What is nerve compression of the elbow?
The ulnar nerve extends from the shoulder to the hand on the inside of the elbow. It is responsible for ensuring that you have feeling in the little finger, on the side of the ring finger facing the outer edge of the hand and in the outer edge of the hand. It also ensures that you can activate the muscles of the ball of the thumb and the back of the hand. This gives you access. The ulnar nerve runs through a bony canal that is spanned by a band of connective tissue, creating a kind of tunnel, the so-called cubital tunnel. There are three critical points on its path from the shoulder to the hand. This can lead to nerve compression of the elbow, also known as sulcus ulnaris syndrome or cubital tunnel syndrome, because various structures constrict the nerve:
- The first point is above the elbow. There the nerve runs through a cord of connective tissue, the “Struthers arcade”. If this cord is thickened, the nerve can suffer pressure damage.
- The second point is exposed on the inside of the elbow. Here the ulnar nerve passes through the bony groove on the inner upper arm, the actual ulnar sulcus. The region is also known as the Musician’s Bone, commonly called “Mäuschen”. You probably know the pain when you bump into something.
- The third site is most frequently affected by constriction. It is the area where the ulnar nerve enters your forearm muscles.
If the nerve cannot run freely in the cubital tunnel, pressure acts on it at the constricted point. This results in discomfort, tingling and numbness in the areas of the hand supplied by the ulnar nerve. If the pressure persists, this will impair the motor skills of your hand.
Nerve compression at the elbow: Causes and risk factors
As the ulnar nerve runs relatively superficially through your arm, this makes it susceptible to external interference. Nerve compression at the elbow is therefore often caused by local pressure damage to the nerve in the bone groove. However, experts are often unable to clearly identify the reasons for the narrowing and damage.
Possible causes are:
- Changes to the elbow after fractures.
- Osteoarthritis of the elbow joint, which causes bone spurs to form.
- Inflammatory changes, e.g. due to rheumatoid arthritis.
- Chronic pressure damage to the nerve if you frequently rest your elbow on a hard surface, such as a table.
- Stress caused by intensive use of the arm, for example when pitching in baseball.
- Hardening of the connective tissue band, which therefore narrows the nerve canal.
You cannot avoid many of the risk factors for nerve compression at the elbow. All you can do is make sure that you do not rest your arms on a hard surface for long periods and avoid sports that put strain on the elbow joint.
Symptoms: Tingling, numbness, grip disorders in the hands
The narrowing of the cubital tunnel mainly causes symptoms in your hand:
- You feel discomfort, tingling, falling asleep on the outer edge of the hand, the little finger and on the side of the ring finger facing the little finger. Initially, these symptoms only occur with certain movements or when external pressure is applied to the nerve. However, if the constriction of the nerve tract persists, the discomfort remains.
- If the compression of the ulnar nerve persists, your hand will lose strength. You feel this restriction when writing, when you want to open the screw cap of a bottle or even when you spread your fingers.
- Over time, the muscles in the hand atrophy. A so-called claw hand is formed.
- Most sufferers also have pain in the hand, forearm and elbow.
If the disease progresses, the symptoms can lead to incapacity to work.
Nerve compression on the elbow: Diagnosis with us
We will first ask you about your complaints, when and where exactly the problems occur. It is typical that your little finger repeatedly falls asleep and that your hand becomes weaker and weaker in the later stages. If, according to your description, you suspect nerve compression at the elbow, an electrophysiological examination can confirm this. We measure how well the nerve still conducts the electrical impulses (NLG). The examination objectively determines whether there is a constriction or conduction disorder of the nerve and how severe it is. If we suspect that a joint spur, a ganglion or a degenerative change in the elbow joint (caused by osteoarthritis, for example) is causing cubital tunnel syndrome, we can perform an X-ray or ultrasound examination.
Nerve compression at the elbow: Prevention, early detection, prognosis
The only way to prevent a narrowing of the cubital tunnel is to avoid strain caused by one-sided movements or resting the elbow on a hard surface for long periods.
Early detection is possible if you visit us at the first signs of numbness on the outside of the hand, the little finger and the side of the ring finger facing it.
The prognosis for treatment of nerve compression of the elbow depends on how far the nerve has already been damaged. If there is no irreversible damage, the prognosis is relatively good. Discomfort such as tingling under the skin disappears relatively quickly. However, more severe sensory disorders often take a very long time to improve. As a rule of thumb, you can assume that the nerve recovers about 1 mm per day from its constriction point to the fingers. It is therefore not surprising that you can observe improvements in nerve function for up to a year or even longer.
Nerve compression at the elbow: Treatment by surgery
Nerves are sensitive structures. If the pressure on the ulnar nerve has been present for too long, its function may be irreparably impaired. Then, in addition to the sensory disturbances, there is an increasing weakening of the hand muscles. In the early stages, when the symptoms and electrophysiological changes are only minor, conservative therapy can help.
