Pinched ulnar nerve: how to treat? Ulnar nerve neuropathy - symptoms. What does it threaten

Typical symptoms of numbness of the fingers of the right hand are manifested in the form of paresthesia. First of all, this is the loss of exteroceptive (surface) sensitivity of one or several fingers at once. In addition, there are sensations of itching and "crawling", as well as burning and coldness in the fingers.

With a long monotonous load or an uncomfortable position (when the hand is “numb”), this is due to temporary violation blood supply to the limb, as a result of which the conduction of nerve impulses changes. If after a few minutes after changing the position of the body (or rubbing the fingers) the numbness disappears, then this is exactly the indicated case.

With constantly occurring numbness of the fingers of the right hand, paresthesias become a sign of either pathology of any departments nervous system, or neurodegenerative processes, or autoimmune diseases(systemic lupus erythematosus). In this case, you need to seek medical help.

Symptoms of numbness of the fingers of the right hand, as well as the fingertips, as doctors note, in the majority of cases arise due to damage to nerve fibers in osteochondrosis or are the result of compression of the nerve trunks in pathologies of the peripheral nervous system.

Numbness of the little finger and ring finger of the right hand

Numbness of the fingers of the right hand is the most pronounced sign of tunnel neuropathies. Nerve trunks from spinal cord to the fingertips they go through special channels, which in some places narrow between the vertebrae. It is in these places that the nerve is compressed, which leads to the development of the so-called tunnel syndromes or peripheral neuropathies, which account for 30% of diseases of the peripheral nervous system.

So, numbness of the little finger and numbness of the ring finger of the right hand can be the result of cubital tunnel syndrome (compression syndrome ulnar nerve). The ulnar nerve, which conducts nerve impulses to the little finger and half of the ring finger, passes through the cubital canal located behind the inner side of the elbow.

Most often, numbness of the little finger and numbness of the ring finger of the right hand with neuropathy of the ulnar nerve can be observed when the elbow joint is in a bent state for a long time. That is why so often similar symptoms those who work with the elbow resting on the surface (table, machine, etc.) complain. In addition, when overloaded elbow joint in drivers and musicians, with injuries in athletes, as well as during work associated with vibration, there is a thickening of the joint and ligaments. As a result, cubital canal syndrome occurs and its symptom appears - numbness of the right little finger and numbness of the ring finger of the right hand, which may be accompanied by pain with pressure on the elbow and weakness in the hand. It is impossible to let the neuropathy of the ulnar nerve go by itself: it threatens with atrophy of the muscles of the hand.

Right thumb numbness

Carpal or carpal tunnel syndrome (from the Greek karpos - wrist) is caused by numbness of the thumb of the right hand, numbness of the index finger of the right hand, numbness of the middle finger of the right hand and half of the ring finger. IN this case compression of the median nerve occurs as it passes through the carpal tunnel.

This happens from constant voltage with prolonged static and dynamic load on one muscle group and on the wrist joint (for example, when working at a computer, as well as for painters, seamstresses, violinists). This syndrome is also called stenosing ligamentosis of the transverse ligaments by narrow specialists: excessive loads on the hand tendon wrist joint swell and compress the nerve trunk. It is for this reason that the fingers become numb, and numbness of the fingers of the right hand often occurs at night, and in the morning a person may feel stiffness in the movements of the fingers.

Carpal tunnel syndrome can also appear with diseases such as arthrosis, arthritis, neurofibroma, hemangioma, etc. It must be treated this syndrome, since the muscles of the thumb can atrophy, and the person will not be able to bend it.

Numbness of the index finger of the right hand

With dystrophic disorders in the cartilage of the vertebral joints - osteochondrosis - there is a decrease in their elasticity, strength and shape, which leads to pinching of nerve fibers. As a result, patients complain of pain in the neck, shoulder girdle and chest, frequent headaches, fatigue, drops blood pressure, dizziness and tinnitus, impaired coordination of movements, "flies" before the eyes. Besides, neurological manifestations osteochondrosis of the cervical and thoracic spine are numbness of the index finger of the right hand. In this case, very often numbness is felt in the thumb.

Numbness of the index finger of the right hand may be the result of pathologies of the elbow joint, primarily such as arthrosis (epicondylosis) and arthritis. With arthrosis, the elbow joint begins to collapse and becomes inflamed, which leads to pain radiating to the hand, limited mobility of the arm at the elbow, numbness of the fingers and the inability to properly clench the hand into a fist.

And with arthritis of the right elbow joint, inflammation leads to a deterioration in the conduction of nerve impulses and numbness of the index finger of the right hand. Arthritis can occur as a result of infection, as well as after injuries or constant overloads of the elbow joint.

Numbness of the middle finger of the right hand

If, with a partial loss of sensitivity of the index finger, there is numbness of the middle finger of the right hand, then doctors see the cause of this pathology in functional disorders intervertebral discs, cervical discs or muscles of the cervical region. These disorders occur with a compression effect on the nerve endings, which manifests itself not only in the form of paresthesia, but also in the weakness of the fingers, as well as pain in the forearm and shoulder.

Numbness of the middle finger of the right hand occurs when the distal processes of the nerve endings of the radial nerve are affected. That is it peripheral neuropathy, which can develop after stretching or tearing of the nerve, for example, with subluxation of the elbow joint. But the most typical cases are associated with the carpal tunnel syndrome mentioned earlier.

