Damage to the ulnar nerve. Neuropathy of the ulnar nerve treatment. Features of medical care

Bruises, sprains. In conservative treatment, methods are used to increase the range of motion, relieve inflammation and swelling of the periarticular tissues. For this, they are used pharmacological preparations and physiotherapeutic procedures - diathermic currents, massage, electrophoresis. Therapeutic gymnastics and physical education classes help to restore the range of motion in the joint, strengthen muscles, ligaments and tendons. When diagnosing a complicated pathology or serious injury, patients are shown surgical intervention. In the list of popular treatments elbow joint- interpositional, unlined, wedge-shaped arthroplasty and joint arthroplasty.

Etiology and symptoms

Treatment depends on why the elbow joints hurt. The cause of pathologies can be a disease that affects all joints in the body. This occurs when there is gout, chondrocalcinosis, malignant and benign neoplasms, tendinitis,. Puffiness and disappear after the elimination of the underlying disease. Some pathologies are not yet amenable to any conservative or surgical method of therapy, for example, rheumatoid arthritis. Therefore, drugs are used in the treatment to prevent relapses and reduce the severity of symptoms. There are also specific causes of pain and stiffness of movements in the elbow joint:

. With the progression of the disease in or vertebrae, large blood vessels are squeezed by bone growths. The cubital tunnel syndrome provoked by compression is diagnosed ulnar nerve;
bursitis. The disease is isolated, often occurs with injury or excessive physical exertion. It often provokes general pathology eg gout. Bursitis occurs due to aseptic or infectious inflammation synovial bag. One of the symptoms is a visible and well-palpable induration in the elbow area;
or . Pain in the elbow joint is the result of destructive-degenerative changes in tissues. The causes of arthritis or arthrosis are increased physical activity, aging of the body, endocrine disorders, autoimmune pathologies, bad habits;
diffuse fasciitis. The disease is accompanied by pain and limited mobility of the elbow joint. Visible external damage is the deformation of the skin in the form orange peel. With a complicated course of fasciitis, a small seal is formed;
intervertebral hernia in the thoracic or cervical spine. Its formation can cause pinching nerve endings. Elbow pain is considered referred. In the absence of medical intervention, functions are disturbed, the skin sensitivity of the forearm decreases, atrophy of the biceps muscle develops;
epicondylitis. A characteristic symptom of the pathology is severe pain when trying to bend or straighten the hand. Methods for treating epicondylitis, or "", in the elbow joint depend on its type. For lateral pathology, inflammation of the tendons attached to the bone base is characteristic, and the preservation of the functional activity of the elbow. With internal epicondylitis, the range of motion in the joint may be somewhat limited. The disease accompanies those responsible for flexion. The pain radiates to the elbow joint and forearm.

Injury to the joint usually occurs when falling with an emphasis on the hand. manifested by severe pain, rapidly developing inflammatory edema, inability to bend or straighten the elbow. For posterior dislocation, deformation of the joint, shortening of the forearm, and restriction of movement are characteristic. With an anterior dislocation, an elongation of the forearm on the injured side and a deepening above the joint are diagnosed. Loss of sensitivity of the hand is possible with lateral dislocation due to compression or violation of the integrity of the nerve fibers.

When the ligaments and tendons are stretched or ruptured, the functional activity of the elbow joint decreases, the symmetry of the muscle relief is disturbed, swelling and severe pain occur. A characteristic symptom of a bruise is a hematoma, provoked by damage to small blood vessels.

Patients who underwent conservative treatment of damaged ligaments of the elbow joint were examined at the Research Institute of Traumatology and Orthopedics. In 50% of people, joint function has not fully recovered. Therefore, many traumatologists immediately prescribe a surgical operation to patients.

Medical therapy

Symptoms and treatment of the elbow joint are closely related. To reduce the severity of strong pain syndrome injectable solutions are required. With a weak, aching pain, the use of tablets, capsules or dragees is sufficient. Treatment carried out at the initial stages of pathology is most effective. It allows you to completely eliminate the symptoms of injuries or diseases, restore the joint to its previous mobility.

The main methods of treatment of the elbow joint	The name of the drugs, medical procedures, methods of surgical intervention
	Teraflex, Structum, Piascledin, Dona, Mukosat, Chondroitin, Glucosamine-Maximum
	Celeston, Diprospan, Hydrocortisone, Flosteron, Kenalog, Triamcinolone, Prednisolone
	, Diclak, Nimulide, Ketorol, Voltaren, Ortofen, Indomethacin, Nimesulide, Ketorolac, Ibuprofen, Artrosilene, Celecoxib
Preparations for local application	Kapsikam, Diklak, Viprosal, Apizartron, Nayatox, Ibuprofen, Voltaren, Finalgon, Menovazin ointment and solution, Ketorol
	Diathermic currents, electrophoresis, laser therapy, sodium chloride baths
Surgery	Interpositional, unpadded, wedge-shaped arthroplasty and joint arthroplasty

Non-steroidal anti-inflammatory drugs

NSAIDs are the drugs of first choice in the treatment of pathologies of the musculoskeletal system, including the elbow joint. They have anti-inflammatory, analgesic, antipyretic effects. Taking NSAIDs helps to eliminate pain, tissue swelling and bruising. And when symptoms occur general intoxication body drugs effectively cope with elevated temperature, chills, fever and. What a doctor can prescribe:

Nimesulide (80 rubles);
Ketorolac (45 rubles);
Celecoxib (210 rubles);
Diclofenac (40 rubles);
Meloxicam (65 rubles);
Ibuprofen (40 rubles);
(65 rubles).

With severe pain, take a tablet 3 times a day for a week. Ointments and gels are applied slightly above the area of pain and inflammation 2-4 times a day. NSAIDs are combined with proton pump inhibitors, active ingredients which become esomeprazole, pantoprazole, omeprazole, rabeprazole. These drugs prevent the development of a pronounced adverse reaction of nonsteroidal drugs - damage to the gastric mucosa. NSAIDs are not prescribed to patients with severe pathologies of the digestive system, kidneys, liver, pregnant women and breastfeeding women.

Regular use of NSAIDs increases the risk of decompensation of chronic heart failure in patients with diseases of cardio-vascular system. This is due to the toxic effects of drugs on the kidneys. Water and sodium begin to linger in the body, tone increases peripheral vessels, increase afterload.

Chondroprotectors

Chondroprotectors are drugs used to prevent the progression of destructive-degenerative changes in the elbow joint. Their reception is recommended for patients at the stage of rehabilitation after surgical operation. Chondroprotectors are used as prophylactic from damage to the joints by people actively involved in sports or experiencing physical stress in the service. Structure-modifying agents usually include collagen, hyaluronic acid, vitamins A, E, B2, B6, B1, B12. Some of them contain extracts marine fish and invertebrates, connective tissues of large cattle, extracts from medicinal plants. The following chondroprotectors have proven themselves in the treatment of diseases of the elbow joint:

Teraflex and Teraflex Advance (from 500 rubles);
Structum (1430 rubles);
Alflutop (1500 rubles);
Rumalon (2100 rubles);
Piascledin (1250 rubles);
Don (1300 rubles);
Mukosat (645 rubles);
Chondroxide (650 rubles).

The duration of taking chondroprotectors depends on the stage of the course of the disease or the degree of injury to the elbow joint. In severe form or osteoarthritis, treatment is required for 1-2 years. Chondroprotectors gradually accumulate in other articular structures. After 3-4 weeks, they begin to show a pronounced anti-inflammatory and analgesic activity, which persists for several months after drug withdrawal. To increase therapeutic effectiveness, rheumatologists recommend the simultaneous use of systemic and local chondroprotectors - cream, Teraflex, Artro-Active.

B.A. Michel was researched therapeutic action chondroitin on the joint, the main criterion for evaluating which was the width of the joint space on x-ray images. It was found that taking 0.8 g of the chondroprotector daily caused a statistically significant stabilizing effect on the width of the joint space in arthrosis.

Intra-articular administration of drugs

Intra-articular injection - the introduction of the drug into the cavity of the elbow joint. it obligatory part conservative treatment any inflammatory pathology (arthritis) and degenerative-dystrophic disease (arthrosis). The introduction of a medicinal solution into the joint gives the patient no more pain than intravenous or intramuscular injection. This method of therapy is used to quickly stop a strong inflammatory process and eliminate symptoms.

The regular introduction of chondroprotectors contributes to the gradual restoration of cartilage tissues in diseases of the lungs and medium degree gravity. Intra-articular injections avoid surgery on the elbow joint. What drugs are used during the procedure:

glucocorticosteroids - Celeston, Diprospan, Hydrocortisone, Flosteron, Kenalog;
chondroprotectors - Zeel-T, Chondrolon, Alflutop, Chondroitin, Glucosamine;
hyaluronic acid or its derivatives - Crespin-gel, Sinocrom, Ostenil.

Preparations with hyaluronic acid are used to restore the required volume of synovial fluid. Its deficiency provokes rapid wear of the articular tissues, characteristic.

In rheumatology, the use of gas injections is practiced. Introduced into the joint cavity carbon dioxide passed through several stages of purification. Carbon dioxide stimulates the acceleration of metabolism, improves blood circulation and microcirculation in damaged tissues. After several sessions of treatment procedures, the range of motion in the joint is restored, its morning swelling and pain disappear.

