Cubital Tunnel Syndrome
Cubital tunnel syndrome is a pinched nerve at the elbow commonly known as the "funny bone". This might be caused by trauma or repetitive use of the elbow and may be caused by continuous use of the elbow in a flexed position. This causes the nerve to become stretched and irritated as opposed to when the arm is extended and the nerve is in a relaxed position. The diagnosis can be confirmed with electrodiagnostic testing including nerve conduction velocity and the electromyogram. Nerve conduction velocity studies, the speed of the nerve across the elbow, will be slowed when there is nerve compression and electromyogram studies, the innervation of the muscles, might be affected by the pinched nerve.
For this problem there are three modes of treatment; no treatment, conservative, and surgical. Unfortunately with conservative treatment, only splinting with the arm in an extended position has been found to be helpful. Night time splinting is achieved with a custom made long arm splint that the patient will wear at night time and as often as possible during the day. Unfortunately it is cumbersome to keep the arm out straight all the time and therefore this is usually used only at night.
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If conservative treatment is successful, you may see improvement in four to six weeks. You may need to continue wearing your elbow pad or splint at night to control symptoms. Try to do your activities using healthy body and wrist alignment. Limit repeated motions of the arm and hand, and avoid positions and activities where the elbow is held in a bent position.
Recovery after elbow surgery depends on the procedure used by your surgeon. If you only had the medial epicondyle removed, you'll have a soft bandage wrapped over your elbow after surgery. Therapy can progress quickly after this type of surgery. Treatments start out with range-of-motion exercises and gradually work into active stretching and strengthening. You just need to be careful to avoid doing too much, too quickly.
Therapy goes slower after ulnar nerve transposition surgery. You could require therapy for three months. This is because the flexor muscles had to be sewn together to form the new tunnel. Your elbow will be placed in a splint and wrapped in bulky dressing, and your elbow will be immobilized for three weeks.
When the splint is removed, therapy will begin with passive movements. In passive exercises, your elbow is moved, but your muscles stay relaxed. Your therapist gently moves your arm and gradually stretches your wrist and elbow. You may be taught how to do passive exercises at home.
Active therapy starts six weeks after surgery. You begin to use your own muscle power in active range-of-motion exercises. Light isometric strengthening exercises are started. You may begin careful strengthening of your hand and forearm by squeezing and stretching special putty. These exercises work the muscles without straining the healing tissues.
At about eight weeks, you'll start doing more active strengthening. Your therapist will give you exercises to help strengthen and stabilize the muscles and joints in the wrist, elbow, and shoulder. Other exercises are used to improve fine motor control and dexterity of the hand.
Some of the exercises you'll do are designed get your elbow working in ways that are similar to your work tasks and sport activities. Your therapist will help you find ways to do your tasks that don't put too much stress on your elbow. Before your therapy sessions end, your therapist will teach you a number of ways to avoid future problems.
 Jayce Reinhardt · Sun May 17, 2009 @ 08:01pm · 0 Comments |
