Diseases of the elbow joint - symptoms, causes and treatment features. Ulnar nerve damage (ulnar nerve neuropathy, ulnar nerve neuropathy)

The ulnar nerve is most often affected at the level of the elbow.

The cause is frequently repeated stretching and compression of the nerve. Sometimes compression develops after a fracture.

External compression occurs when the ulnar groove is shallow (with tetraplegia, anesthesia, coma).

Defeat ulnar nerve usually manifests itself as numbness in the little finger and medial surface of the hand, weakness of the hand muscles. Percussion in the elbow area reveals positive symptom Tinnel.

Conservative treatment follows the same principles as for carpal tunnel syndrome. For cubital tunnel syndrome, it is recommended to avoid prolonged flexion of the forearm; immobilization of the elbow joint with a splint at night is indicated. When atrophy of the hand muscles appears, it is indicated surgery.

Symptoms of ulnar nerve neuropathy

The ulnar nerve supplies innervation following muscles: ulnar flexor of the hand (m. flexor carpi ulnaris), deep flexor of the fingers, ulnar part (m. flexor digitorum profundus); adductor muscle thumb(m. adductor pollicis), muscle that abducts the little finger (m. abductor digiti quinti); short flexor of the fifth finger (m. flexor digiti quinti brevis), muscle opposing the fifth finger (m. opponens digiti quinti), short flexor of the thumb (m. flexor pollicis brevis), lumbrical muscles III and IV (mm. lumbricales); interosseous muscles (mm. interossei).

The motor function of the ulnar nerve is to flex the hand and deflect it to the ulnar side; flexion of the proximal and extension of the middle and distal phalanges of the V, IV and partially III fingers; adduction and abduction of fingers; adduction of the first finger.

The territory of sensitive innervation is the ulnar part of the palmar and dorsum of the hand (11/2 fingers on the palm and 21/2 fingers on the dorsum). Deep sensitivity is most impaired in the fifth finger.

Symptoms of damage to the ulnar nerve at different levels. At high defeat ulnar nerve (on the shoulder, compression in the ulnar canal), flexion of the hand is difficult, the hand deviates to the radial side; the adduction of the first finger is weakened and it is retracted outward; difficulty holding objects with fingers I and II; flexion of the proximal and extension of the distal phalanges of the V–IV (III) fingers, adduction and extension of the V, IV fingers are impaired. The predominance of antagonist muscles leads to the formation of a “clawed, bird’s foot” (hyperextension of the proximal phalanges and flexion of the distal phalanges). Atrophy of the interosseous muscles, hypothenar muscles, and muscles in the first dorsal space develops.

Sensory disturbances are recorded on the ulnar side of the palm and the dorsum of the hand and fingers. In these areas, cyanosis, hyperemia, thinning and dry skin, and changes in nails are often detected.

The causes of damage to the ulnar nerve at this level can be bone fractures, joint deformation, dislocation of the nerve, trauma (compression) of the nerve during prolonged work in one position at a desk or at a desk, prolonged bed rest(especially in unconscious), when the nerve is pressed against the bone by the hard plane of the table or the edge of the bed.

The clinical picture of nerve damage in the middle and lower thirds of the forearm is distinguished by the preservation of palmar flexion of the hand.

Compression of the ulnar nerve at the level of the wrist joint appears various syndromes. Ulnar wrist syndrome is characterized by pain and paresthesia in the ulnar part of the hand, hypoesthesia of the fifth finger, weakness of flexion of the fifth (IV) and adduction of the first fingers. Pain can be provoked by palpation, tapping, or applying a cuff.

Neuropathy of the deep branch of the ulnar nerve (pisiform-uncinate tunnel) is manifested only by movement disorders, flexion, abduction and abduction of the fingers, adduction of the first finger, and atrophy of the muscles of the hand are impaired.

Dorsal branch neuropathy (trauma styloid process ulna, pressure from bracelets, handcuffs) is manifested by pain, paresthesia and impaired sensitivity on the dorsum of the V, IV, III fingers.

Study of ulnar nerve function

1. Active movements are assessed - flexion of the hand and fingers.

2. The patient is asked to clench his fingers into a fist - fingers V, IV (III) are not clenched enough. If this movement is prevented, then weakness of the flexors of these fingers is felt.

3. The patient is asked to “scratch” the table with his little finger with the hand tightly fitting - the movement fails.