Physiotherapy procedures

Physiotherapy is prescribed to patients regardless of the cause of pain in the elbow joint. They slow down the progression of degenerative pathologies and stimulate the recovery of bone and cartilage tissues after injury. The combination of physiotherapy manipulations with a course of taking drugs significantly accelerates the recovery of patients. Contraindications to their implementation are acute inflammatory process in the joint cavity and (or) its infection pathogenic bacteria. The greatest therapeutic effectiveness is typical for such physiotherapy procedures:

diathermic currents. The principle of operation of this method of electrotherapy lies in the deep heating of damaged tissues with high-frequency currents (usually 1.65 MHz) of high strength. Under the influence of heat, metabolic processes are accelerated, blood supply to tissues with nutritious and bioactive compounds is normalized. is running enhanced regeneration tissues and restoration of the initial mobility of the elbow joint;
cryotherapy. Physiotherapy is usually used to treat injuries, the clinical manifestations of which are extensive swelling and bruising. During cryotherapy, liquid nitrogen is applied to the damaged joint. Microcirculation is restored, blood circulation improves, swelling and bruises resolve;
laser therapy. The procedure is carried out using a low-energy laser study to activate metabolic processes. Laser therapy contributes to the relief of a chronic inflammatory process and the elimination of molecular oxygen deficiency. After 5-10 sessions of physiotherapy, the need for taking painkillers decreases or completely disappears;
sodium chloride baths. These procedures have analgesic, anti-inflammatory and immunomodulatory effects. There is a kind of spraying of salt crystals on damaged tissues, creating a warming effect. Cells begin to consume more oxygen, metabolism and healing of joint structures are accelerated.

The most commonly prescribed physiotherapy procedure is electrophoresis. A tampon soaked in a medicinal solution is applied to the elbow area. On top of it are electrodes through which a weak electric current is passed. Under the influence of impulses, drug molecules penetrate into the hyaline cartilage, synovial fluid, bone tissue. During electrophoresis, the maximum absorption of active ingredients into the joint cavity is carried out.

In rheumatology and traumatology, the use of a modern physiotherapeutic method - shock wave therapy is practiced. It consists in an extracorporeal short-term effect on bone and connective tissues with acoustic pulses of low frequency. SWT is used in the treatment of pathologies of the elbow joint, including epicondylitis.

Do not drown out the pain in the elbow joint. Careful diagnostics and a competent therapeutic scheme will help prevent the progression of pathology. Treatment, started immediately after the onset of the first symptoms, significantly speeds up recovery.

It is responsible for the mobility and sensitivity of everything brachial plexus.

But with neuralgic diseases, the functions of the ulnar nerve are disturbed. Various lesions of the ulnar nerve (neuropathy, neuritis, tunnel and cubital syndromes) are quite common and can be associated with a number of different factors.

Anatomical and physiological reference

It is impossible to understand what exactly caused the dysfunction of the ulnar nerve without the most elementary knowledge of the anatomy of the human body, since only in this way can a complete picture of the course of the nerve fibers in the elbow be obtained.

The ulnar nerve is a long nerve located in the brachial plexus. It consists of biological fibers СVII-CVIII (7th and 8th cervical), which come directly from spinal cord.

The nerve enters the arm itself directly from the armpit and moves to the intermuscular septum of the medial region in the middle of the shoulder and lies in the bone-fibrous canal, which is formed inside the shoulder, tendon and wrist. This channel is medical literature is called capital or Mushet channel.

It is in this place that the ulnar nerve is located almost on the very surface and as close as possible to the bones, and it is here that the compression of nerve fibers most often occurs.

As a rule, everyone who at least once in his life injured his elbow, whether it was a fracture or a simple blow on a doorknob, felt quite unpleasant sensations that cause an instant aggravation of the pain syndrome (also, the nerve can pulsate at any time on its own in this place and well feel it to the touch).

After the fiber gradually goes beyond this channel, it is between the forearm muscles, but still part of its endings are in the muscle area. Passing to the border of the forearm, it is divided into several parts (external and dorsal), as well as a small palmar branch, passing from the forearm to the palmar ligament and wrist. This department human body is responsible for the perception of the external world - flexion and extension of the limb occurs.

Anatomical knowledge contributes to the rapid diagnosis of pathology.

The ulnar nerve, its anatomy, functions and diseases in the program of Elena Malysheva:

Neuropathy is the most common disease of the ulnar nerve

Ulnar nerve neuropathy is a process of numbness and decreased sensation in the fingers and hand as a whole. Running stage this disease leads to muscle atrophy, which can lead to complete numbness of the tips of the phalanges.

There are two types of ulnar neuropathy:

Primary - the development of an inflammatory reaction does not depend on another pathological process occurring in the body. Most often, this condition is observed in people who for a long time rest their elbow on the working surface of a machine or table, the armrest of a chair, etc.
Secondary (or symptomatic) - a complication of a disease that already exists in a person. The most common cause of the development of degenerative-dystrophic changes is compression (pinching) of the ulnar nerve, which is characteristic of some diseases:

osteomas - benign neoplasm bone tissue;
synovitis - inflammation of the synovial membrane;
fractures and dislocations of the shoulder or forearm;
hand injury;
tendovaginitis - inflammation of the inner articular membrane;
deforming osteoarthrosis - a chronic disease of cartilage and articular tissues;
bursitis of the elbow joint - inflammation of the articular bag;
post-traumatic arthritis.

In some cases, neuropathy develops as a result of a severe acute infectious disease (typhoid or typhoid fever, tuberculosis, syphilis).

General clinical picture

In general, damage to the ulnar nerve in neuropathy is characterized by a violation of its main functions, which leads to a decrease in mobility, pain, a decrease in the sensitivity of a particular muscle group and general malaise. The cause of this condition may be damage that was caused to the fiber by squeezing a separate part of the elbow (this leads to pinching and damage to the nerve).

In addition, such damage can act as a separate or adjacent disease.

Zones of numbness in neuropathy of the ulnar nerve

Symptoms of neuropathy of the ulnar nerve are expressed as follows:

a decrease in the sensitivity of the limb, which leads to the absence of pain;
numbness of the limb, which deprives it of mobility.

Establishing diagnosis

In order to establish damage to the ulnar nerve, a standard neurological examination is performed, during which the causes and nature of the disease are clarified. by the most informative method lesion diagnosis is electroneuromyography. It allows you to determine with maximum accuracy the location and degree of damage to the nerve fibers, as well as to determine the level of damage to the nerve roots that form the elbow joint.

With modern patient treatment, the diagnosis of ulnar nerve injury is a quick and most accurate procedure.

Treatment of neuropathy consists of the following procedures:

first of all, the patient is placed in a hospital, since neuropathy of the ulnar nerve is a serious disease and without the constant supervision of a doctor, the patient's condition can only worsen;
painkillers are prescribed to reduce pain;
An effective method of treating the disease is detoxification therapy, vitamins to maintain the body, anti-inflammatory drugs on a non-steroidal basis, which reduce the inflammatory process.

Symptoms and treatment of neuralgia

Origin ulnar neuralgia may be different - somatic and infectious pathologies, trauma, prolonged compression.

The inflammatory process affects the fibers peripheral nerves and appears:

pain syndrome;
numbness upper limb(violation of the passage of a nerve impulse to the brain);
violation of the functional activity of the muscles of the hand.

Treatment of neuralgia of the elbow joint is complex and consists of the use of medication and physiotherapy methods:

with the help of a plaster splint, the arm is fixed in a bent position and suspended in a special bandage - in this way, the cause that caused neuralgia is most often eliminated;
in case of an inflammatory reaction antibacterial agents, in acute infectious disease - antiviral;
to relieve swelling, it is necessary to take diuretic potassium-sparing drugs;
B vitamins are considered an effective tool for improving cellular metabolism;
to improve trophism and blood circulation in tissues, Papaverine is highly recommended;
to maintain the physiological tension of the nerve and muscle tissues, electrophoresis, ampli-pulse and UHF are prescribed;
massage sessions the patient can conduct independently, starting with rubbing the fingertips, flexion and extension of the joints of the phalanges and hands.

Inflammatory process in the elbow area

Ulnar neuritis is an inflammation accompanied by constant painful sensations in the elbow joint, numbness of the limb and weakness of the entire muscle.

Symptoms of ulnar neuritis:

burning sensation in the elbow;
swelling of the limbs of pink-purple color;
weakness;
change in body temperature;
drooping of the limb when it is overstrained.

Treatment is the following set of procedures:

First of all, the brush is fixed to prevent it from hanging down. This is done with a compression bandage and, as a rule, the arm is completely immobilized.
The next step of treatment is daily therapeutic exercises, taking anti-inflammatory and pain medications.

After a while, when the mobility of the arm improves, the exercises will become more difficult, gradually increasing the load.

Pinched ulnar nerve

Pinching of the ulnar nerve (cubital tunnel syndrome or ulnar nerve compression, ulnar syndrome) can lead to reduced sensation and complete loss of arm mobility.

Pinching is expressed by the following symptoms:

numbness and decreased mobility of the limb;
change muscle mass in the hand;
pain syndrome.

Treatment of cubital tunnel syndrome:

compliance with a constant regimen (therapeutic exercises, reducing physical activity, and so on);
physiotherapy;
taking painkillers.

tunnel syndrome

The tunnel syndrome of the ulnar nerve is a specific deviation that manifests itself in neuralgic diseases. There is a pinched nerve in the shoulder and forearm.