Numbness of the fingers of the right hand most often occurs when there is a violation of the blood supply to the hands and problems with the spine. This symptom is also included in the clinical picture of many diseases that can lead to very serious consequences such as limb amputation or death.

Treatment for numbness of the fingers of the right hand is prescribed according to the results of the diagnosis. The totality of factors causing hypesthesia can be divided into six main groups:

Injuries; Pathology of the spine; Inflammation of the joints; Circulatory disorders; Damage to the nervous system; Diseases of endocrine origin.

Causes of numbness in the fingers of the right hand

The causes of numbness in the fingers of the right hand can partly be determined by which fingers are numb. For example, if hypesthesia occurs in the index or middle finger, then this may be due to injury or inflammation of the elbow joint, and numbness of the ring or little finger most likely indicates a malfunction of cardio-vascular system. In any case, if there is numbness, tingling or pain in the fingers, then you need to contact a neurologist and establish accurate diagnosis to avoid complications.

The causes of numbness in the fingers of the right hand can be injuries such as bruises, sprains or fractures. Excessive voltage muscles of the neck-collar region also leads to numbness, for example, when wrong position head and neck while working at a desk or due to an uncomfortable posture while sleeping.

The following diseases require systematic treatment:

Osteochondrosis of the cervical spine; Hernia intervertebral disc; Rheumatoid arthritis; Circulatory disorders in the arm; Thrombosis upper limb; Ischemic stroke of the intervertebral artery; Blockage of cerebral vessels; carpal tunnel syndrome; Raynaud's disease.

Numbness of the fingers of the right hand with osteochondrosis

Numbness of the fingers of the right hand can be observed with osteochondrosis of the cervical region, protrusion and intervertebral hernia.

Degenerative-dystrophic changes in the spine are characterized by a decrease in the intervertebral discs and loss of elasticity of the fibrous ring. This leads to the so-called radicular syndrome. Most often, when the roots are pinched, the pain radiates from the neck along the shoulder blades and the radial surface of the forearm to the hand. The localization of pain and numbness of the fingertips, both of the right hand and the left, directly depends on which root is subject to compression:

C6 - in the thumb; C7 - in the index, middle and nameless; C8 - in the little finger.

Hypoesthesia is also possible in the absence of physiological changes cervical region, for example, with a forced position of the body for a long time.

With osteochondrosis, fingers go numb most often on one hand. Treatment consists of eliminating inflammation and swelling, but sometimes surgery is also required.

Finger numbness in rheumatoid arthritis

Numbness of the fingertips, both right and left, may be accompanied by rheumatoid arthritis. This disease is characterized by the defeat of several joints of the hand at the same time, according to the type of polyarthritis. In this case, the wrist joints, as well as small interphalangeal and metacarpophalangeal joints, are affected symmetrically.

The main symptoms of rheumatoid arthritis in the affected area are:

Sustained violation of flexion-extension (contracture); fusiform and S-shaped deformation joints; Bone growths between the phalanges; Muscular atrophy; local boost temperature; Redness and swelling; Numbness of fingers of right hand at night; morning stiffness movements; It's a dull pain.

Deterioration of well-being in the form of weakness, weight loss and periodic increase temperature at rheumatoid arthritis accompanies the development of articular syndrome. With time pathological changes affect the respiratory and cardiovascular systems, the gastrointestinal tract and the kidneys.

Numbness in the fingers due to impaired circulation

Numbness of the fingers of the right hand can occur as a result of various circulatory disorders, in particular with such diseases:

Thrombosis of the upper limb; Blockage of cerebral vessels; Ischemic stroke of the intervertebral artery.

If, after hypesthesia, increasing pain appears in the arm, then this may indicate a blockage large arteries thrombus. The cessation of normal blood supply without treatment is fraught with the development of necrosis and loss of a limb.

If there is numbness of the fingers of the right hand and foot, as well as weakness, nausea and headaches, then this may be a sign of a left-sided ischemic stroke. It develops within a few days, which allows you to recognize it in time and prevent paralysis. right side body.

Blockage of the vertebral artery with an abundance of collateral circulation may be asymptomatic, but in some cases causes massive heart attack in the medulla oblongata and cerebellum.

Numbness of the fingers of the right hand due to malfunctions of the nervous system

Some lesions of the nervous system may be characterized by numbness of the fingers of the right hand. Hypesthesia occurs with carpal tunnel syndrome and Raynaud's disease.

Carpal tunnel syndrome affects the functioning of the hand and wrist. When the median nerve is pinched in carpal tunnel pain occurs in the places of innervation. Characterized by numbness of the fingers of the right hand at night and early morning. The pain can radiate down the arm to the shoulder and neck. Over time, the flexor muscles of the fingers weaken and atrophy, resulting in almost complete incapacity of the limb.

Raynaud's disease is caused by a disorder nervous regulation vascular tone, resulting in small blood vessels shrink in response to external stimuli, for example, in the cold. The first attack of the disease can be provoked past infections, as well as overwork or hypothermia. Raynaud's disease can also be a complication of brain injury or severe psycho-emotional shock. The disease has three stages:

Angiospastic; Angioparalytic; Trophoparalytic.

At the first stage, at which the development of the disease often ends, under the influence of cold or stress, the skin becomes colder, turns white, and then turns blue due to trophic disturbance. After a few minutes, the blood supply is restored and the symptoms disappear. After an attack, paresthesia or numbness of the fingertips of the right hand appears. With symmetrical lesions, indicating a neurological origin of the disease, symptoms are observed on both hands.