4. The patient is asked to hold a sheet of paper with straightened fingers I and II. When the doctor tries to pull out the sheet, the distal phalanx of the first finger bends (function median nerve).

5. The patient is asked to bend and adduct the hand. The physician resists movement and feels weakness in the wrist flexors.

6. The patient is asked to, overcoming the doctor’s resistance, adduct the first finger - the adduction force is reduced.

7. The patient is asked to spread and adduct his fingers on a horizontal surface, overcoming the doctor’s resistance.

8. Evaluate appearance brushes (“clawed brush”).

9. Sensitivity is examined: hypoesthesia is recorded along the ulnar edge of the palmar and dorsal surface (5 fingers on the palmar surface and 4 fingers on the dorsal surface).

Consultation regarding treatment using traditional methods oriental medicine (acupressure, manual therapy, acupuncture, herbal medicine, Taoist psychotherapy and other non-drug treatment methods) is carried out at the address: St. Petersburg, st. Lomonosova 14, K.1 (7-10 minutes walk from the Vladimirskaya/Dostoevskaya metro station), with 9.00 to 21.00, no lunches and weekends.

It has long been known that best effect in the treatment of diseases is achieved through the combined use of “Western” and “Eastern” approaches. Treatment time is significantly reduced, the likelihood of disease relapse is reduced. Since the “eastern” approach, in addition to techniques aimed at treating the underlying disease great attention pays attention to “cleansing” of blood, lymph, blood vessels, digestive tracts, thoughts, etc. - often this is even a necessary condition.

The consultation is free and does not oblige you to anything. on it all data from your laboratory and instrumental methods research over the last 3-5 years. By spending just 30-40 minutes of your time you will learn about alternative methods treatment, you will find out How can you increase the effectiveness of already prescribed therapy?, and, most importantly, about how you can fight the disease yourself. You may be surprised how logically everything will be structured, and understanding the essence and reasons - the first step to successfully solving the problem!

Damage to the ulnar nerve (ulnar nerve neuropathy) (G56.2) is pathological condition, in which the ulnar nerve is affected, manifested by disruption of the muscles of the hand responsible for movement ring finger and little finger, numbness in this area.

Etiology of damage to the ulnar nerve: compression of the nerve in the area of ​​the elbow joint ( long work with support on the elbows); fracture of the internal condyle of the humerus or supracondylar fracture; compression in the wrist area; past infections.

Symptoms of ulnar nerve damage

Patients complain of pain in the little finger, tingling sensation, burning sensation in the hand. Gradually, numbness and weakness of the little finger appear, the impossibility of palmar flexion of the hand, and difficulty in adducting and extending the fingers of the hand.

An objective examination of the patient reveals paresthesia, hypoesthesia in the little finger, along the medial surface of the hand (70%). Weakness of the interosseous muscles, adductor pollicis, and hypothenar muscles (70%). Atrophy of the interosseous and hypothenar muscles (50%). Hyperextension in the metacarpophalangeal joints and flexion in the interphalangeal joints (55%). When clenching the hand into a fist, the little and ring fingers do not bend completely (Fig. 3). Pitre's test (inability to bring the fourth and fifth fingers of the hand when the palm rests on a hard surface) - 60%. Flexion of the terminal phalanx of the fifth finger is impossible. In the area of ​​innervation of the ulnar nerve there may be autonomic disorders- cyanosis, impaired sweating, local increase in temperature.

Diagnostics

• Electroneuromyography.
• X-ray or CT scan elbow and/or wrist joint.

Differential diagnosis:

• Damage to the lower part brachial plexus.

Treatment of ulnar nerve damage

Treatment is prescribed only after confirmation of the diagnosis by a medical specialist. Nonsteroidal anti-inflammatory drugs and vitamins are indicated. Physiotherapy, massage, exercise therapy, novocaine and hydrocortisone blockades, and acupuncture are provided. Surgical treatment is prescribed for compression of the ulnar nerve.

Essential drugs

There are contraindications. Specialist consultation is required.

• (non-steroidal anti-inflammatory drug). Dosage regimen: IM - 100 mg 1-2 times a day; after pain relief, it is prescribed orally in daily dose 300 mg in 2-3 doses, maintenance dose 150-200 mg/day.
• (non-steroidal anti-inflammatory drug). Dosage regimen: IM at a dose of 75 mg (contents of 1 ampoule) 1 time/day.
• (vitamin B complex). Dosage regimen: therapy begins with 2 ml intramuscularly 1 time per day for 5-10 days. Maintenance therapy - 2 ml IM two or three times a week.