Elbow treatment tunnel syndrome wrist means:

limitation of motor activity;
physiotherapy;
taking vitamins and non-steroidal anti-inflammatory drugs.

Damage to the ulnar nerve, if not properly treated, can lead to a decrease in sensitivity, and subsequently cause complete numbness of the arm.

therapeutic exercises and other exercises aimed at developing the ulnar nerve;
taking vitamins that help strengthen nerve endings.

This section was created to take care of those who need a qualified specialist, without disturbing the usual rhythm of their own lives.

Symptoms of ulnar neuritis. Diagnostics and methods of treatment

Neuritis refers to diseases of an inflammatory nature, involving the peripheral part in the process. nervous system. The disease can cover both one nerve in isolation, and several at the same time. In this case, it is customary to talk about polyneuritis. The extent of the lesion depends on the cause of the pathological process.

Depending on the place of influence of the provoking factor and the localization of the nerve ending, it is customary to distinguish neuritis of the ulnar nerve, facial, intercostal, peroneal nerve, cochlear neuritis and many others.

Regardless of the affected nerve, it is still possible to identify the main symptoms inherent in all neuritis. Among them, the most common is pain in the localization of the nerve ending, a change in the threshold of sensitivity, a decrease in strength in the muscles of certain parts of the body.

Neuritis of the ulnar nerve affects a fairly large number of people. Among all neuritis, the defeat of this nerve is in second place.

Predisposing factors to the occurrence of neuritis

Several factors may be involved in the development of neuritis at the same time, however, in some situations, it is possible to identify a specific cause. Thus, the following provoking factors are most often observed:

hypothermia, general or local, due to exposure to temperatures with a low degree over a long time period on a certain part of the body or the body as a whole;
infectious agents, for example measles, diphtheria, influenza, typhoid fever, brucellosis or herpes;
traumatic lesion of both the nerve itself and the area of \u200b\u200bthe bone where it passes. As a result, its pinching is observed with the further development of neuritis. So, with neuritis of the elbow joint, a fracture of the internal humeral condyle and epicondyle can be diagnosed.
vascular pathology, which helps to reduce local blood circulation, as a result of which the nutrition of the nerve is disturbed;
hypovitaminosis with insufficient levels of vitamins and trace elements;
intoxication with alcohol or salts of heavy metals, such as arsenic, mercury, lead;
endocrine pathology ( diabetes, thyroid dysfunction);
anatomical features of the structure of the musculoskeletal canal, in the cavity of which the nerve passes, of congenital origin or as an acquired pathology. The ulnar nerve is localized in the ulnar sulcus, where it is compressed by a fibrous arch located between the flexors of the hand.
compression of the nerve trunk with irradiation of characteristic symptoms along the branched nerves. Similar states can occur during sleep, in an incorrect sitting position, with a sharp change in body position or during surgery in this area. Neuritis of the ulnar nerve often develops during prolonged work with leaning on the elbows on the machine, desk or armrests.
osteochondrosis, herniated discs.

Clinical manifestations of ulnar neuritis

Clinical symptoms and intensity of manifestations of neuritis depend on the degree of functional load of the affected nerve, the severity of the lesion and the area innervated by this nerve. Most of nerves of the peripheral part of the nervous system consists of fibers of a sensitive, motor and vegetative type. As a result, the following symptoms are noted:

Changes in sensory sensations, which can be manifested by numbness, paresthesia (tingling or "goosebumps"), an increase in the threshold of sensitivity, or a complete loss of tactile perceptions;
Change in motor activity with the development of paralysis with complete immobilization of a certain part of the body or paresis - with a partial decrease motor ability. The basis of this process is a decrease in strength in the muscles that are innervated by the affected nerve. In the future, their atrophy, decrease or disappearance of tendon reflexes is possible.
Vegetative disorders with trophic changes, manifested by the appearance of puffiness, blue skin, local hair loss, depigmentation, increased sweating, brittle nails and the appearance of trophic ulcers.

These symptoms may occur at the onset of neuritis or in more advanced stages. However, pain syndrome is an integral clinical manifestation. different intensity, as well as specific symptoms for each specific area of the body.

Neuritis of the elbow joint will include symptoms such as the appearance of paresthesia and a decrease in the sensitivity of the palmar surface of the hand in the area of half of the 4th and full 5th fingers. In addition, half of the 3rd and completely the 4th and 5th fingers are affected on the back surface.

Also, the disease is characterized by weakness of the adductor and abductor muscles of the 4th and 5th fingers. Further, malnutrition or atrophy of the muscles elevating the little finger and thumb, and the interosseous, worm-like muscles of the hand, may develop. As a result of atrophic processes, the palm looks flat.

The brush with neuritis of the ulnar nerve outwardly resembles a "clawed paw", since the joints on both sides of the middle finger phalanges are bent, and the rest are unbent.

In addition, along the location of the ulnar nerve, it may be infringed in certain anatomical areas (musculoskeletal canals) with the development of carpal tunnel syndrome.

Diagnostic criteria for ulnar neuritis

To diagnose the disease, certain tests specific to ulnar neuritis are used:

to determine the level of damage, it is necessary to clench the hand into a fist, after which the 4th, 5th and partially 3rd fingers will not be able to fully bend to form a fist;
if you press the brush tightly against a flat surface, for example, a table, then with the little finger it is impossible to carry out scratching movements on this surface;
in addition, in this position it is not possible to spread and adduct fingers, especially the 4th and 5th;
an attempt to hold the paper with the straightened 1st finger ends in failure, since there is no flexion of the distal phalanx. As a result of damage to the median nerve, innervated long flexor of the 1st finger, this function is not available.

Therapeutic tactics for neuritis of the ulnar nerve

The main direction in the treatment of the disease is the identification of the cause and its elimination in the near future. In case of an infectious process, they are used antibacterial drugs, to which the pathogenic flora is sensitive, and antiviral drugs.

If the cause of neuritis is a vascular pathology with impaired local circulation and the development of ischemia, then it is recommended to use vasodilators (papaverine).

With a traumatic genesis of neuritis of the ulnar nerve, mobilization of the limb is necessary. To reduce the activity of the inflammatory process, non-steroidal anti-inflammatory drugs are used - indomethacin, diclofenac. With severe pain syndrome, analgesics are used.

Auxiliary therapy includes B vitamins and decongestants with a diuretic effect. As the severity of the process decreases, anticholinesterase drugs, in particular prozerin, and biogenic stimulants (lidase) should be added.

Comprehensive treatment of neuritis involves the inclusion of physiotherapy procedures. It is advisable to start using them from the second week. Ultraphonophoresis with hydrocortisone, electrophoresis with novocaine, lidase and prozerin, UHF and pulsed currents are widely used. If necessary, electrical stimulation of the affected muscles should be used.

In addition, massage and physiotherapy exercises have proven their effect, due to which the groups of affected muscles are restored. Occupation exercise it is necessary to start from the second day after fixing the limb with a bandage. Prior to this, it is recommended to do gymnastics in the water.

Massage consists in massaging each phalanx of the fingers, starting with the big one. In addition, flexion and extension of all interphalangeal joints should be performed in order to activate blood circulation and eliminate congestion. Also effective circular motions and finger abduction.

If ulnar nerve neuritis has arisen due to its compression in the musculoskeletal canal with the development of carpal tunnel syndrome, then it is advisable to use local administration of drugs directly into this canal. In this case, hormonal and analgesic drugs are necessary to reduce swelling, pain and the activity of the inflammatory process.

Surgical treatment is necessary when the nerve is compressed in order to decompress it. In the case of a long-term inflammatory process, destructive phenomena are observed, as a result, surgical intervention is recommended. It is based on the stitching of the affected nerve, and in more neglected forms - its plastic.

Thus, with the correct timely diagnosis and effective treatment, ulnar neuritis has a favorable outcome. Treatment and rehabilitation take a total of more than two months. In the future, to prevent re-damage or neuritis of another nerve, it is recommended to avoid injuries, hypothermia and control the state of concomitant pathology.

Treatment of neuropathy of the ulnar nerve

Neuropathy is nerve damage that causes pain and impaired movement. Ulnar nerve neuropathy often occurs as a result of compression.

Ulnar nerve

The ulnar nerve is a branched structure of nerve fibers that emerge from the spinal cord. It passes through the armpit, shoulder, elbow and forearm, all the way to the flexor carpi tendon.

The nerve passes through the canal Mushe (cubital canal). Its feature lies in the surface location, which is due to high risks compression and damage to the ulnar nerve.

Depending on the location of the nerve lesion, the symptoms can be different - from pain to weakening of the fingers.

Causes of damage

Ulnar neuropathy develops due to:

shoulder injury;
dislocations and fractures of the forearm and hand;
compression in the cubital canal.

Most cases develop as a result of nerve compression in the cubital canal. This occurs as a result of frequent monotonous extensor movements in the joint during sports. Such a defeat is typical for people who train hard in the gym.

Neuropathy can occur in people prone to the habit of sticking their bent arm out the car window, or leaning on their elbow while working.

