Ulnar nerve neuropathy what exercises. Symptoms, diagnosis and treatment of ulnar nerve neuritis

Neuropathy ulnar nerve– this is a lesion of the ulnar nerve, as a result of which its function is disrupted, 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 gain information about the causes, clinical features of ulnar nerve neuropathy at various levels of damage, and methods of its treatment.

A little anatomy

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 brachial plexus. It consists of fibers C VII -C VIII (7th and 8th cervical) roots, which come out of 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 osteofibrous canal formed by the internal epicondyle of the shoulder, the olecranon process 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. Anyone who has hit their elbow at least once has experienced this peculiarity of the superficial location of the 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 topographical features the course of the nerve 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, 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, 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. With fractures, dislocations and other “acute” causes of ulnar nerve neuropathy, sensory and motor disturbances occur 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 unpleasant sensations to very pronounced 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 area wrist joint, palmar surface of the ulnar edge of the hand and palmar surface of the little finger and ring finger. The back of the hand does not experience such sensations (which distinguishes this syndrome from cubital tunnel syndrome). Both 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 in flexion of the fourth and fifth fingers, they cannot be fully pressed to the palm, difficulty spreading and bringing the fingers together, it is impossible to bring thumb to the palm;
• the brush can take on a “clawed” (“bird-like”) shape;
• with the long-term existence of the process they develop muscle atrophy, the hand is losing 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 damage to the 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 resting your elbows on the table during office work or telephone conversations, or placing your hand on the window in the car when driving, then 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, they resort to surgical intervention. 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 that indicate possible ulnar nerve neuropathy.

Thus, ulnar nerve neuropathy is pathological condition arising as a result of a number of reasons. The main clinical symptoms of the disease are pain, sensory disturbances and muscle weakness in the area of ​​the ulnar edge of the hand and IV, V fingers 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 of peripheral nerves. Clinic, basics of diagnosis and treatment” (from 5:45):

Lesions of different etiologies n. ulnaris, accompanied by a violation of its sensory and motor functions. It manifests itself as weakness when trying to clench your hand into a fist and hold objects with your hand, lack of sensitivity in the skin of the fifth and partially fourth fingers, atrophy of the hypotenor and small muscles of the hand, appearance brushes, similar to a clawed paw. Diagnosis of ulnar neuropathy relies on the results of neurological examination, electrophysiological testing, and x-rays of bones and joints. Therapeutic tactics are built taking into account the genesis of neuropathy and can include both medication and physiotherapeutic methods, as well as surgical treatment.

General information

Ulnar nerve neuropathy is a fairly common lesion of the peripheral nervous system. It often accompanies injuries to the elbow joint, and therefore occurs not only in the practice of neurologists, but also in the field of traumatology.

The anatomical location of the ulnar nerve is such that the most vulnerable place is its section, localized in the area of ​​the elbow joint in the so-called. cubital (ulnar) canal. The symptom complex of compression of the ulnar nerve in this canal is called cubital tunnel syndrome in neurology. Among all neuropathies of compression origin, it ranks second (the first belongs to carpal tunnel syndrome, one of the variants of median nerve neuropathy).

Anatomy of the ulnar nerve

The nerve originates in the medial fascicle (C7-C8, Th1) of the brachial plexus. Without giving up branches, it passes along inside shoulder, then passes to its posteromedial surface. In the area of ​​the elbow joint it runs along the posterior surface of the internal epicondyle of the shoulder, where it is actually subcutaneous. Then it enters the cubital canal formed by the olecranon process, internal epicondyle, ligament and tendons of the forearm muscles.

Elbow to wrist n. ulnaris runs along the medial edge of the inner surface of the forearm. Here it gives motor branches to the medial portion of the flexor digitorum muscle and the flexor carpi ulnaris muscle. At the head of the ulna, the nerve gives off a dorsal branch that innervates the skin of the ulnar side of the dorsum of the hand, back surface V, IV and partially III fingers. Moving to the palm, n. ulnaris is divided into superficial and deep branches. The first is responsible for sensory perception of the skin of the little finger and the half of the ring finger facing it. The second is for the innervation of the hypotenor muscles and small muscles of the hand, as well as the joints, ligaments and bones of the hand. After originating from the ulnar nerve, the deep branch passes through Guyon's canal, located between the pisiform bone and the metacarpal palmar ligament.