Neuritis refers to diseases of an inflammatory nature, involving in the process peripheral part nervous system. The disease can affect either one nerve in isolation or 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 considered pain syndrome in places where the nerve ending is localized, a change in the sensitivity threshold, a decrease in strength in the muscles of certain areas of the body.

Ulnar nerve neuritis is quite striking a large number of of people. Among all neuritis, damage to this nerve is in second place.

Predisposing factors to the occurrence of neuritis

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

Clinical manifestations of ulnar nerve 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 sensory, motor and autonomic fibers. As a result, the following symptoms are observed:

1. Changes in sensory sensations, which may manifest as numbness, paresthesia (tingling or goosebumps), increased sensitivity threshold or complete loss of tactile perception;
2. Change 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. 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.
3. Vegetative disorders with trophic changes, manifested by the appearance of swelling, blue discoloration skin, local hair loss, depigmentation, increased sweating, brittle nails and the appearance of trophic ulcers.

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

Elbow neuritis will include symptoms such as paresthesia and decreased sensitivity palmar surface brushes on the area of ​​half of the 4th and full of the 5th fingers. In addition, half of the 3rd and the entire 4th and 5th fingers are affected on the dorsal surface.

The disease is also characterized by weakness of the adductor and abductor muscles of the 4th and 5th fingers. Further, hypotrophy or atrophy of the muscles that elevate the little finger and thumb, and the interosseous, lumbrical muscles of the hand may develop. As a result atrophic processes the palm looks flat.

The hand with ulnar nerve neuritis looks like a “clawed paw”, since the joints on both sides of the middle digital phalanges are bent, and the rest are straightened.

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

Diagnostic criteria for ulnar nerve neuritis

To diagnose the disease, certain tests specific to ulnar nerve 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 the 3rd fingers will not be able to fully bend to form a fist;
• if you press your hand tightly against a flat surface, for example, a table, then it is impossible to make scratching movements on this surface with your little finger;
• in addition, in this position there is no possibility to spread and adduct the fingers, especially the 4th and 5th;
• an attempt to hold the paper straight with the 1st finger ends in failure, since flexion of the distal phalanx is not observed. As a result of damage to the median nerve, innervated by the long flexor of the 1st finger, this function is unavailable.

Therapeutic tactics for ulnar nerve neuritis

The main direction in treating the disease is to identify the cause and eliminate it in the near future. If available infectious process are used antibacterial drugs to which you are sensitive pathogenic flora, and antiviral drugs.

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

At traumatic genesis Ulnar nerve neuritis requires mobilization of the limb. To reduce activity inflammatory process non-steroidal anti-inflammatory drugs are used - indomethacin, diclofenac. For severe pain, analgesics are used.

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

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

In addition, massage has proven its effect and physiotherapy, thanks to which restoration of groups of affected muscles is observed. Physical exercises should begin on the second day after fixing the limb with a bandage. Before this, it is recommended to do gymnastics in water.

The massage consists of massaging each phalanx of the fingers, starting with the thumb. 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 occurs as a result of its compression in the musculoskeletal canal with the development of tunnel syndrome, then it is advisable to use local administration of drugs directly into this canal. In this case, hormonal and painkillers 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 of which surgical intervention is recommended. It is based on suturing the affected nerve, and in more advanced forms, its plastic surgery.

Thus, with correct timely diagnosis and effective treatment Ulnar nerve neuritis has a favorable outcome. Treatment and rehabilitation generally take more than two months. In the future, to prevent recurrent damage or neuritis of another nerve, it is recommended to avoid injuries, hypothermia and monitor the condition of concomitant pathology.

Why do elbow joints hurt?

Ulnar nerve neuropathy is a lesion of the ulnar nerve, as a result of which its function is impaired, which affects sensitivity in the hand area and causes a decrease in the strength of individual muscles of the hand. There are quite a few reasons that cause this condition. There are places along the arm along the ulnar nerve where it is most often subject to compression. Compression in these areas even has separate names: cubital canal syndrome, Guyon's canal syndrome. Each of these syndromes has its own clinical features, but all of them belong to the category of ulnar nerve neuropathy. From this article you will learn about the reasons why clinical features ulnar nerve neuropathy various levels lesions, methods of its treatment.

It is difficult to understand the uniqueness 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 on the course of the ulnar nerve fibers.