Further development is characterized by an increase in the duration of attacks, increased pain and swelling. Subsequently deep violation tissue nutrition causes ulcers, necrosis and gangrene. Often, all three stages can affect adjacent fingers of one hand.

Whatever the etiology of numbness in the fingers of the right hand, treatment of the underlying cause must be started as soon as possible, since some diseases have very serious consequences.

Video from YouTube on the topic of the article:

Numbness of the fingertips of one or both hands is a fairly common problem faced not only by the elderly, but also by middle-aged and young age. Complete or partial lack of sensitivity in the fingertips may be accompanied by a slight tingling and even pain.

If we do not take into account the loss of sensitivity, which may be associated with being in the same position during sleep, then this condition can be regarded as a persistent dysfunction of the body. In most cases, loss of sensation in the tops of the fingers can indicate a violation of blood circulation. To establish true reason why the fingertips on the hand go numb, you may need to consult several medical professionals such as a cardiologist, a neurologist, an internist, a rheumatologist, and an endocrinologist.

Ignoring given state can lead to aggravation of the pathological process and the development of complications.

Causes

Scroll possible causes numbness of the fingertips, is wide enough. If the tips are numb index fingers, this may indicate dystrophic changes intervertebral discs in the cervical spine (osteochondrosis). If the tip of the thumb, as well as the middle and index fingers, goes numb, then this often indicates an inflammatory process in the elbow joint.

Numbness of the tops of the 4th and 5th fingers indicates pathologies of the cardiovascular system. It is impossible to draw a definite parallel between these cases, since reliable diagnosis can only be put by a doctor, and only on the basis of the diagnostic data obtained.

Loss of sensation in the fingertips during pregnancy is common in the 3rd trimester, and is caused by the presence of peripheral edema that compresses the nerve endings.

To the most probable reasons loss of sensation in the fingertips can be attributed to:

functional disorders of the spinal column; nerve root injury different localization; degenerative changes intervertebral discs in the cervical and thoracic spine (osteochondrosis); consequences of ischemic stroke; diabetes I and II types; hernia of the chest and lumbar spine; compression of nerve endings in the area of the elbow and wrist joints; circulatory disorders of the upper limbs; Raynaud's disease; hypovitaminosis of B vitamins (B1, B6, B12); pathology on the part endocrine system; traumatic injuries of the upper limbs; excessive alcohol consumption and smoking.

Each of the above causes must be confirmed by laboratory, clinical and instrumental methods diagnostics.

Diagnostics

The primary task of diagnosis is to exclude and prevent severe violations cerebral circulation, which is achieved by conducting all the necessary types of research. In case of complaints of loss of sensitivity in the fingertips, the doctor may prescribe the following types of studies:

X-ray examination of the cervical spine, which will detect the localization and degree of infringement of the nerve endings and blood vessels. For maximum information, radiography should be carried out in several projections. Dopplerography of the neck area, which allows you to assess the degree of patency of the large arteries of the neck; Electroencephalography of the brain to assess electrical activity cerebral cortex. MRI of the brain and vertebrobasilar zone. This study is carried out in order to assess the state of the vessels of the same name. Echoencephalography or ultrasound examination of the brain. This technique allows you to determine pathological changes in the structures of the brain.

It is possible to proceed to a more detailed diagnosis of the cause of loss of sensitivity in the fingertips, only if there is no serious violations circulation, as well as pathologies of cerebral vessels.

Treatment

The selection of a treatment plan should be based on the cause that caused the loss of sensitivity in the tops of the fingers. Treatment methods cervical osteochondrosis of the spine can cause significant harm to a person if he suffers from Raynaud's disease, the same can be said by reversing the diseases in places.

In some cases, a change of clothing is enough to restore sensitivity to a person, and some gymnastic exercises. If, as a result of the diagnostics, a circulatory disorder was detected or diabetes mellitus was diagnosed, then pharmacotherapy of the underlying disease will be required.

Medical therapy

If the fingertips on the left hand go numb, and this is caused by osteochondrosis of the cervical spine, then the pharmacotherapy of this disease will include the following groups of drugs:

Non-steroidal anti-inflammatory drugs (NSAIDs). The appointment of this group of drugs is carried out in the initial stage, and in the acute stage, when there is a need for relief pain syndrome. Multivitamin preparations, and a complex of B vitamins (B1, B6, B12). The use of this group of drugs allows you to accelerate the regeneration of damaged nerve fibers; Biostimulants of anabolic action (Riboxin, potassium orotate). The purpose of using this group of drugs is to stimulate regenerative processes in the motor segment of the spinal cord. Psychotropic drugs. The use of this group is possible only in the absence of an anesthetic effect while taking NSAIDs; enzymatic preparations. The most effective enzyme is papain, the action of which is aimed at resorption of the affected intervertebral disc.

If your fingertips are numb right hand, and this arose due to impaired peripheral circulation, the following groups of drugs can be prescribed by a doctor:

Angioprotectors. The action of this group of drugs is aimed at improving microcirculation in the body, normalizing the permeability of the capillary wall, as well as improving metabolic processes V vascular wall; Prostaglandins(E-1). Their action is based on the improvement of general blood flow, vasodilation, and a decrease in peripheral vascular resistance; Blockers calcium channels . Due to the use of this group of drugs, there is an improvement in microcirculation in the vessels of the brain, as well as the restoration of nerve cells; Antispasmodics. This group received wide application in the treatment of peripheral circulatory disorders; Ganglioblockers. The main effect of this group of drugs is achieved due to their ability to expand arterioles, veins and venules. The use of this group allows to achieve the effect of blood redistribution in the blood vessels of the upper extremities; Alpha-adrenergic blockers. The purpose of this group of drugs is to improve the blood supply to peripheral organs and tissues.