Damage to the fibers in the wrist area can be caused by:

the load on the wrist associated with the peculiarities of long-term work (rotation of the instrument in the hands, playing the violin, working with a vibrating instrument);
walking with a cane;
cycling;
riding a motorcycle over rough terrain.

There are also a number of organic pathologies that provoke nerve compression - these are tumor neoplasms, vascular aneurysms and arthritis of the elbow.

Symptoms of the disease

Symptoms of neuropathy largely depend on the location of the lesion.

If the nerve is compressed in the elbow joint, patients note:

local pain spreading to the forearm and hand in the little finger area;
local burning and tingling sensation;
decreased sensitivity;
muscle weakness.

If the treatment of the lesion is not started in time, muscle atrophy develops over time.

When squeezing the nerve in the area of \u200b\u200bthe brush, the following symptoms are noted:

pain in the area of the first three fingers of the hand;
temporary disturbances of sensitivity;
increased pain at night;
violation of flexion of the little finger and ring finger;
muscle atrophy, reduction in hand size.

Nerve damage in this area is also known as ulnar wrist syndrome. Due to the location of the nerve, the symptoms appear in the wrist area.

Establishing diagnosis

Problems with the diagnosis of an experienced doctor does not arise. A lesion of the ulnar nerve can be determined using a simple diagnostic technique, which consists in assessing the pain syndrome by tapping or pressing on the nerve in different places.

To determine the degree of damage, diagnostic methods are used to assess the speed of passage of nerve impulses through the fibers.

Radial nerve injury

Neuritis of the upper extremities also includes neuropathy of the radial nerve. This nerve passes through the shoulder and back of the forearm, and when it is affected, pain radiates to the wrist.

Radial neuropathy most often occurs due to compression of the canal in the forearm. This can happen as a result of an incorrect position during sleep or monotonous work with a load on the arm.

Radial neuropathy often accompanies people with injuries, as a result of which they are forced to move on crutches. In this case, squeezing occurs due to the load on the arm when walking.

The pathology of the radial nerve is characterized by the following symptoms:

violation of flexion of the fingers;
hand weakness;
local numbness and burning sensation;
violation of reflexes;
amyotrophy.

Due to the weakness of the hand, it is difficult for patients to hold something in their fingers. Accompanied by the inability to turn the brush palm up.

Neuropathy of the radial nerve without timely treatment leads to the development of atrophy.

Medical treatment

Neuropathy of the radial nerve is treated comprehensively. Therapy includes:

drug treatment;
massage;
exercises;
complex of physiotherapeutic procedures.

Surgical treatment is used only in case of organic pathology, to get rid of which traditional methods impossible.

Non-steroidal anti-inflammatory drugs based on ibuprofen or diclofenac are used to relieve pain. With the help of these drugs, inflammation and swelling of the tissues around the damaged canal is also successfully stopped.

With severe pain, which cannot be removed with pills, apply local injections analgesics, as well as medical blockade.

To improve the condition of nerve fibers, the intake of B vitamins is mandatory.

Physiotherapy

Treatment should be comprehensive, so doctors often resort to physiotherapy. Most effective methods is ultrasound treatment, electrophoresis with lidocaine and stimulation methods muscle function with the help of current.

With damage to the ulnar nerve, treatment contributes to:

removal of puffiness;
improvement of local metabolic processes;
acceleration of regeneration;
restoration of motor function;
prevention of muscle atrophy.

Physiotherapeutic methods are indicated only after the removal of acute pain and inflammation.

A good effect can be achieved with massage or acupuncture. Preference should be given to methods that involve the impact on pain points. This allows you to quickly improve overall well-being and restore the motor function of the affected limb.

Neuropathy can be treated with exercise. It contributes to the prevention of muscle atrophy, improves local metabolic processes and helps to quickly restore motor activity.

It is recommended to complement physiotherapy and massage independent execution exercises. You can also ask the doctor to teach the patient the basics of self-massage techniques and additionally massage the sore arm at home.

Surgical treatment is used if the disease is associated with a narrowing of the channel through which the nerve passes. After the operation, a long period of rehabilitation follows, during which massage and physiotherapy are used to restore the motor function of the hand.

Forecast and prevention

The treatment of neuropathy takes from three months to six months, however, a noticeable relief in the patient's condition occurs a few days after the start of the medication.

The prognosis largely depends on timely treatment for help and the nature of the damage. If the problem is recognized in time and the treatment is not delayed, the disease is successfully treated and disappears without a trace.

With muscle atrophy, it is difficult to restore normal motor activity. Recovery takes a long time, sometimes it is necessary to resort to surgical intervention.

Prevention of neuropathy of the elbow and wrist is the absence of strong monotonous repetitive loads. Regular intake of vitamin complexes will help improve the condition of nerve fibers.

When working with a load on the area in which the ulnar or radial nerve passes, it is necessary to take a break and perform simple exercises. This will avoid channel compression. Professional athletes should periodically change the type of load, this will help prevent squeezing the channel.

Good preventive measure is massage and acupuncture (acupuncture).

The disease can become a complication after a fracture, dislocation or injury of the elbow. To prevent this from happening, it is necessary to undergo an examination in a timely manner and consult a doctor about prevention.

The information on the site is provided for informational purposes only, does not claim to be reference and medical accuracy, and is not a guide to action. Do not self-medicate. Consult with your physician.

Ulnar nerve neuropathies: why they occur and how to treat

The anatomical structure of some areas through which the ulnar nerve passes creates many prerequisites for its compression. Such places are the cubital canal (Mouchet's canal), formed by several structures in the area of the elbow joint, and Guyon's canal, formed in the wrist area. Compression of the nerve fibers in these areas leads to neuropathy of the ulnar nerve. These conditions are accompanied by a number of sensory disturbances and a decrease in the strength of some muscles of the hand.

Signs of neuropathy of the ulnar nerve depend on the place of compression. In this regard, two variants of the course of this disease are distinguished - cubital canal syndrome and Guyon's syndrome (ulnar wrist syndrome). Their manifestations are in many respects similar, but they also have characteristics. In this article, we will acquaint you with the causes, main manifestations and methods of treatment of such neuropathies.

The reasons

There are many reasons for the development of neuropathies of the ulnar nerve. They are conditionally divided into two groups:

Post-traumatic neuropathies. Nerve damage is caused by a sprain, tear, or tear caused by a lateral dislocation of the elbow, subluxation of the elbow, or dislocation of the elbow with a fracture of the olecranon.
Compression neuropathies (cubital canal syndrome and Guyon's syndrome). Nerve compression can be caused by some professional skills or habits, as well as various diseases accompanied by an inflammatory process, swelling or bone changes in the passages of the nerve.

Nerve compression in the cubital canal can be provoked by:

long-term intravenous infusions (droppers);
the habit of leaning your hand on the surface of the table during a long telephone conversation;
frequent movements in the elbow joint;
work in which the elbow rests on a machine, office table or other object for a long time;
the habit of motorists to lean on the edge of an open window.

Nerve compression in Guyon's canal can be provoked by:

prolonged use of a cane;
frequent driving of a motorcycle or bicycle;
work associated with the frequent use of various tools (pliers, screwdrivers, jackhammers, drills or other vibrating devices).

In addition to these factors, compression neuropathy can be caused by such diseases and conditions:

rheumatoid arthritis;
tumors;
aneurysms of nearby vessels;
deformities of bones or connective tissue in the area of the elbow joint after a fracture;
deforming arthrosis, chondromatosis and chondromalacia;
synovial cysts and tendon sheath thickening in tenosynovitis.

Symptoms

Symptoms of cubital tunnel syndrome:

reduced sensitivity of the ulnar edge of the hand, ring finger and little finger;
pain in the cubital fossa, spreading to the forearm, ulnar edge of the hand, ring finger and little finger, aggravated by movement in the elbow;
paresthesia in the cubital fossa, ring finger and little finger, forearm, ulnar edge of the hand;
motor disorders, expressed in muscle weakness, difficulty in abduction and flexion of the hand, flexion of the ring finger and little finger;

Symptoms of Guyon's canal syndrome:

reduced sensitivity of the ring finger and little finger from the side of their palmar surface (at the same time, sensitivity is preserved from the back side);
painful sensations of the ring finger and little finger from the side of their palmar surface, the ulnar edge of the hand and the wrist joint;
paresthesia in the palmar surface of the ring finger and little finger, wrist joint and ulnar edge of the hand;
movement disorders, expressed in weak flexion of the ring finger and little finger and difficulty in bringing and spreading the fingers, the thumb is not brought to the palm;
muscle atrophy and changes appearance("clawed" or "bird" brush).

Diagnostics

In most cases, the diagnosis of neuropathies is not difficult. After questioning and examining the patient, the doctor conducts a tapping test. To do this, he lightly taps with a hammer on the places of possible compression of the nerve. If symptoms of compression - pain, paresthesia - are detected, the presence of neuropathy of the ulnar nerve is confirmed.

Electroneuromyography can be used to determine the area of damage to nerve fibers. The same method allows for differential diagnosis between neuropathy and damage to the nerve roots that emerge from the vertebral foramina and form its trunk.

If it is necessary to identify bone defects, the patient is prescribed X-ray or MRI. And to visualize the structural changes that occur in the nerve trunk at the entrance to the pinching canal, ultrasound is used.