The ulnar nerve is a long nerve of the brachial plexus. It consists of fibers C VII -C VIII (7th and 8th cervical) roots, which exit 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 osteo-fibrous canal formed by the internal epicondyle of the shoulder, the olecranon process of the ulna and the supracondylar ligament, the tendon of the flexor carpi ulnaris. This canal is called cubital (Mouchet canal). It turns out that in this place the nerve is located quite superficially and at the same time close to the bone formations. This circumstance determines high frequency compression of nerve fibers in this place. Everyone who has hit their elbow at least once has experienced this peculiarity. surface location ulnar nerve. You can even feel it in this place.

After leaving the canal, the ulnar nerve follows between the muscles of the forearm (at the same time giving part of the branches to the muscles). At the border of the lower and middle third of the forearm, the nerve is divided into the dorsal branch of the hand (which innervates the skin of the dorsal part of the fourth, fifth and ulnar part of the third fingers) 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 and the palmar ligament of the wrist. The ulnar nerve is also often subject to compression at this location. The palmar branch of the ulnar nerve innervates the muscles of the hand and the skin of the palmar surface of the fifth and ulnar half of the fourth finger.

Knowledge of the topographical features of the nerve course helps in diagnosing its lesions. For example, if muscle weakness innervated by the ulnar nerve is detected in the area of ​​the hand and forearm, 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 damage is located at the level of Guyon’s canal . The level of damage is important if the need arises surgical treatment.

Causes of ulnar nerve neuropathy

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 by compression. Nerve compression does not have to be acute or 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 area of ​​the cubital canal, compression is provoked by:

• frequently repeated flexion movements in the elbow joint;
• work related to resting your elbows on a machine, desk, workbench;
• drivers’ habit of putting 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 applies more to women, since they like to chat for a very long time with their friends);
• long-term intravenous infusions when the arm is fixed in an extended position for a significant period of time (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 in the area of ​​Guyon's canal is called ulnar carpal syndrome. This condition is provoked by:

• regular work with tools (screwdrivers, pliers, forceps, vibrating tools, including jackhammers, etc.), that is, these are professional issues. Of course, using pliers or a screwdriver just a few times will not cause damage to the ulnar nerve. There may be compression of the nerve in this area in violinists;
• constant use of a cane;
• Frequent riding of a bicycle or motorcycle (during professional sports using these vehicles).

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

Symptoms of ulnar nerve neuropathy

When a nerve is damaged, its functions are first disrupted, that is, sensory (including pain) and motor (related to muscle strength) problems appear. Sensory disturbances usually occur first, and decreased muscle strength develops as nerve compression continues. For fractures, dislocations and other “acute” causes of ulnar nerve neuropathy, sensory and movement disorders arise simultaneously.

Cubital tunnel syndrome

Symptoms indicating damage to the ulnar nerve in this area are:

• pain in the area of ​​the ulnar fossa (inner surface of the elbow joint), which spreads to the forearm, IV and V fingers (both palm and back), to the ulnar edge of the hand (adjacent to the little finger). In these same areas, paresthesia may occur: tingling sensations, crawling, burning, twitching, and so on. At first, the pain is periodic, intensifies at night, and is provoked by movements in the elbow joint (flexion is more to blame). Gradually, the pain begins to bother you constantly and increases in intensity from discomfort to very severe pain;
• decreased sensitivity along the ulnar edge of the hand, in the area of ​​the little finger and ring finger. Moreover, there is one peculiarity - the very first sensitivity changes in the area of ​​the little finger;
• somewhat later (compared to sensory disorders) motor disorders occur. Muscle weakness manifests itself as difficulty in flexing and abducting the hand to the ulnar side, impaired flexion of the little and ring fingers, and when trying to clench the hand into a fist, the fourth and fifth fingers are not pressed against the palm. If you place your palm on the table and try to scratch the table with your little finger, then in case of ulnar nerve neuropathy this will not be possible. The fingers cannot be brought together and spread apart;
• with long-term compression of the ulnar nerve, atrophy of the hand muscles develops. The hand becomes thinner, the bones protrude more clearly, and the spaces between the fingers sink. However, the rest of the arm and the opposite hand look completely normal;
• the hand takes on the appearance of a “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 carpal syndrome)

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

• sensory disorders: pain and paresthesia of the wrist joint, the palmar surface of the ulnar edge of the hand and the 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 pain and paresthesia intensify at night and with hand 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 fourth and fifth fingers, they cannot be completely pressed to the palm, difficulty in spreading and bringing the fingers together, it is not possible to bring the thumb to the palm;
• the brush can take on a “clawed” (“bird-like”) shape;
• When the process persists for a long time, muscle atrophy develops and the hand loses weight.