Treatment of other diseases that can cause a violation of peripheral sensitivity should be carried out by the appropriate groups of drugs, and under the condition of constant medical supervision.

Traditional medicine methods

As an effective addition to the main treatment, you can use some tips traditional medicine, which, due to their simplicity and accessibility, will help remove the symptoms of numbness of the fingertips.

As a rubbing, you can use wild rosemary tincture, which you can prepare yourself: you need to take 2 tbsp. l. dry rosemary herb and pour 250 ml apple cider vinegar. The resulting mixture should be infused for 7 days. Ready tincture must be rubbed problem areas 4 times a day. good effect have hand baths. To do this, pour warm water into one container, and cold water into another container. Next, one should alternately lower the hands into each vessel with water, with an interval of 1.5 minutes. The procedure can be repeated up to 4 times a day. As compresses, you can use freshly prepared warm pumpkin puree. To do this, apply warm pumpkin puree to the hands, cover with polyethylene and woolen cloth on top.

Prevention

The following tips can be an excellent prevention of diseases of the musculoskeletal system, and the cardiovascular system, which can affect the level of peripheral sensitivity.

it is necessary to follow the regime rational nutrition avoiding alcohol and smoking; when choosing gloves, preference should be given to natural materials, rather than their synthetic counterparts; while at work, you should take regular breaks with an interval of 45-50 minutes. During a break, give Special attention gymnastics for the hands, which stimulates blood circulation.

Therapeutic gymnastics can act not only as preventive measure, but also perfectly complement the main treatment. A more detailed discussion of methods of treatment and prevention is carried out during an in-person consultation with a doctor.

The ulnar nerve is indispensable in providing fine motor skills brushes. Its fibers are responsible for the sensitivity and movement of the fingers. A pinched nerve in the elbow joint is dangerous due to partial disability, a decrease in the quality of life due to pain, the need surgical intervention as the process progresses. The reasons for the infringement may be different, but in any case, in order to avoid sad complications, you need to consult a doctor in a timely manner and start treatment.

The ulnar nerve comes from brachial plexus, passes through inner surface hands from the cervical spine to the fingers.

Anatomical features

The most dangerous areas in terms of infringement for nerve fibers are the elbow joint and Guyon's canal of the wrist joint. There, the nerve trunk goes along complex tendon-bone canals. Even minor deformations of cartilage, tendons or bones due to inflammation, injuries lead to its infringement, carpal tunnel syndrome develops.

Also, clamping is possible along the nerve fibers by an inflamed muscle or ligament, a neoplasm of soft tissues. In the elbow joint, in some areas they lie very superficially, accessible to external pressure. Therefore, when the elbow is struck, there is a shooting pain and numbness that reaches the fingers.

This nerve contains sensory and motor fibers, which explains the occurrence of numbness, pain and limitation of movement when it is damaged. Breaking it motor function and nutrition lead to muscle atrophy and gradual deformation of the hand.

Reasons for the defeat

Pinching can be of different origin:

compression of the nerve with frequent support of the arm on the elbow (vulnerable office workers, wheelchair users and people who have the habit of constantly leaning their elbow on the armrest of the chair, the edge of the table);
injury lower divisions humerus, elbow joint, hand, including injuries, unsuccessful injections, dislocations, fractures, sprains;
hernia of the cervical spine, squeezing the branches of the brachial plexus;
tumors of the ulnar nerve and soft tissues of the periarticular region;
diseases of the joints (, elbow or wrist joints);
inflammation of the muscles of the forearm, hand, which innervates this nerve.

In addition, diabetes mellitus, professional overload, nervous stress, hypothermia.

Symptoms of a pinched nerve in the elbow

There are sensory, motor, trophic disorders and autonomic disorders.

The patient is concerned about pain along the nerve different nature. There is a limitation of movement:

elbow joint (flexion, extension);
wrist joint (flexion, lateral movements);
brush (flexion of the ring finger and little finger, adduction of the thumb, dilution and reduction of the fingers of the hand).

There are changes in sensitivity in the zone of innervation: numbness, burning, tingling.

Tissue malnutrition: muscular atrophy brushes with retraction of interosseous spaces, weight loss of the palm.

There may be vegetative disorders - cold, pale, sometimes cyanotic skin of the hand and forearm, impaired sweating.

In the advanced stage, deformation of the hand occurs. Due to damage to the interosseous muscles, it is difficult to straighten nail phalanges fingers, which leads to the formation of a clawed paw.

Characteristics of the consequences of pinching the ulnar nerve

Infringement can lead to neuritis or neuralgia. These pathological conditions have a number of differences.

Distinctive signs of neuritis and neurology

signs	Neuritis	Neuralgia
Cause	inflammation	injury, trauma
The nature of the pain	aching, persistent, aggravated by movement	paroxysmal, sharp, shooting, resembling an electric shock. Often occur without provocation
The nature of pathological changes	inflammatory process in all nerve fibers	damage to sensitive fibers only
Predominant symptoms	prolapse - decreased sensitivity, reflexes, strength	irritation - hyperesthesia, revitalization of tendon reflexes, attacks of pain
Treatment	anti-inflammatory therapy	antiepileptic drugs

Diagnostics

Includes a thorough questioning of the patient, neurological examination with the appointment of an examination to clarify the diagnosis.