Treatment

The choice of treatment for neuropathies of the ulnar nerve is largely determined by the causes of their development. When the nerve is torn as a result of fractures, an operation is performed to stitch it together. After that, the patient needs rehabilitation, which can take about six months. If the compression of the nerve is caused by other reasons, then the patient is prescribed conservative therapy, and surgical intervention is recommended only if medical and physiotherapeutic treatment is ineffective.

Conservative therapy

With compression of the ulnar nerve, it is recommended to wear fixing devices to limit compression during movement. For this, special orthoses, bandages or splints can be used. Some of them can only be used at night.

If the compression of nerve fibers is provoked by habits or movements that must be performed due to their professional activities, then the patient should completely abandon them. In addition, during treatment, it is necessary to avoid movements that cause increased pain or other symptoms.

To eliminate pain and signs of inflammation at the onset of the disease, non-steroidal anti-inflammatory drugs are prescribed:

For local anesthesia Versatis medicated patch containing Lidocaine may be used.

With severe edema, diuretic drugs (Furosemide), anti-edematous and anti-inflammatory agents (L-lysine aescinate) and capillary-stabilizing agents (Cyclo-3-fort) are used to reduce compression.

To improve the nutrition of the nerve, B vitamins are used:

In the absence of signs of elimination of the inflammatory reaction, instead of non-steroidal anti-inflammatory drugs, administration is prescribed by injection into the cubital canal or Guyon's canal of a mixture of Hydrocortisone solution and local anesthetic(Lidocaine or Novocaine). In most cases, this procedure eliminates the symptoms of neuropathy and has a lasting therapeutic effect.

Medical treatment of neuropathies is supplemented by physiotherapy procedures:

acupuncture;
electrophoresis with drugs;
ultrasound;
massage;
physiotherapy;
electromyostimulation.

Surgery

With the ineffectiveness of conservative therapy and severe cicatricial changes in the area where the nerve passes through the canals, surgical intervention is recommended. The purpose of such operations is to eliminate (cut and remove) structures that compress the ulnar nerve.

During compression in the cubital canal, its plasticity is performed, part of the epicondyle is removed and a new canal is created to move the nerve. In cases of Guyon's canal syndrome, a transection of the palmar carpal ligament is performed above the canal.

Performing a surgical operation allows you to release the nerve from compression, but additional treatment is prescribed to fully restore all its lost functions:

drugs - analgesics, drugs to improve the nutrition of the nerve and its conductivity, vitamins, diuretics;
physiotherapy procedures;
physiotherapy.

After the operation is completed, the patient's hand is immobilized with a splint or splint for 7-10 days. After its removal, the patient is allowed to perform passive movements. After 3-4 weeks, it is allowed to commit active movements and only after 2 months, exercises with a load and throws can be performed.

The duration of rehabilitation of the patient after such surgical interventions is about 3-6 months. The completeness of the restoration of nerve functions largely depends on the timeliness of the treatment started. In advanced cases, even surgical intervention does not allow for complete rehabilitation, and some violations of sensitivity and movement will accompany the patient throughout his life.

Ulnar nerve neuropathies can be provoked different reasons, which determine the further tactics of treatment of the disease. The main manifestations of these neurological pathologies consist in the appearance of pain, paresthesia and sensory disturbances. And the effectiveness of their treatment is largely determined by the timeliness of contacting a doctor.

Which doctor to contact

If signs of neuropathy of the ulnar nerve appear, a consultation with a neurologist is necessary. After studying the complaints and examining the patient, the doctor may prescribe an electroneuromyography, radiography, ultrasound or MRI. In case of injuries or advanced disease, it may be recommended to consult a surgeon for further surgical treatment.

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The ulnar nerve is a branched structure of nerve fibers that emerge from the spinal cord. It passes through the armpit, shoulder, elbow and forearm, all the way to the flexor carpi tendon.

The nerve passes through the canal Mushe (cubital canal). Its peculiarity lies in its superficial location, which causes high risks of compression and damage to the ulnar nerve.

Depending on the location of the nerve lesion, the symptoms can be different - from pain to weakening of the fingers.

Causes of damage

Ulnar neuropathy develops due to:

shoulder injury;
dislocations and fractures of the forearm and hand;
compression in the cubital canal.

Neuropathy can occur in people prone to the habit of sticking their bent arm out the car window, or leaning on their elbow while working.

Damage to the fibers in the wrist area can be caused by:

the load on the wrist associated with the peculiarities of long-term work (rotation of the instrument in the hands, playing the violin, working with a vibrating instrument);
walking with a cane;
cycling;
riding a motorcycle over rough terrain.

There are also a number of organic pathologies that provoke nerve compression - these are tumor neoplasms, vascular aneurysms and arthritis of the elbow.

Symptoms of the disease

Symptoms of neuropathy largely depend on the location of the lesion.

If the nerve is compressed in the elbow joint, patients note:

local pain spreading to the forearm and hand in the little finger area;
local burning and tingling sensation;
decreased sensitivity;
muscle weakness.

If the treatment of the lesion is not started in time, muscle atrophy develops over time.

When squeezing the nerve in the area of \u200b\u200bthe brush, the following symptoms are noted:

pain in the area of the first three fingers of the hand;
temporary disturbances of sensitivity;
increased pain at night;
violation of flexion of the little finger and ring finger;
muscle atrophy, reduction in hand size.

Nerve damage in this area is also known as ulnar wrist syndrome. Due to the location of the nerve, the symptoms appear in the wrist area.

Establishing diagnosis

To determine the degree of damage, diagnostic methods are used to assess the speed of passage of nerve impulses through the fibers.

Radial nerve injury

Neuritis of the upper extremities also includes neuropathy of the radial nerve. This nerve passes through the shoulder and back of the forearm, and when it is affected, pain radiates to the wrist.

Radial neuropathy most often occurs due to compression of the canal in the forearm. This can happen as a result of an incorrect position during sleep or monotonous work with a load on the arm.

Radial neuropathy often accompanies people with injuries, as a result of which they are forced to move on crutches. In this case, squeezing occurs due to the load on the arm when walking.

The pathology of the radial nerve is characterized by the following symptoms:

violation of flexion of the fingers;
hand weakness;
local numbness and burning sensation;
violation of reflexes;
amyotrophy.

Due to the weakness of the hand, it is difficult for patients to hold something in their fingers. Accompanied by the inability to turn the brush palm up.

Neuropathy of the radial nerve without timely treatment leads to the development of atrophy.

Medical treatment

Neuropathy of the radial nerve is treated comprehensively. Therapy includes:

drug treatment;
massage;
exercises;
complex of physiotherapeutic procedures.

Surgical treatment is used only in the case of organic pathology, which is impossible to get rid of by traditional methods.

With severe pain, which cannot be removed with pills, local injections of analgesics are used, as well as medical blockades.

To improve the condition of nerve fibers, the intake of B vitamins is mandatory.

Physiotherapy

Treatment should be comprehensive, so doctors often resort to physiotherapy. The most effective methods are ultrasound treatment, electrophoresis with lidocaine and methods of stimulating muscle function using current.

With damage to the ulnar nerve, treatment contributes to:

removal of puffiness;
improvement of local metabolic processes;
acceleration of regeneration;
restoration of motor function;
prevention of muscle atrophy.

Physiotherapeutic methods are indicated only after the removal of acute pain and inflammation.

Neuropathy can be treated with exercise. This contributes to the prevention of muscle atrophy, improves local metabolic processes and helps to restore motor activity faster.

It is recommended to supplement physiotherapy and massage with independent exercise. You can also ask the doctor to teach the patient the basics of self-massage techniques and additionally massage the sore arm at home.

Forecast and prevention

The treatment of neuropathy takes from three months to six months, however, a noticeable relief in the patient's condition occurs a few days after the start of the medication.

The prognosis largely depends on the timely appeal for help and the nature of the damage. If the problem is recognized in time and the treatment is not delayed, the disease is successfully treated and disappears without a trace.

With muscle atrophy, it is difficult to restore normal motor activity. Recovery takes a long time, sometimes it is necessary to resort to surgical intervention.

Prevention of neuropathy of the elbow and wrist is the absence of strong monotonous repetitive loads. Regular intake of vitamin complexes will help improve the condition of nerve fibers.

A good preventive measure is massage and acupuncture (acupuncture).

Ulnar neuropathy: causes, symptoms and treatment

Ulnar nerve neuropathy is a lesion of the ulnar nerve, as a result of which its function is impaired, which affects the sensitivity in the hand area and causes a decrease in the strength of individual muscles of the hand. There are many reasons for this condition. On the arm along the course of the ulnar nerve there are places in which it is most often subjected to compression. Compression in these areas has even individual titles: cubital canal syndrome, Guyon canal syndrome. Each of these syndromes has its own clinical features, but they all belong to the category of ulnar neuropathy. From this article you will get information about the causes, clinical features of ulnar nerve neuropathy on various levels injury and how to treat it.

A bit of anatomy

It is difficult to understand the originality of lesions of the ulnar nerve at various levels without basic knowledge of its anatomy and topography, so we will dwell on the basic information about the course of the fibers of the ulnar nerve.