Individual fibers of the ulnar nerve may be subject to compression in Guyon's canal. And then the symptoms can occur in isolation: either only sensory disturbances, or only motor ones. In the absence of an application for medical care and the treatment inevitably begins to subject the entire nerve to compression, and then the symptoms will be mixed.

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

If the ulnar nerve is damaged in any part of its course, in addition to the above two syndromes, then the symptoms of this condition will also be similar sensory and movement disorders. Fracture humerus, bones of the forearm with compression of the ulnar nerve by bone fragments will manifest itself as pain in the area of ​​the ulnar part of the forearm, hand and IV, V fingers, weakness in flexion of the hand, ring finger, little finger, abduction and extension of all fingers of the hand. In case of fractures or dislocations, it is somewhat easier to identify damage to the ulnar nerve, since the cause of such symptoms is obvious.

Diagnostics

To establish the diagnosis of ulnar nerve neuropathy, it is necessary to conduct a neurological examination with a tapping test. 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 where they exit the spinal cord and vertebral foramina, although clinical symptoms may resemble ulnar nerve neuropathy) . Diagnosis of ulnar nerve neuropathy is not particularly difficult if the doctor is attentive to the existing symptoms.

Treatment of ulnar nerve neuropathy

The approach to the treatment of ulnar nerve neuropathy is determined, first of all, by the cause of its occurrence. If the disease occurs as a result of a fracture of the arm bones with traumatic injury nerve fibers, then surgical intervention may be immediately required to restore the integrity of the nerve. If the cause lies in long-term and gradual compression of the ulnar nerve, then first they resort to conservative methods of treatment and only if they are ineffective, surgical treatment is performed.

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

When a nerve is compressed in the area 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 products can be used only at night to reduce everyday difficulties that arise due to hand fixation. It is necessary to change the motor pattern, that is, if there is a habit of leaning your elbows on the table during office work or telephone conversations or if you put your hand on the glass of a car while driving, you need to get rid of it. You should also avoid movements that increase nerve compression.

From medications first 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. For pain relief, you can use a lidocaine patch (Versatis) topically. For decongestant purposes, diuretics (Lasix), L-lysine escinate, Cyclo-3-fort can be used. B vitamins (Neurorubin, Neurovitan, Combilipen, Milgamma) have some analgesic and trophic effect. To improve nerve conduction, Neuromidin is prescribed.

If immobilization and non-steroidal anti-inflammatory drugs do not have an effect, then an injection of hydrocortisone with an anesthetic is resorted to in the area where the nerve is compressed (Guyon's canal or cubital canal). Usually this procedure has a good healing effect.

Physiotherapy is widely used in the treatment of ulnar nerve neuropathy. Ultrasound, electrophoresis with various drugs, electrical muscle stimulation is the most commonly used procedure. Massage and acupuncture are effective. Physical therapy plays an important role in helping to restore muscle strength.

However, sometimes if you seek medical help late, you can restore normal work it is not possible to treat the ulnar nerve using only conservative methods.
In such cases, surgical intervention is resorted to. The essence of surgical treatment is to release the ulnar nerve from compression. In case of cubital tunnel syndrome, this can be plastic surgery of the canal, creating a new canal and moving the ulnar nerve there, removing part of the epicondyle; in Guyon's canal syndrome, this can be a dissection of the palmar carpal ligament above the canal. Using these methods, the nerve is released, but this alone is not enough to fully restore function. After a successful operation, you must use medications(vitamins, agents that improve nerve trophism and conductivity, decongestants, painkillers), physiotherapeutic methods and physical therapy. It may take 3 to 6 months to fully restore ulnar nerve function. In advanced cases, when medical help was sought very late and there is severe muscle atrophy, full recovery impossible. Some motor and sensory disorders may remain with the patient forever. Therefore, you should not hesitate to consult a doctor if you experience symptoms indicating possible neuropathy ulnar nerve.