During the examination, the patient is tested. The patient cannot:

clench the brush into a fist;
press your palm to the table, and then bend your little finger or bring and spread your fingers;
hold a piece of paper between your thumb and forefinger;
hold objects due to weakness and deformation of the hand.

With pressure along the nerve trunk, pain and numbness in the arm increase.

In the zone of innervation, sensitivity is reduced.

Instrumental Methods

The following surveys are carried out:

radiography (sometimes with contrast) of the joint;
cervical spine, elbow or wrist joint;
EMG - electromyography, reveals the conductivity of nerve impulses, the degree of muscle damage;
ENG - electroneurography, determines the level of damage;
biopsy - if a tumor of the nervous tissue is suspected.

Pinched nerve in the elbow joint: treatment methods

The main goal of therapy is to fight pain and restore the conduction of impulses along the nerve trunk. Treatment should be complex, long-term. Success presupposes the joint efforts of the doctor and the patient.

Protective mode with the exception of overloads, injuries and hypothermia of the hand. Often used fixation of the hand and forearm with a special splint or dosed wearing of a supporting corset to avoid deformities.

Drug therapy

Goals: relieve pain, swelling, improve the nutrition of nerve cells. Are used:

NSAIDs, including in the form of ointments and gels;
means for restoring nerve conduction;
antispasmodics;
vascular drugs;
B vitamins;
antioxidants;
glucocorticoid hormones for intraarticular blockades.

Physiotherapy

The following procedures are performed:

electrophoresis with analgesics and antispasmodics;
electrical stimulation of the affected muscles;
laser therapy;
thermotherapy;
exercise therapy to restore fine motor skills;
acupuncture;
upper limb massage with development elements.

Surgery

The patient should be aware that the rehabilitation of the affected ulnar nerve is a lengthy process. In the absence of positive dynamics within two months, the issue of surgical intervention should be decided.

Currently underway endoscopic operations for the purpose of decompression of the nerve trunk with very good results in case of timely treatment.

Prevention

It is important to avoid injuries of the joint, prolonged position of the arm in a bent state with support on the elbow. If this forced position due to work, it is necessary to take breaks, massage a tired hand.

If discomfort and movement restrictions appear in the upper limb, you should consult a doctor. Attempts to cope with the problem on their own, as a rule, only lead to the loss of valuable time, since the nervous tissue dies quickly, and it is long and difficult to recover. Ignoring anxiety symptoms, you can start the process.

A pinched nerve in the elbow joint leads to a permanent dysfunction of the hand, difficulty in self-care, negative emotions due to hand deformity, and movement restrictions. Therefore, immediate diagnosis and complex treatment with careful implementation of medical recommendations.

If the ulnar nerve is affected, the mobility of the hand and its sensitivity are reduced or completely disappear. This pathology in medicine is called neuropathy.

Neuropathy, for the reasons that caused it, is divided into two categories:

Post-traumatic;
Compression.

Post-traumatic neuropathy is the result of a sprain, partial tear or complete rupture of the nerve of the elbow joint. Such damage may be preceded by subluxation of the elbow joint, lateral dislocation or dislocation in front, accompanied by a fracture of the olecranon.

Compression neuropathy is a pinching of the ulnar nerve in narrow channels (in the cubital canal in the elbow joint or Guyon's canal in the hand joint).

This happens with a tumor, inflammation or changes in the structure of tissues in the channels. The causes are such diseases:

Rheumatoid arthritis.
Deforming arthrosis.
Chondromalacia and chondromatosis.
Tenosenovitis and synovial cysts.
malignant formations.
Pressure on the nerve of the abductor of the little finger.

Often, pinching of the ulnar nerve occurs in the process of repositioning the joint in case of dislocation or combination of bone fragments in case of fracture. If skeletal traction is performed, passive stretching of the nerve at the elbow joint may also occur. This pathology is called secondary neuritis.

If there is repeated damage to the elbow joint in the area where the nerve passes, late neuritis develops.

Ulnar nerve neuropathy - symptoms

Symptoms vary depending on the severity of the injury. At complete break nerve in the elbow joint are noted:

Loss of sensation skin little finger and half of the ring finger;
Paralysis of the flexor muscles and adductor muscles of the thumb;
Paralysis of the interosseous muscles in the area of the transition of the palm to the fingers - there is a "syndrome of claw fingers".

With incomplete nerve damage, the symptoms are as follows:

tingling sensation on inside palms.
Weakening of the muscles of the hand.
Decreased muscle volume between the thumb and forefinger.
Loss of sensation in the little finger, partial numbness of the ring finger.
Pain along the nerve of the elbow joint.

The stronger the damage to the nerve fibers, the more pronounced the symptoms will be.

Methods for diagnosing a pinched nerve in the elbow joint

Froman's tests are performed to accurately diagnose when examining the victim. First, the patient must lower thumbs hands on the surface of the table so that the table top is between them and index fingers, and perform such a movement, as if about to squeeze the lid.

Even with minor nerve damage, the patient will not be able to keep the thumb level on the tabletop, he will lower it to his side and bend.

Next, the patient is offered to grab a sheet of thick paper with the side surfaces of the fingers, while bending the fingers is impossible. The finger of the hand that is damaged will not be able to remain straight, it will bend at the interphalangeal joint.