Causes of ulnar nerve neuropathy

The most common mechanisms for the development of ulnar neuropathy are traumatic injury to the nerve and its compression in the cubital canal. Nerve injury may be accompanied by: arm bruise, forearm dislocation, supracondylar fracture of the shoulder, fracture of the medial condyle of the shoulder, fracture of the forearm, isolated fracture of the ulna or fracture of the olecranon, dislocation of the hand. Cubital tunnel syndrome often occurs in people who are accustomed to resting on their elbow. For example, resting your elbow on a desk, a machine, the side of a car door, etc.

Compression of the nerve in the cubital canal and Guyon's canal is possible with inflammatory or anatomical changes structures that form these channels. Thus, compression neuropathy of the ulnar nerve can be observed with osteoma, sprain, synovitis, tendovaginitis, deforming osteoarthritis, rheumatoid arthritis, osteodystrophy, bursitis of the elbow joint, post-traumatic arthrosis of the wrist joint and other diseases. Work associated with prolonged pressure of instruments (screwdriver, hammer, scissors, forceps, etc.) on this area can provoke ulnar neuropathy at the level of Guyon’s canal.

Symptoms of ulnar nerve neuropathy

Defeat n. ulnaris at the level of the cubital canal is characterized by weakness in the hand, which manifests itself when trying to pick up something in the hand (for example, lift a kettle from the stove), play the piano, type on the keyboard, etc. Sensory disturbances are manifested by a feeling of numbness in the little finger, partially in the ring finger and the ulnar edge of the palm. Typically there is a feeling of discomfort in the area of ​​the elbow joint, often pain in it, radiating into the hand along the ulnar edge of the forearm. Often, an increase in the listed symptoms is observed in the morning, which is associated with the habit of many patients to sleep with their hands under the pillow or under the head, which means bending them at the elbow joints.

On examination, attention is drawn to the hypotrophy of the hypotenor and small muscles of the palm, the position of the fingers in the form of a clawed paw (the main phalanges are in extension, and the middle ones are bent).

Ulnar neuropathy in Guyon's canal has similar manifestations. The difference is localization pain syndrome only in the area of ​​the base of the hand and hypotenor, the presence of sensory disorders exclusively on the palmar surface of the little finger and half of the ring finger with complete preservation of the sensitivity of the dorsum of the hand.

Diagnosis of ulnar nerve neuropathy

IN acute period ulnar nerve neuropathy important point is the exclusion/limitation of static and dynamic loads that enhance pathological manifestations diseases. For patients suffering from cubital tunnel syndrome, to limit flexion of the arm at the elbow during night sleep, it is recommended to bandage a rolled towel to the flexor surface of the elbow. Subsequently, when the inflammatory process subsides and the pain syndrome decreases, a special exercise therapy complex is prescribed.

IN Lately All more people are faced with a pathology such as ulnar nerve neuritis. This disease is inflammatory process, affecting peripheral nerve fibers. And the ulnar nerve, which runs very close to the skin, is easily injured during normal activities. As a result, there are severe pain, the performance of the hand and the sensitivity of the hand may be impaired. Treatment of neuritis should begin as early as possible, when the first symptoms appear.

general characteristics

Ulnar nerve neuritis is statistically the most common among similar diseases. After all, this nerve is the most vulnerable to external influences. Especially with the modern lifestyle, when people spend a lot of time leaning on their elbows. The ulnar nerve runs shallow in this area, so it is easily damaged. After all, even slight pressure on it can lead to inflammation.

Office workers, programmers and other people whose professional activity associated with the need to rest your elbows on the table or armrests of a chair. In addition, neuritis is common in athletes who expose their hands to increased loads. But besides traumatic injury, the cause of inflammation may be hypothermia. Therefore, builders, loaders and other people who work in damp, cold conditions are susceptible to neuritis.

Causes

To properly treat this disease, it is necessary to determine why the inflammation occurred. Usually the cause of the pathology is immediately clear, especially if the neuritis is post-traumatic or occurs after hypothermia.