The ulnar nerve is a long nerve of the brachial plexus. In its composition follow fibers C VII -C VIII (7th and 8th cervical) roots that come out of the spinal cord. The nerve enters the arm from the axillary fossa, then pierces the medial intermuscular septum in the middle of the shoulder, lies in the bone-fibrous canal formed by the internal epicondyle of the shoulder, the olecranon ulna and supracondylar ligament, tendon of the flexor carpi ulnaris. This channel is called cubital (Mouche channel). It turns out that in this place the nerve is located rather superficially and at the same time close to the bone formations. This circumstance causes a high frequency of compression of nerve fibers in this place. Everyone who has hit with an elbow at least once has felt on himself this feature of the superficial location of the ulnar nerve. It can even be felt in this place.

After exiting the canal, the ulnar nerve follows between the muscles of the forearm (simultaneously giving part of the branches to the muscles). At the border of the lower and middle thirds of the forearm, the nerve divides into the dorsal branch of the hand (which innervates the skin of the dorsal part of the IV, V and ulnar part of the III fingers of the hand) and the palmar branch, which passes from the forearm to the hand through Guyon's canal. Guyon's canal is formed by small bones of the hand, the palmar ligament of the wrist. In this place, the ulnar nerve is also often subjected to compression. The palmar branch of the ulnar nerve innervates the muscles of the hand and the skin of the palmar surface of the fifth, ulnar half of the fourth finger of the hand.

Knowledge of the topographic features of the course of the nerve helps in the diagnosis of its lesions. For example, if weakness of the muscles innervated by the ulnar nerve is detected in the area of the hand and forearm, then this means that the level of nerve damage is located above the middle third of the forearm, and if muscle weakness is detected only in the area of the fingers, then the nerve lesion is located at the level of Guyon's canal . The level of the lesion is important if there is a need for surgical treatment.

Causes of neuropathy of the ulnar nerve

The ulnar nerve can be damaged by:

fractures, dislocations of the bones of the shoulder, forearm and hand;
compression in the area of fibro-osseous canals (cubital and Guyon).

Most often, the ulnar nerve is damaged precisely during compression. Nerve compression does not have to be acute, sudden. On the contrary, more often it develops slowly, as a result of prolonged exposure to a traumatic factor. What causes compression of the ulnar nerve? In the region of the cubital canal, compression is provoked by:

repetitive flexion movements in the elbow joint;
work related to the support of the elbows on the machine, desk, workbench;
the habit of drivers to put their bent arm out the window, resting their elbow on its edge;
the habit of talking on the phone for a long time, resting your hand on the table with your elbow (this problem is more for women, because they like to chat with friends for a very long time);
long intravenous infusions when the hand is on significant gap time fixed in an extended position (and the nerve is subjected to compression). This is only possible in severely ill patients who receive almost continuous infusion therapy.

Compression of the ulnar nerve at Guyon's canal is called ulnar carpal syndrome. This condition is caused by:

regular work with tools (screwdrivers, pliers, tongs, vibrating tools, including jackhammers, and so on), that is, this professional matters. Of course, using pliers or a screwdriver just a few times will not damage the ulnar nerve. Perhaps compression of the nerve in this area in violinists;
constant use of a cane;
frequent cycling or motorcycle riding (during professional sports using these vehicles).

In addition to these reasons, neuropathy of the ulnar nerve can occur when the nerve is compressed by a tumor, an aneurysm of a nearby vessel, enlarged lymph nodes, arthrosis (or arthritis) of the elbow or wrist joints.

Symptoms of neuropathy of the ulnar nerve

When a nerve is damaged, its functions are primarily impaired, that is, sensory (including pain) and motor (associated with muscle strength) problems appear. Usually sensory disturbances occur first, and a decrease in muscle strength develops with continued nerve compression. With fractures, dislocations and other "acute" causes of neuropathy of the ulnar nerve, sensory and motor disorders occur simultaneously.

Cubital Canal Syndrome

Symptoms that indicate damage to the ulnar nerve in this area are:

pain in the region of the cubital fossa (the inner surface of the elbow joint), which spread to the forearm, IV and V fingers (both the palmar part and the back), to the ulnar edge of the hand (adjacent to the little finger). In the same areas, paresthesias can occur: sensations of tingling, crawling, burning, twitching, and so on. At first, the pain is periodic, aggravated at night, provoked by movements in the elbow joint (flexion is more “guilty”). Gradually, the pains begin to disturb constantly and increase in intensity from unpleasant sensations to very pronounced pains;
decreased sensitivity along the ulnar edge of the hand, in the area of the little finger and ring finger. Moreover, there is one feature - the very first sensitivity changes in the area of \u200b\u200bthe little finger;
somewhat later (compared to sensory disorders) motor disorders occur. Muscle weakness manifests itself as difficulty in flexing and abducting the hand in ulnar side, violation of the flexion of the little finger and ring finger, when trying to squeeze the hand into a fist, IV and V fingers do not press against the palm. If you put your palm on the table and try to scratch the table with your little finger, then in the case of neuropathy of the ulnar nerve this will not be possible to do. Fingers cannot be brought together and spread apart;
with prolonged existence of compression of the ulnar nerve, atrophy of the muscles of the hand develops. The hand becomes thinner, the bones protrude more clearly, the interdigital spaces sink. In this case, the rest of the arm and the opposite hand look completely normal;
the hand takes on the appearance of "clawed" or "bird" (due to the predominance of the function of other nerves of the hand that are not affected).

Guyon's canal syndrome (ulnar wrist syndrome)

The symptoms of this pathological condition are in many ways similar to those of cubital canal syndrome. However, there are a number of differences that make it possible to distinguish the levels of damage. So, the elbow syndrome of the wrist manifests itself:

sensitive disorders: pain and paresthesia of the wrist joint, palmar surface of the ulnar edge of the hand and palmar surface of the little finger and ring finger. The back of the hand does not experience such sensations (which distinguishes this syndrome from cubital tunnel syndrome). Both pains and paresthesias are aggravated at night and with brush movements;
decreased sensitivity in the area of the palmar surface of the little finger and ring finger. On the back surface of these fingers, sensitivity is not lost (which is also a difference);
motor disorders: weakness of flexion of the IV and V fingers, they cannot be completely pressed to the palm, difficulty in spreading and reducing the fingers, it is impossible to bring the thumb to the palm;
the brush can acquire a “clawed” (“bird”) shape;
with a long existence of the process, muscle atrophies develop, the hand becomes thinner.

Compression in the Guyon canal may be subjected to individual fibers ulnar nerve. And then the symptoms can occur in isolation: either only sensory disturbances, or only motor ones. In the absence of seeking medical help and treatment, the entire nerve will inevitably begin to be compressed, and then the signs will be mixed.

There is a diagnostic technique that works regardless of the place of compression of the ulnar nerve. This technique consists in tapping (with a neurological hammer), lightly tapping with something on the place where, presumably, the nerve is being compressed. And as a result, the above sensitive symptoms occur. That is, if you lightly tap on inner surface elbow joint, it is possible to cause pain and paresthesia in the zone of its innervation. This technique confirms the presence of neuropathy of the ulnar nerve.

If the ulnar nerve is damaged in any part of its course, in addition to the above two syndromes, then similar sensory and motor disorders will also be symptoms of this condition. fracture humerus, bones of the forearm with compression of the ulnar nerve by bone fragments will manifest itself as pain in the ulnar part of the forearm, hand and IV, V fingers, weakness of flexion of the hand, ring finger, little finger, mixing and dilution of all fingers of the hand. With fractures or dislocations, it is somewhat easier to identify damage to the ulnar nerve, since there is a clear cause of such symptoms on the face.

Diagnostics

To establish the diagnosis of neuropathy of the ulnar nerve, it is necessary to conduct a neurological examination with a tapping test. A very informative method is electroneuromyography, which allows you to determine the level of damage to nerve fibers and even differentiate, if necessary, damage to the ulnar nerve from damage to the nerve roots that form its trunk (damage to the roots occurs in the area of their exit from the spinal cord and vertebral foramina, although clinical symptoms may resemble neuropathy ulnar nerve). Diagnosis of neuropathy of the ulnar nerve is not particularly difficult when careful attention doctor to the symptoms.

Treatment of neuropathy of the ulnar nerve

The approach to the treatment of neuropathy of the ulnar nerve is determined, first of all, by the cause of its occurrence. If the disease arose as a result of a fracture of the bones of the arm with traumatic injury nerve fibers, then you may immediately need surgery to restore the integrity of the nerve. If the reason lies in the prolonged and gradual compression of the ulnar nerve, then at first they resort to conservative methods of treatment, and only if they are ineffective, surgical treatment is performed.

Restoration of the integrity of the ulnar nerve in case of fractures of the arm with rupture of the fibers is carried out by suturing the nerve. In this case, it may take about 6 months to restore function. The sooner nerve integrity is restored, the better the prognosis.

When a nerve is compressed in the region of the cubital canal or Guyon's canal, the first measure should be to reduce the compression of its fibers during movements. This is achieved with the help of various fixing devices (orthoses, splints, bandages). Some of these funds can only be used at night to reduce the domestic difficulties that arise in connection with the fixation of the hand. It is necessary to change the motor stereotype, that is, if there is a habit of resting your elbows on the table when office work or phone conversations or put your hand on the glass in the car while driving, then you need to get rid of it. Movements that increase pressure on the nerve should also be avoided.