The diagnosis is confirmed by Tinnel's symptom - the symptoms increase if the doctor performs pressure movements along the cubital canal of the elbow joint. The degree of sensitivity is determined with the help of light touches or injections in different parts of the hand.

X-rays, MRI, ultrasonography. Ultrasound can also determine how badly the nerve is damaged.

A method such as electromyography allows you to determine whether there are violations of the impulse in the area located below the damaged nerve.

Ulnar nerve pinched treatment

Treatment of neuropathy of the elbow joint can be both surgical and conservative. The method is determined taking into account the cause of the pathology and the degree of nerve damage.

If there is no atrophy of muscle tissue, and there is no persistent deformity of the fingers, it is possible conservative treatment. If the nerve is damaged in the cubital canal, the following methods are used:

Compliance with a certain regimen: loads should be minimal, monotonous movements should be avoided, do not allow the hand to be for a long time in a bent position.
Treatment with non-steroidal anti-inflammatory drugs that effectively relieve pain and inflammation, B vitamins to improve blood circulation and metabolic processes in the damaged nerve.

With a pinched nerve in the Guyon canal, the treatment is not fundamentally different, but the introduction of glucocorticosteroids is added to the listed methods.

Surgical treatment is indicated if medication treatment has failed, if there are significant scars in the nerve passage in the canals, or if it is necessary to restore the functionality of the hand as soon as possible - for example, in professional athletes who cannot interrupt training to carry out conservative treatment.

Treatment surgically It consists in dissecting tissues and removing those parts of them that compress the nerve and cause inflammation. In some cases, in order to avoid re-damage to the nerve, it is transplanted to the inner surface of the elbow joint.

After the operation, a fixing splint is applied to the arm, after which it is carried out rehabilitation treatment using NSAID ointments, analgesics, vitamins, thermal procedures and massage. Mandatory appointment physiotherapy after tire removal.

The ulnar nerve is indispensable in providing fine motor skills of the hand. Its fibers are responsible for the sensitivity and movement of the fingers. A pinched nerve in the elbow joint is dangerous due to partial disability, a decrease in the quality of life due to pain, and the need for surgical intervention as the process progresses. The reasons for the infringement may be different, but in any case, in order to avoid sad complications, you need to consult a doctor in a timely manner and start treatment.

How does pathology occur?

The ulnar nerve originates from the brachial plexus, runs along the inner surface of the arm from the cervical spine to the fingers.

Anatomical features

The most dangerous areas in terms of infringement for nerve fibers are the elbow joint and Guyon's canal of the wrist joint. There, the nerve trunk goes along complex tendon-bone canals. Even minor deformations of cartilage, tendons or bones due to inflammation, injuries lead to its infringement, carpal tunnel syndrome develops.

This nerve contains sensory and motor fibers, which explains the occurrence of numbness, pain and limitation of movement when it is damaged. Violation of its motor function and nutrition leads to muscle atrophy and gradual deformation of the hand.

Reasons for the defeat

Pinching can be of different origin:

compression of the nerve with frequent support of the arm on the elbow (office workers, wheelchair users and people who have the habit of constantly resting their elbow on the armrest of the chair, the edge of the table are vulnerable);
injuries of the lower sections of the humerus, elbow joint, hand, including wounds, unsuccessful injections, dislocations, fractures, sprains;
hernia of the cervical spine, squeezing the branches of the brachial plexus;
tumors of the ulnar nerve and soft tissues of the periarticular region;
joint diseases (arthritis, arthrosis of the elbow or wrist joints);
inflammation of the muscles of the forearm, hand, which innervates this nerve.

In addition, diabetes mellitus, professional overload, nervous stress, and hypothermia contribute to the development of pathology.

Symptoms of a pinched nerve in the elbow

There are sensitive, motor, trophic disorders and vegetative disorders.

The patient is concerned about pain along the nerve of a different nature. There is a limitation of movement:

elbow joint (flexion, extension);
wrist joint (flexion, lateral movements);
brush (flexion of the ring finger and little finger, adduction of the thumb, dilution and reduction of the fingers of the hand).

There are changes in sensitivity in the zone of innervation: numbness, burning, tingling.

Tissue malnutrition: muscle atrophy of the hand with retraction of the interosseous spaces, weight loss of the palm.

There may be vegetative disorders - cold, pale, sometimes cyanotic skin of the hand and forearm, impaired sweating.

In the advanced stage, deformation of the hand occurs. Due to damage to the interosseous muscles, it is difficult to straighten the nail phalanges of the fingers, which leads to the formation of a clawed paw.

Characteristics of the consequences of pinching the ulnar nerve

Infringement can lead to neuritis or neuralgia. These pathological conditions have a number of differences.

Distinctive signs of neuritis and neurology

Cause	inflammation	injury, trauma
The nature of the pain	aching, persistent, aggravated by movement	paroxysmal, sharp, shooting, resembling an electric shock. Often occur without provocation
The nature of pathological changes	inflammatory process in all nerve fibers	damage to sensitive fibers only
Predominant symptoms	prolapse - decreased sensitivity, reflexes, strength	irritation - hyperesthesia, revitalization of tendon reflexes, attacks of pain
Treatment	anti-inflammatory therapy	antiepileptic drugs

Diagnostics

It includes a thorough questioning of the patient, a neurological examination with the appointment of an examination to clarify the diagnosis.