But there are other factors that can cause inflammation of the ulnar nerve:

• serious infectious and inflammatory diseases - measles, diphtheria, influenza, herpes;
• endocrine pathologies, especially dysfunction thyroid gland or diabetes;
• osteochondrosis or hernia intervertebral disc;
• lack of minerals and vitamins in the body;
• cardiovascular pathologies leading to poor circulation;
• intoxication as a result of ingestion large quantity certain medications, alcohol or salt poisoning heavy metals;
• arthritis, arthrosis and other diseases of the elbow joint.

The main signs of ulnar nerve neuritis are pain and numbness in the hand

Symptoms

The ulnar nerve is responsible for the innervation of the little and ring fingers, for the work of the muscles that adduct the pollicis, flex the wrist, and adductor and abductor all fingers. Therefore, its defeat immediately affects the functioning of the hand. Manifestations of neuritis depend on the degree and localization of the inflammatory process. But the main symptom is always pain. At first it is aching, then it can become sharp, even burning or shooting.

Other symptoms of ulnar nerve neuritis depend on which nerve fibers are most affected. The disease usually begins with a loss of sensitivity.

Damage to sensory fibers is manifested by numbness, a tingling or crawling sensation. Sometimes the sensitivity of the hand is completely impaired. But most often these sensations are localized in the palm of the hand, as well as the 4th and 5th fingers.

Then signs of damage to the motor fibers of the nerve develop. Convulsions may occur and finger movement functions may be impaired. It is especially difficult to bend your hand or clench your fingers into a fist. Tendon reflexes gradually disappear, and paresis or complete paralysis of the hand appears. Because of this, muscle atrophy develops after some time.

In the absence of treatment, trophic disorders gradually appear. Due to damage to the autonomic nerve fibers, swelling develops, the skin turns blue, hair may begin to fall out, and nails may crumble. In the most advanced cases appear trophic ulcers.

Diagnostics

It is advisable to begin treatment of neuritis as early as possible, when the first signs of inflammation appear. Indeed, as the pathology progresses, atrophy of the hand muscles and complete loss of its functions are possible. Usually, a specialist can immediately determine the presence of neuritis, since the hand has a characteristic shape - like a clawed paw. The little finger is moved to the side, the 3rd and 4th fingers are bent.

To diagnose the disease, there are several tests that will help make a preliminary diagnosis without examination. The patient is asked to place the hand on the table and move the little finger, and also try to spread the fingers to the side. If the ulnar nerve is damaged, this cannot be done. The patient also cannot keep between the big and index fingers sheet of paper, and also clench the brush into a fist.

But it is still necessary to conduct an examination to confirm the diagnosis. Most often, MRI, ultrasound and electromyography are prescribed, which help determine the extent of muscle damage.

When making a diagnosis, attention is paid to the characteristic position of the hand in the form of a “clawed paw”

Treatment

Treatment of ulnar nerve neuritis should be comprehensive. First of all, the cause of the inflammatory process is determined, and measures are taken to eliminate it. If this infection, antibacterial or antiviral drugs, in case of circulatory problems, vasodilators are needed, for example, Papaverine. In addition, immediately after diagnosis, the arm is immobilized using a splint. The hand should be in a straight position, fingers bent. And the hand is suspended on a scarf or a special bandage. This immobilization is needed for 2 days. Limiting exercise helps avoid severe pain and prevents muscle atrophy.

After this they appoint complex treatment, which includes the following methods:

• reception medicines;
• physiotherapeutic procedures;
• massage;
• physiotherapy;
• folk recipes.

Drug therapy

On initial stage mandatory method Treatment is to take non-steroidal anti-inflammatory drugs. In addition to reducing inflammation, such medications help relieve pain, often very severe. Ketorol, Nimesulide, Indomethacin, Diclofenac are prescribed. If they do not help relieve pain, analgesics can be used, for example, Baralgin or corticosteroids - Prednisolone, Diprospan, Hydrocortisone. If neuritis is accompanied by tunnel syndrome, hormonal drugs are used as injections directly into the canal.

To improve the conduction of nerve impulses, Proserin or Physostigmine are used. And as an auxiliary therapy, it is necessary to prescribe B vitamins. Diuretics may be required to relieve swelling. Potassium-sparing agents are mainly used, for example, Veroshpiron. In addition, medications are prescribed that improve blood circulation and metabolic processes. Useful biogenic stimulants, for example, "Lidaza".