Thus, ulnar nerve neuropathy is a pathological condition that occurs as a result of a number of reasons. Main clinical symptoms diseases are pain, sensory disturbances and muscle weakness in the area of ​​the ulnar edge of the hand and IV, V fingers of the hand. Ulnar nerve neuropathy is treated conservatively and surgically. The choice of treatment depends on the cause of the neuropathy and individual characteristics course of the disease. Success in treatment is largely determined by the timeliness of seeking medical help.

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

Elbow is complex joint, which is a connection of three bones. Because of this, and also because it is often exposed to a lot of stress, there are many diseases that affect it. Diseases of the elbow joint do not pose a threat to the patient's life, but can cause him a lot of inconvenience and suffering.

What diseases affect the elbow

Many people are bothered by pain in the elbow joint. Some try to remove them with pills or folk remedies, believing that they simply overworked themselves. But there are diseases that, without proper treatment lead to serious complications. Therefore, it is advisable, if your elbow hurts, to consult a doctor for a diagnosis. correct diagnosis. The following diseases may occur in this area:

• due to degenerative changes Osteoarthrosis, osteochondrosis, gout, chondrocalcinosis develop in cartilage and bone tissue;
• inflammatory diseases (arthritis, tendinitis, bursitis, epicondylitis, fasciitis);
• cubital tunnel syndrome, neuritis and nerve root damage due to other diseases;
• various injuries of the elbow joint.

What is epicondylitis

This inflammatory disease resulting from intense physical activity. It occurs in athletes, in those who perform monotonous hard work. This disease occurs most often in people over 35 years of age, but young people can also suffer from it, for example, after an injury. And old people and patients with osteoporosis encounter epicondylitis even after light exertion.

Inflammation and pain in the elbow can occur in representatives of the following professions:

• massage therapists;
• carpenters;
• tennis athletes, golfers, weightlifters and others;
• artists and painters;
• agricultural workers.

Inflammation and pain in the elbow can occur due to damage to the muscles and ligaments

Epicondylitis is characterized by damage to the muscles and ligaments, usually in one arm, which is subject to heavy loads. Unlike other diseases of the elbow joint, it is characterized by the following features:

• the elbow hurts only with exertion, nothing bothers the patient at rest;
• pain mainly occurs when bending or straightening the joint;
• Muscle tone decreases, the hand cannot hold certain objects;
• the appearance of the joint does not change;
• Pain rarely occurs at night.

Often the disease becomes chronic form, periodically worsening after exercise. It can radiate to the forearm and even the hand. If long time not carried out necessary treatment, inflammation of the ligaments can spread to other tissues and cause, for example, bursitis.

Inflammatory diseases of the elbow joint

If inflammation develops in or near the joint, this can be understood by the following symptoms:

• swelling and redness of soft tissues;
• strong It's a dull pain, independent of physical activity and often occurring at night;
• limitation of hand mobility.

Bursitis is an inflammation of the olecranon process, it can be recognized by the formation of a lump on the elbow

Depending on where the inflammation is localized, several diseases of the elbow joint can be distinguished.

• Olecranon bursitis occurs most often on one arm. Its cause may be a traumatic effect on the outer part of the joint. After bruises and constant pressure on the elbow, the synovial bursa of the joint becomes inflamed. The disease can be recognized by the formation of a painful tumor in this place.
• Arthritis most often affects both elbow joints. The disease usually occurs suddenly, swelling develops, and pain appears. It gets worse in the morning. Most often this place is affected rheumatoid arthritis related to the violation immune system. In this case, the disease develops gradually and becomes chronic.
• Elbow tendinitis is an inflammation of the tendons. It often occurs as a complication of other diseases.

What is cubital tunnel syndrome?

The main ulnar nerve passes through the joint cavity. Sometimes it gets pinched between the tissues of bones and ligaments. This occurs due to injury or after periodic compression of the nerve during physical activity.

The most common causes of carpal tunnel syndrome are incorrect arm position when working at a computer, prolonged use of armrests when driving a car, or working at a machine. This neuropathy can occur when tissues become swollen due to an inflammatory disease.

Symptoms of the disease are “shooting” pain, which often spreads to the entire forearm, numbness and tingling in the fingers. Weakness or atrophy of the hand muscles is often observed. The patient cannot hold objects or clench his fingers into a fist. Numbness and paresis can affect almost half of the hand on the little finger side. In some cases, the hand resembles a clawed paw because the fingers are forced to spread out.

The disease is difficult to treat and surgery is often required. Conservative therapy possible on early stages when sensitivity is not yet impaired. NSAIDs are used, drugs that relieve swelling, improve metabolism and blood circulation. An important component of treatment is physical therapy; excessive stress on the joint must be avoided.