During the examination, the patient is tested. The patient cannot:

clench the brush into a fist;
press your palm to the table, and then bend your little finger or bring and spread your fingers;
hold a piece of paper between your thumb and forefinger;
hold objects due to weakness and deformation of the hand.

With pressure along the nerve trunk, pain and numbness in the arm increase.

In the zone of innervation, sensitivity is reduced.

Instrumental Methods

The following surveys are carried out:

radiography (sometimes with contrast) of the joint;
MRI of the cervical spine, elbow or wrist joint;
EMG - electromyography, reveals the conductivity of nerve impulses, the degree of muscle damage;
ENG - electroneurography, determines the level of damage;
biopsy - if a tumor of the nervous tissue is suspected.

Pinched nerve in the elbow joint: treatment methods

The main goal of therapy is to fight pain and restore the conduction of impulses along the nerve trunk. Treatment should be complex, long-term. Success presupposes the joint efforts of the doctor and the patient.

Drug therapy

Goals: relieve pain, swelling, improve the nutrition of nerve cells. Are used:

NSAIDs, including in the form of ointments and gels;
means for restoring nerve conduction;
antispasmodics;
vascular drugs;
B vitamins;
antioxidants;
glucocorticoid hormones for intraarticular blockades.

Physiotherapy

The following procedures are performed:

electrophoresis with analgesics and antispasmodics;
electrical stimulation of the affected muscles;
laser therapy;
thermotherapy;
exercise therapy to restore fine motor skills;
acupuncture;
upper limb massage with development elements.

Surgery

Currently, endoscopic surgeries are being performed to decompress the nerve trunk with very good results in case of timely treatment.

Prevention

It is important to avoid injuries of the joint, prolonged position of the arm in a bent state with support on the elbow. If this forced position is due to work, you must definitely take breaks, massage your tired hand.

If discomfort and movement restrictions appear in the upper limb, you should consult a doctor. Attempts to cope with the problem on their own, as a rule, only lead to the loss of valuable time, since the nervous tissue dies quickly, and it is long and difficult to recover. By ignoring the alarming symptoms, you can start the process.

Neuritis of the ulnar nerve is an inflammatory process various etiologies that affects the peripheral nerve fibers and is manifested by pain, numbness, loss of function of the innervated muscles; - treatment is complex and includes medication and physiotherapy.

Etiology

Neuritis of the ulnar nerve

The ulnar nerve leaves the brachial plexus along with the radial nerve, descends down the medial side of the shoulder and passes through the posterior surface of the medial epicondyle to the forearm and hand. It carries nerve impulses to the deep muscles of the flexors of the hand and fingers, is responsible for the work of the muscles of the little finger and leads the index, ring fingers and the little finger to the middle. The most common diseases that affect this nerve are neuritis and neuralgia.

Ulnar neuritis is considered a disease of people, which most spend time in the office. This is due to the fact that such workers are used to leaning on the elbow and can eventually injure the ulnar nerve, which does not run deep in this place.

Near the ulnar nerve passes the radial, which can also be affected with prolonged compression, for example, during sleep. Therefore, the clinical picture may simultaneously resemble neuralgia of the radial and ulnar nerves.

Other reasons include any infectious agent, hypothermia, damage to the nervous tissue by toxic substances, including chronic use alcoholic beverages. Special place occupies post-traumatic neuritis.

Also some somatic diseases can cause neuritis. For example, diabetes, insufficient production of thyroid hormone.

Manifestations

In microbial 10, neuritis and neuropathy are not distinguished separately. Both of these conditions are included in the definition of ulnar nerve disease.

Neuritis of the ulnar nerve is manifested by numbness of the arm in the part that is innervated by this nerve. This symptom is short-lived and may be replaced by a tingling or burning sensation in the area. Numbness can be complete or partial and sometimes ends with convulsions.

Also markedly reduced physical activity in the injured arm, up to the onset of paralysis. It is difficult for the patient to bend the arm in the hand, he finds it difficult to bring the fingers to each other. These symptoms are explained not only by a decrease in innervation, but also by a violation of tissue trophism. Further after the adequate treatment I can be residual effects in the form of reduced reflexes or muscle weakness.

Also, malnutrition is manifested by swelling, blue skin, local hair loss and increased fragility of nails. This is due to tissue malnutrition and the treatment of diseases of the ulnar nerve should include measures aimed at eliminating these symptoms.

The pathognomonic symptom is the drooping of the hand, as well as the inability to bend the fingers into a fist. On examination, the hand looks like this: the fourth and third fingers are bent, the little finger is set aside.

If the patient's main symptom is pain and impaired movement, and there are no autonomic disorders, then we can talk about neuralgia of the ulnar nerve. Pain and numbness in most cases is present in the little finger and ring finger.

Diagnostics

In order to diagnose and treat ulnar neuritis, in addition to an external examination and history taking, you can ask the patient to perform a few simple steps.

The patient should press the palm with spread fingers to the surface of the table and try to scratch it with the little finger. A person with inflammation of the ulnar nerve will not be able to do this;
Also, the patient cannot fulfill the request to spread his fingers in different directions;
With inflammation of the ulnar nerve, you cannot fully bend your fist and squeeze a piece of paper with two fingers.

These simple tests help to accurately determine the damage to the nerve. Differential diagnosis must be carried out with a lesion of the radial nerve. If it is damaged, the patient's hand hangs down and cannot be straightened on its own. Also, with neuralgia of the radial nerve, the thumb is brought to the index finger and there is a disorder in the sensitivity of the first three fingers of the hand.

