Dupuytren's Contracture Specialist

Georgia Hand, Shoulder & Elbow -  - Orthopaedic Specialist

Georgia Hand, Shoulder & Elbow

Orthopaedic Specialists & Orthopaedic Surgeons located in Atlanta, GA & Marietta, GA

As nerves travel down your arm, they’re vulnerable to compression and irritation, leading to conditions such as cubital tunnel syndrome and radial tunnel syndrome. The orthopaedic physicians at Georgia Hand, Shoulder & Elbow in Atlanta and Marietta, Georgia, are experts at evaluating nerve conditions in your arms. If you have numbness, tingling, or pain in your arms, hands or fingers you need to contact Georgia Hand, Shoulder & Elbow to schedule a complete evaluation and protect yourself from loss of arm function.

Dupuytren's Contracture Q & A

Cubital Tunnel Syndrome - what is it?

The symptoms of cubital tunnel syndrome are caused by compression or irritation of the ulnar nerve at the elbow. The ulnar nerve travels around the inside of the elbow (side closest to your body). The ulnar nerve gives sensation to the little finger, a portion of the ring finger, and the back of the hand on the side towards the little finger. When you "hit your funny bone", you have actually bumped your ulnar nerve. This is one of a group of syndromes called compressive neuropathies. The most common is carpal tunnel syndrome.

The problem can occur without an obvious cause or it can begin after an injury to the nerve. Keeping the elbow bent for a prolonged time (like when talking on the phone) or placing pressure on the nerve can cause the problem.

What are the symptoms?

The most common symptom of Cubital tunnel syndrome is tingling or numbness in the ring and little finger. Some people also have pain on the inside of the elbow or in the forearm. The ulnar nerve controls most of the small muscles in the hand. Because of this, a common symptom is a sense of weakness or slight decrease coordination. In more advanced cases, the muscles in the hand may become visibly smaller (atrophy).

How is it evaluated?

Cubital tunnel syndrome is typically diagnosed by the patient's history and an examination. The nerve at the elbow may be tender or irritated. An assessment of sensation in the hand and fingers can show numbness in the distribution of the ulnar nerve. Muscles controlled by the ulnar nerve may be weak.

There is a test to evaluate the function of the nerve. Your doctor may order it in some cases. Numbness and weakness can also be caused by nerve compression in the neck (sometimes described as having a "pinched nerve"). Therefore your doctor may ask about neck symptoms or order tests to evaluate this.

How is it treated?

The treatment of Cubital tunnel syndrome begins with education. Simply knowing what daily activities contribute to the problem is important in treatment and prevention. At night it is important to avoid having your elbow continuously bent. A soft pad worn on the elbow at night can help keep your arm in an ideal position.

If these treatments are not successful surgery is also an option. The surgery is designed to decrease compression on the nerve as it passes around the inside of the elbow. Your doctor can review the specifics of the procedure in detail with you. The operation is performed as an outpatient procedure. General anesthesia is usually required. Maximum recovery takes several months. Improvement of symptoms is typical, though, not everyone will recover full function of the nerve.

 

Radial Tunnel Syndrome - what is it?

The symptoms of radial tunnel syndrome are caused by compression and irritation of the radial nerve in the forearm. This problem is an example of a group of syndromes called compression neuropathies. The most common is carpal tunnel syndrome.

The area of compression is in the upper forearm and on what is commonly called the top of the forearm (the same side of your forearm as the back of your hand).

This syndrome can be caused by overuse or direct injury to the nerve. However, it is common for the symptoms to develop and an exact cause is not known.

What are the symptoms?

The most common symptom is pain in the upper forearm. The pain may radiate down the forearm to the back of the wrist and hand. Unlike other nerve compression syndromes, numbness and weakness are not common symptoms.

The symptoms may be made worse by use of the hand, wrist, and elbow.

How is it evaluated?

This problem is usually diagnosed by your symptoms and a physical examination. There are certain areas of the forearm which are very specifically tender in radial tunnel syndrome. Also putting stress on certain muscle groups can make the symptoms worse and confirm the diagnosis. It is possible to test the function of the radial nerve. However, this test is not as reliable in radial tunnel syndrome as it is in other nerve compression syndromes. The most reliable information is obtained from your doctor examining you and listening to your symptoms.

How is it treated?

After the diagnosis is made, the first step in treatment is identifying activities which make the symptoms worse so that they can be limited. Protective splinting of the elbow and/or wrist can be helpful. Therapy is often used and includes techniques to decrease inflammation around the nerve.

Surgery is possible to decompress the nerve in the forearm. However, for this syndrome, it is most common to resolve the problem without surgery. You and your doctor will discuss surgery if your symptoms persist in spite of other treatment.