndrome)
• Golfer’s Elbow
Trigger Point Therapy
Whilst CTS is understood to be a condition that is caused by compression
to the ulnar nerve often by connective tissue or bone, it may also sometimes be caused functionally by trigger points in the Triceps, Flexor Carpi Radialis and Ulnaris muscles.
When a trigger point develops, the host muscle becomes shorter, thicker, and less efficient. Because muscles are made up of 75% water and water does not compress well, they become functionally swollen, which often leads to a taut band that can have further pressure effects on local tissues.
Any change in shoulder, wrist, or elbow mechanics over time may manifest in areas of tight muscles where trigger points may develop.
Trigger point therapy in tandem with stretching and strengthening exercises can often be extremely effective in providing both short and long term relief from the symptoms of CTS.
This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
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