From medications first they resort to non-steroidal anti-inflammatory drugs (Diclofenac, Ibuprofen, Nimesulide, Meloxicam and others). These drugs can reduce pain, swelling in the area of the nerve and adjacent formations, and remove inflammation. A lidocaine patch (Versatis) can be used topically for pain relief. For decongestant purposes, diuretics (Lasix), L-lysine aescinate, Cyclo-3-fort can be used. Vitamins of group B (Neurubin, Neurovitan, Kombilipen, Milgamma) have some analgesic and trophic effect. Neuromidin is prescribed to improve nerve conduction.

If immobilization and non-steroidal anti-inflammatory drugs do not work, then they resort to the injection of Hydrocortisone with an anesthetic into the area where the nerve is being compressed (Guyon's canal or cubital canal). Usually this procedure has a good therapeutic effect.

In the treatment of neuropathy of the ulnar nerve, physiotherapy is widely used. Ultrasound, electrophoresis with various drugs, electrical muscle stimulation are the most commonly used procedures. Effective massage, acupuncture. Not the last role is played by physiotherapy exercises, which helps to restore muscle strength.

However, sometimes with a late request for medical help, restore normal work ulnar nerve only conservative ways does not seem possible. In such cases, resort to surgical intervention. The essence of surgical treatment is to release the ulnar nerve from compression. With cubital canal syndrome, this can be plastic canal, creating a new canal and moving the ulnar nerve there, removing part of the epicondyle, with Guyon canal syndrome, this is a dissection of the palmar ligament of the wrist above the canal. With the help of such methods, the nerve is released, but this alone is not enough to fully restore function. After a successful operation, it is necessary to use medications (vitamins, agents that improve nerve trophism and conduction, decongestants, painkillers), physiotherapy methods and exercise therapy. It may take 3 to 6 months to fully restore function of the ulnar nerve. In advanced cases, when medical help was sought very late and there is severe muscle atrophy, full recovery impossible. Part of the motor and sensory disorders may remain with the patient forever. Therefore, you should not hesitate to contact your doctor if you have symptoms that indicate a possible ulnar nerve neuropathy.

Thus, neuropathy of the ulnar nerve is pathological condition resulting from a number of reasons. The main clinical symptoms of the disease are pain, sensory disturbances and muscle weakness in the area of the ulnar edge of the hand and IV, V fingers. Neuropathy of the ulnar nerve is treated conservatively and promptly. The choice of treatment depends on the cause of the neuropathy and individual characteristics the course of the disease. Success in treatment is largely determined by the timeliness of seeking medical help.

Educational film “Neuropathy of peripheral nerves. Clinic, the basics of diagnosis and treatment "(from 5:45):

Ulnar nerve and its diseases: neuropathy, neuritis, tunnel syndrome and others

In the entire shoulder weave, the ulnar nerve is given the most honorable place, since it, starting in the forearm, reaches the hand. It is responsible for the mobility and sensitivity of the entire brachial plexus.

Anatomical and physiological reference

The ulnar nerve is a long nerve located in the brachial plexus. It consists of biological fibers CVII-CVIII (7th and 8th cervical), which come directly from the spinal cord.

The nerve enters the arm itself directly from the armpit and moves to the intermuscular septum of the medial region in the middle of the shoulder and lies in the bone-fibrous canal, which is formed inside the shoulder, tendon and wrist. This channel in the medical literature is called capital or Mushe channel.

It is in this place that the ulnar nerve is located almost on the very surface and as close as possible to the bones, and it is here that the compression of nerve fibers most often occurs.

After the fiber gradually goes beyond this channel, it is between the forearm muscles, but still part of its endings are in the muscle area. Passing to the border of the forearm, it is divided into several parts (external and dorsal), as well as a small palmar branch, passing from the forearm to the palmar ligament and wrist. This department of the human body is responsible for the perception of the external world - flexion and extension of the limb occurs.

Anatomical knowledge contributes to the rapid diagnosis of pathology.

The ulnar nerve, its anatomy, functions and diseases in the program of Elena Malysheva:

Neuropathy is the most common disease of the ulnar nerve

Ulnar nerve neuropathy is a process of numbness and decreased sensation in the fingers and hand as a whole. The advanced stage of this disease leads to muscle atrophy, which can lead to complete numbness of the tips of the phalanges.

There are two types of ulnar neuropathy:

Primary - the development of an inflammatory reaction does not depend on another pathological process occurring in the body. Most often, this condition is observed in people who for a long time rest their elbow on the working surface of a machine or table, the armrest of a chair, etc.
Secondary (or symptomatic) - a complication of a disease that already exists in a person. The most common cause of the development of degenerative-dystrophic changes is compression (pinching) of the ulnar nerve, which is characteristic of some diseases:

osteoma - a benign neoplasm of bone tissue;
synovitis - inflammation of the synovial membrane;
fractures and dislocations of the shoulder or forearm;
hand injury;
tendovaginitis - inflammation of the inner articular membrane;
deforming osteoarthrosis - a chronic disease of cartilage and articular tissues;
bursitis of the elbow joint - inflammation of the articular bag;
post-traumatic arthritis.

In some cases, neuropathy develops as a result of a severe acute infectious disease (typhoid or typhoid fever, tuberculosis, syphilis).

General clinical picture

In addition, such damage can act as a separate or adjacent disease.

Zones of numbness in neuropathy of the ulnar nerve

Symptoms of neuropathy of the ulnar nerve are expressed as follows:

a decrease in the sensitivity of the limb, which leads to the absence of pain;
numbness of the limb, which deprives it of mobility.

Establishing diagnosis

In order to establish damage to the ulnar nerve, a standard neurological examination is performed, during which the causes and nature of the disease are clarified. The most informative method of damaging the diagnosis is electroneuromyography. It allows you to determine with maximum accuracy the location and degree of damage to the nerve fibers, as well as to determine the level of damage to the nerve roots that form the elbow joint.

With modern patient treatment, the diagnosis of ulnar nerve injury is a quick and most accurate procedure.

Treatment of neuropathy consists of the following procedures:

first of all, the patient is placed in a hospital, since neuropathy of the ulnar nerve is a serious disease and without the constant supervision of a doctor, the patient's condition can only worsen;
painkillers are prescribed to reduce pain;
An effective method of treating the disease is detoxification therapy, vitamins to maintain the body, anti-inflammatory drugs on a non-steroidal basis, which reduce the inflammatory process.

Symptoms and treatment of neuralgia

The origin of ulnar neuralgia can be different - somatic and infectious pathologies, injuries, prolonged compression.

The inflammatory process affects the fibers of the peripheral nerves and manifests itself:

pain syndrome;
numbness of the upper limb (impaired passage of a nerve impulse to the brain);
violation of the functional activity of the muscles of the hand.

Treatment of neuralgia of the elbow joint is complex and consists of the use of medication and physiotherapy methods:

with the help of a plaster splint, the arm is fixed in a bent position and suspended in a special bandage - in this way, the cause that caused neuralgia is most often eliminated;
in case of an inflammatory reaction, antibacterial agents are prescribed, in case of an acute infectious disease, antiviral agents;
to relieve swelling, it is necessary to take diuretic potassium-sparing drugs;
B vitamins are considered an effective tool for improving cellular metabolism;
to improve trophism and blood circulation in tissues, Papaverine is highly recommended;
to maintain the physiological tension of the nerve and muscle tissues, electrophoresis, ampli-pulse and UHF are prescribed;
massage sessions the patient can conduct independently, starting with rubbing the fingertips, flexion and extension of the joints of the phalanges and hands.

Inflammatory process in the elbow area

Neuritis of the ulnar nerve is an inflammation accompanied by constant pain in the elbow joint, numbness of the limb and weakness of the entire muscle.

Symptoms of ulnar neuritis:

burning sensation in the elbow;
swelling of the limbs of pink-purple color;
weakness;
change in body temperature;
drooping of the limb when it is overstrained.

Treatment is the following set of procedures:

First of all, the brush is fixed to prevent it from hanging down. This is done with a compression bandage and, as a rule, the arm is completely immobilized.
The next step of treatment is daily therapeutic exercises, taking anti-inflammatory and pain medications.

After a while, when the mobility of the arm improves, the exercises will become more difficult, gradually increasing the load.

Pinched ulnar nerve

Pinching of the ulnar nerve (cubital tunnel syndrome or ulnar nerve compression, ulnar syndrome) can lead to reduced sensation and complete loss of arm mobility.

Pinching is expressed by the following symptoms:

numbness and decreased mobility of the limb;
change in muscle mass in the arm;
pain syndrome.

Treatment of cubital tunnel syndrome:

compliance with a constant regimen (therapeutic exercises, reducing physical activity, and so on);
physiotherapy;
taking painkillers.

tunnel syndrome

The tunnel syndrome of the ulnar nerve is a specific deviation that manifests itself in neuralgic diseases. There is a pinched nerve in the shoulder and forearm.

Treatment for ulnar carpal tunnel syndrome includes:

limitation of motor activity;
physiotherapy;
taking vitamins and non-steroidal anti-inflammatory drugs.

Damage to the ulnar nerve, if not properly treated, can lead to a decrease in sensitivity, and subsequently cause complete numbness of the arm.

therapeutic exercises and other exercises aimed at developing the ulnar nerve;
taking vitamins that help strengthen nerve endings.

This section was created to take care of those who need a qualified specialist, without disturbing the usual rhythm of their own lives.

The defeat of the ulnar nerve ranks second in frequency among the lesions of all nerves that make up the brachial plexus.