Often carpal tunnel syndrome leads to complete loss hand performance. Therefore, it is important to follow measures to prevent nerve pinching: avoid prolonged exposure of the elbow area to objects, and regularly perform exercises to strengthen the muscles.

Elbow pain may be due to damage to the muscles, ligaments, or ulnar nerve.

What other diseases affect the elbow joint?

1. Very rarely, the elbow is affected by arthrosis, only if degenerative processes in a late stage have affected all the joints of the body. This most often happens in old age. For arthrosis, volume synovial fluid decreases, ligaments and cartilage tissue. Therefore, during movement, pain, stiffness occurs, deformation is noticeable, and a crunching sound is heard.
2. Chondrocalcinosis is characterized by the deposition of calcium salts in the joint. Conventional treatment for such a disease it is ineffective, it can only relieve symptoms. Crystals can only be removed by washing the joint cavity.
3. Gout rarely affects the elbows, but it does happen. This is a disease of salt deposition uric acid which cause severe pain, swelling and redness.
4. Pain in the joints of the hands can be caused by diseases and injuries of the spine, which damage nerve fibers. These could be fractures, hernias, osteochondrosis. As a result of these diseases, the biceps muscle atrophies and mobility in the elbow joint is impaired.

Joint injuries

These are the most severe lesions elbow. They are often accompanied by damage to nerves and blood vessels. These may be bruises, dislocations of the elbow joint, fractures of the bones that make it up, rupture or sprain of tendons and muscles. All diseases associated with injuries cause severe pain, especially when moving, often there are joint deformities, tissue swelling, and hematoma.

Even after ordinary elbow bruises, complications are possible. Fluid can accumulate in the joint and arthrosis develops. Sometimes the function of muscles and ligaments is impaired, and it is very difficult to restore them completely.

Statistically, the most common injury upper limbs- This is a dislocation of the elbow joint. It happens because it is the most complex joint formed by three bones. They are all quite thin, so a dislocation is always accompanied by a fracture of one of them. This often causes damage to ligaments, muscles and nerves.

Elbow joint injuries cause severe pain, swelling and hematoma

Treatment

Common symptoms of all diseases of the elbow joint are pain, stiffness in movement, and sometimes swelling. Therefore, the treatment is basically the same. It should be aimed at reducing inflammation and pain, restoration of mobility and regeneration of damaged tissues. Elbow joint diseases can be treated using the following methods:

• A cold compress or ice can help relieve pain and swelling. It should be applied for no more than 30 minutes.
• Ensuring joint immobility. If this is difficult to do, you need to use an elastic bandage or a special orthosis.
• The use of ointments and creams with anti-inflammatory and chondroprotective effects. This could be Nise, Voltaren, Diclofenac, Nimesulide. NSAIDs can also be taken orally.
• For many diseases, medications are prescribed that improve blood circulation, restore bone tissue, normalizing metabolism. Injections of B vitamins are given and medications containing calcium are taken.
• Physiotherapeutic procedures are also effective. Ultrasound, Bernard currents, phonophoresis, UHF, paraffin applications, massage, exercise therapy. Usually a course of 10 procedures is prescribed; in difficult cases, an individual treatment program is drawn up.

In addition to these methods of therapy, it is necessary to carry out special treatment elbow disease that was diagnosed in the patient. For injuries, this is immobilization; for inflammation, NSAIDs, antibiotics, and other drugs are also prescribed. Treatment is selected individually, depending on the characteristics of the patient’s condition.

An anti-inflammatory ointment will help relieve pain in the elbow joint

Traditional methods of treatment

Joint pain can be relieved with folk recipes. But they can only be used in addition to the main treatment prescribed by the doctor. Which methods are the most effective:

• you can make baths with sea ​​salt or pine decoction;
• rub the joint with tinctures of propolis, Kalanchoe or elecampane;
• make compresses with blue clay;
• rub your elbow with a mixture of honey and apple cider vinegar;
• apply applications with celandine juice;
• take orally decoctions of dandelion, calendula, cinquefoil, St. John's wort, chamomile;
• A compress of grated potatoes relieves pain well.

Diseases of the elbow joint cause serious inconvenience, as they hinder movement and cause pain. To avoid this, you need to eat right, protect your elbow from injury and treat inflammation in a timely manner.