Also, as an additional diagnostic method, electromyography can be performed to determine the degree of muscle damage.

Therapy Methods

Treatment of neuritis of the ulnar nerve can begin with the restoration of fixation of the hand with the help of a plaster splint, while the arm remains in a bent state and is hung behind the neck in a scarf.

Also, treatment should be aimed at eliminating the cause that caused inflammation of the nerve. It is necessary to prescribe antiviral or antibacterial drugs at infectious diseases. In violation of blood circulation and tissue trophism, papaverine is used.

As in the treatment of any disease of the nervous tissue, B vitamins and potassium-sparing diuretics are prescribed to relieve swelling.

A special place in the treatment of neuritis and neuralgia is given to physiotherapeutic restorative procedures. They are aimed at improving the trophism of the nervous tissue and maintaining the tone of the muscles of the forearm and wrist.

From the second week of drug treatment, it is worth prescribing electrophoresis with medicinal substances, UHF and impulse currents.

The doctor must also teach the patient the technique of self-massage, which can be done independently at home. You need to start with rubbing the phalanges of the fingers, flexion and extension movements in the joints of the fingers and hand.

For preventive and restorative purposes, it is desirable to avoid hypothermia, repeated exposure to a traumatic agent. People who work in the office should try to lead a less sedentary lifestyle and introduce active breaks into their lives (a short walk, office gymnastics).

Neuritis refers to diseases of an inflammatory nature, involving the process of the peripheral part of the 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 localization nerve ending It is customary to distinguish neuritis of the ulnar nerve, facial, intercostal, peroneal nerve, 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 enough a large number of 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:

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 the nerves of the peripheral part of the nervous system consist of fibers of sensory, motor and vegetative species. 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 in motor ability. At the core this process lies 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 later. advanced stages. However, pain syndrome is an integral clinical manifestation. different intensity, and 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 is possible to infringe it in certain anatomical areas (musculoskeletal canals) with the development 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. If there is infectious process antibacterial drugs are used, to which sensitive pathogenic flora and antiviral drugs.

If the cause of neuritis is 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, should be added, and biogenic stimulants(lidase).

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. Class 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. Circular movements and finger abductions are also effective.

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.

Why do elbow joints hurt?

Neuritis of the ulnar nerve is an inflammatory process of various etiologies that affects the peripheral nerve fibers and is manifested by pain, numbness, loss of function of the innervated muscles; - treatment is complex and includes medication and physiotherapy.

Etiology

The ulnar nerve leaves the brachial plexus along with the radial nerve, descends down the medial side of the shoulder and passes through the posterior surface of the medial epicondyle to the forearm and hand. It carries nerve impulses to the deep muscles of the flexors of the hand and fingers, is responsible for the work of the muscles of the little finger and brings the index, ring and little fingers to the middle. The most common diseases that affect this nerve are neuritis and neuralgia.

Ulnar neuritis is considered a disease of people who spend most of their time in the office. This is due to the fact that such workers are used to leaning on the elbow and can eventually injure the ulnar nerve, which does not run deep in this place.

Near the ulnar nerve runs the radial, which can also be affected by prolonged compression, for example, during sleep. Therefore, the clinical picture may simultaneously resemble neuralgia of the radial and ulnar nerves.

Other reasons include any infectious agent, hypothermia, damage to the nervous tissue by toxic substances, including chronic alcohol consumption. A special place is occupied by post-traumatic neuritis.

Also, some somatic diseases can cause neuritis. For example, diabetes, insufficient production of thyroid hormone.

Manifestations

In microbial 10, neuritis and neuropathy are not distinguished separately. Both of these conditions are included in the definition of ulnar nerve disease.

There is also a marked decrease in activity.
in the injured arm, up to the onset of paralysis. It is difficult for the patient to bend the arm in the hand, he finds it difficult to bring the fingers to each other. These symptoms are explained not only by a decrease in innervation, but also by a violation of tissue trophism. In the future, after adequate treatment, there may be residual effects in the form of a decrease in reflexes or muscle weakness.

Diagnostics

In order to make a diagnosis of ulnar neuritis
nerve and treat it, in addition to an external examination and anamnesis, you can ask the patient to perform a few simple steps.

The patient should press the palm with spread fingers to the surface of the table and try to scratch it with the little finger. A person with inflammation of the ulnar nerve will not be able to do this;
Also, the patient cannot fulfill the request to spread his fingers in different directions;
With inflammation of the ulnar nerve, you cannot fully bend your fist and squeeze a piece of paper with two fingers.

These simple tests can help pinpoint nerve damage. Differential diagnosis should be carried out with a lesion of the radial nerve. If it is damaged, the patient's hand hangs down and cannot be straightened on its own. Also, with neuralgia of the radial nerve, the thumb is brought to the index finger and there is a disorder in the sensitivity of the first three fingers of the hand.

Also, as an additional diagnostic method, electromyography can be performed to determine the degree of muscle damage.

Therapy Methods

Also, treatment should be aimed at eliminating the cause that caused inflammation of the nerve. It is necessary to prescribe antiviral or antibacterial drugs for infectious diseases. In violation of blood circulation and tissue trophism, papaverine is used.

As in the treatment of any disease of the nervous tissue, B vitamins and potassium-sparing diuretics are prescribed to relieve swelling.

From the second week of drug treatment, it is worth prescribing electrophoresis with medicinal substances, UHF and pulsed currents.