Damage to the ulnar nerve causes

In most cases, the cause of neuropathy of the ulnar nerve is its compression in the area of the elbow joint. This pathology can be observed in people when working with elbows on the machine, desk, etc. Most often it occurs in malnourished people. The nerve may be compressed at the level of the wrist. In addition to compression, ulnar nerve neuropathy can be caused by a fracture of the internal condyle of the shoulder, or supracondylar fractures. In more rare cases ulnar neuritis occurs with a variety of infections, such as typhus, typhoid fever etc. According to the function performed, the ulnar nerve is mixed. The motor fibers that make up the nerve innervate the ulnar flexor of the wrist, the deep flexor of the finger, and the adductor thumb muscle. The ulnar flexor of the wrist during contraction produces flexion of the hand, as well as its abduction to the ulnar side. The deep finger flexor flexes the fourth and fifth fingers of the hand. In addition, this nerve innervates the muscles that adduct and spread the fingers. Also, the ulnar nerve innervates the vermiform muscles, which extend the middle and distal phalanges of the fingers. Thus, the ulnar nerve performs the following movements: flexion and extension of the middle and distal phalanges of the fourth and fifth fingers of the hand, dilution and adduction of all fingers except the first, adduction of the thumb. In addition to the above motor acts, the ulnar nerve, together with the median nerve, performs flexion of the hand at the wrist joint, as well as flexion of all fingers except the first in the main phalanges.

The composition of the ulnar nerve includes sensory fibers that innervate the skin on the ulnar surface of the hand, as well as the skin of the fifth and part of the fourth fingers of the hand.

Ulnar nerve injury symptoms

Damage to the ulnar nerve leads to the impossibility of palmar flexion of the hand. The possibility of bending the fourth and fifth fingers is lost, the patient cannot reduce and spread the fingers of the hand, and also carry out the adduction of the first finger of the hand. At objective examination there is atrophy of the small muscles of the hand, hyperextension of the fingers in the region of their main phalanges, due to the preservation of the function of the radial nerve. The middle and distal phalanges of the fingers are in the flexion position. Outwardly, the brush of the affected limb takes the form of a "clawed paw". The patient cannot bend the fourth and fifth fingers of the hand when clenching it into a fist. It is noted the impossibility of bending the distal phalanx of the little finger, as well as adduction of the fingers. Sensitivity disorder manifests itself in the form of numbness or paresthesia. There may be hypoesthesia or anesthesia of the skin of the palmar surface of the fifth and ulnar half of the fourth finger of the hand, as well as on the skin of the back of the hand in the area of the fifth, fourth and half of the third finger. In addition to violations of sensitivity in these areas, sometimes there are autonomic disorders in the form of cyanosis, sweating disorders and local increase skin temperature. To detect the presence of damage to the ulnar nerve, namely its motor function, it is necessary to use a number of tests. The patient is asked to clench the hand into a fist. At the same time, he cannot bend the fourth and fifth fingers of the hand in the region of their distal phalanges. When trying to spread and reduce from the second to the fifth fingers of the hand, with the palm positioned on a horizontal surface, the impossibility of this movement is noted. In a similar position of the hand of the affected upper limb, the patient cannot move the distal phalanx of the little finger. When trying to stretch a strip of paper by holding it between the large index finger brushes, the impossibility of pressing the paper is noted thumb. This is a consequence of dysfunction of the muscle that leads the thumb. The patient in this case holds a strip of paper by bending the distal phalanx of the thumb. The patient can perform this function with the help of the long flexor of the thumb, which receives innervation from the intact median nerve.

The musculoskeletal system is constantly exposed to various pathogenic influences due to heavy loads. Diseases of the elbow joint are formed under the influence of a traumatic, infectious-inflammatory, trophic factor. And also because of the close location of the nerve plexuses, neurological abnormalities are observed. Clinical manifestations can characterize several diseases at the same time, so it is recommended to contact a specialist who will competently carry out the treatment.

Consequences of traumatic exposure and characteristic symptoms

Elbow bruise

Occurs under the influence of a blow, the strength of which depends on the subsequent consequences and therapy. After exposure to the elbow, they appear severe pain, which can be localized in the area of \u200b\u200bthe tendon, muscle apparatus or joint capsule. After the impact, there is a change in the color of the skin and the development of a hematoma, which decreases after the application of a cold compress.

dislocation of the joint

The injury is accompanied by stretching or rupture of tendons and ligaments.

The elbow joint is prone to frequent injuries primarily due to the peculiarities of its structure - it combines 3 bones, has a vulnerable capsule, which is not sufficiently protected by muscle plexuses. A common elbow injury is considered to be a dislocation, which is the result of a direct blow or movement with excessive force. The symptoms are quite vivid, they include:

stiffness of movements;
articulation deformation;
puffiness;
severe pain syndrome.

Elbow fracture

by the most serious consequence Injury is a fracture that can affect the radius, ulna and humerus, and sometimes go directly into the articular plane and damage several bones at the same time. A fracture can develop under the influence of a strong blow, a fall, as well as osteoporosis, in which there is a decrease in the density of the bone structure. Symptoms of this condition are:

soreness and crunch at the time of injury;
puffiness;
complete immobility;
change in the shape of the joint;
bone fragments protruding from the wound with an open fracture;
accumulation of blood in the joint cavity.

The impact of diseases on the elbow joint

Fluid in joint

The disease develops on the inflammatory process.

Excessive accumulation of synovia becomes a direct manifestation, which develops under the influence of traumatism or an infectious pathogen that has entered the joint cavity. Given the peculiarities of the structure of the fluid, the pathology is purulent, hemorrhagic and serous. Therefore, the features of therapy will depend on the type, symptoms and causes that influenced the development of bursitis.

arthritis progression

The defeat of the elbows occurs symmetrically, since the disease is rarely localized. Most often, a manifestation in one place signals the onset of arthritis of the entire musculoskeletal system. The main manifestations include:

pain syndrome (moderate and severe);
swelling of the affected area;
poor motor ability;
redness of the skin;
increased temperature in the articulation area;

arthropathy

Joint infection occurs through the bloodstream.

In this case, it happens secondary lesion tendons and bone joints, which is provoked by other pathologies, mainly of a non-rheumatic nature. They become provocateurs allergic reactions, infectious diseases, endocrine disorders, chronic processes in the body. Most often it is manifested by pain, asymmetry of the lesion, articular changes visible on x-rays.

Fasciitis of the elbow joint

The disease is characterized by the development of an inflammatory process directly in the muscle fascia, i.e., cells muscle tissue. At the same time, the patient in the bone joint has pains of a pulling nature, obvious muscle weakness, which leads to a partial loss of mobility, and the elasticity of the skin in the area of the elbow bend decreases. Treatment of the elbow muscle is carried out both by the folk method and by medication, but under the close supervision of a doctor.

Elbow neuritis

Pathology provokes the development of tunnel syndrome.

Under the influence of an injury in the bend of the arm, pinching of the nerve endings occurs, which can provoke severe pain manifestations even at rest. Patients noted numbness of the skin at the site of the lesion, as well as stabbing sensations in the forearm. Without treatment, the disease can cause serious neurological complications, especially when the joint is hypothermic.

Epicondylitis

A specific disease that affects the area of attachment of the muscle fibers of the forearm to the epicondyles of the humerus. Development is preceded by microtraumas resulting from excessive physical exertion. In medicine, 2 forms are distinguished - lateral and. The main clinical manifestations include:

pain syndrome;
decreased muscle strength in the shoulder complex;
swelling of the periarticular tissues.

Elbow tendonitis

The disease occurs when the inflammatory process affects the tendon at the point of attachment to the joint capsule. It often manifests itself in athletes due to the constant loads exerted on this area. With constant exposure, deformation of the connective tissue occurs, which can lead to the destruction of their structure and rupture. Tendinitis symptoms:

pain on movement
change in skin color;
an increase in temperature in the area of the affected joint;
painful palpation.

How is elbow disease treated?

Features of medical care

Chondoprotectors contribute to the restoration of cartilage tissue.

Inflammatory diseases provoked by injuries and infectious pathogens are primarily treated with drugs, which include tablets, ointments, an injection directly into the joint bag has an effective effect. The main groups include:

Chondroprotectors. Suspend deformation processes in cartilage and reduce clinical manifestations. Among them are "Teraflex", "Artra".
Painkillers. Helps reduce the discomfort that pain causes. Popular drugs are considered "Panadol", "Efferalgan".
Non-steroidal anti-inflammatory drugs. They have analgesic, anti-edematous and anti-inflammatory effects. effective means this group are "Diclofenac", "Ibuprofen".

The complex of procedures is established individually, taking into account all the features of the disease and the causes of its occurrence.

Conducting a physiotherapy course

Under the influence of current, the healing agent acts at the cellular level.

The treatment of the elbow joint is also carried out with the help of specialized procedures that are designed to reduce pain, improve blood circulation, and activate protective mechanisms that can prevent deformation of bone and cartilage tissue. Apply:

shock wave therapy of the elbow joint;
electrophoresis;
phonophoresis.

Conclusion

Diseases of the elbow joint have different grounds for development, but each of them can provoke serious deviations. Therefore, if discomfort occurs in the elbow, it is recommended to seek the advice of a specialist and complete the prescribed course of treatment.