Physiotherapy helps relieve inflammation and restore muscle function

Physiotherapy

This treatment for ulnar nerve neuritis is the most effective treatment method. But physiotherapy is prescribed no earlier than a week after the first symptoms appear. To relieve pain and inflammation, electrophoresis with Novocaine or Lidase, ultraphonophoresis with Hydrocortisone, magnetic therapy, acupuncture, UHF, impulse currents, mud therapy. In addition, electrical myostimulation of the muscles innervated by the ulnar nerve is prescribed.

Physiotherapy

Application begins special exercises after removing the lock. Both passive and active movements are used. the main objective gymnastics - prevent contractures and muscle atrophy, restore their function.

First, it is recommended to perform gymnastics in water. Most exercises focus on finger movements. The hand goes under the water, and with the healthy hand you need to take the fingers one at a time and bend the phalanges, lifting their top. In addition, circular movements and moving your fingers to the sides are useful. Do the same with the entire brush.

An important exercise aimed at developing the thumb and index fingers. You need to place your elbow on the table. Try to simultaneously lower your thumb down and raise your index finger up. Then the same must be done with the index and middle fingers.

After the hand regains the ability to grasp objects, occupational therapy is carried out. Modeling, drawing, rearranging small objects, such as beads, matches, and catching them from the water are useful.

Passive and active finger exercises help restore finger function

ethnoscience

Such methods are used only as a means of auxiliary treatment. They are considered to be ineffective for neuritis. But they can relieve inflammation and reduce pain. Most often used various compresses, decoctions medicinal herbs:

• tie to a sore spot fresh leaves horseradish, burdock or cabbage;
• instead of ointment, you can use bear fat;
• at night, make a compress of red clay diluted with a small amount of table vinegar;
• drink 3 tablespoons of decoction of raspberry leaves and stems before meals.

If treatment is started on time, the prognosis is usually favorable. But full recovery occurs only after a couple of months. And then you need to monitor your health to prevent relapse of the disease. To do this, you need to avoid hypothermia and prolonged monotonous hand movements. You should try not to keep your arm bent at the elbow for a long time. Regular self-massage and therapeutic exercises will also help prevent nerve damage.

Neuropathy is nerve damage that causes pain and impairment. motor function. Ulnar nerve neuropathy most often occurs as a result of compression.

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

The nerve passes through the Mouchet canal (cubital canal). Its peculiarity lies in its superficial location, which determines high risks compression and .

Depending on the location of the nerve damage, symptoms can vary from pain to weakening of the fingers.

Causes of damage

Ulnar neuropathy develops due to:

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

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

Neuropathy can occur in people who have the habit of sticking their bent arm out of a car window or leaning on their elbow while working.

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

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

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

Symptoms of the disease

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

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

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

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

When a nerve is compressed in the hand area, the following symptoms are noted:

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

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

Establishing diagnosis

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

To determine the extent of damage, use diagnostic methods, allowing one to estimate the speed of passage of nerve impulses along the fibers.

Radial nerve damage

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

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

Radial neuropathy often accompanies people with injuries that require them to walk on crutches. In this case, compression occurs due to the load on the arm when walking.

Pathology of the radial nerve is characterized by the following symptoms:

• impaired finger flexion;
• weakness of the hand;
• local numbness and burning sensation;
• impaired reflexes;
• amyotrophy.

Due to hand weakness, patients find it difficult to hold anything in their fingers. Accompanied by the inability to turn the hand palm up.

Radial nerve neuropathy without timely treatment leads to the development of atrophy.

Drug treatment

Radial nerve neuropathy is treated comprehensively. Therapy includes:

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

Surgical treatment is used only in the case of organic pathology, which can be eliminated traditional methods impossible.

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

For severe pain that cannot be relieved with pills, local injections of analgesics and medical blockades are used.

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

Physiotherapy

Treatment must be comprehensive, so doctors often resort to physical therapy. Most effective methods is ultrasound treatment, electrophoresis with lidocaine and methods of stimulating muscle function using current.

If the ulnar nerve is damaged, treatment promotes:

• relieving swelling;
• improvement of local metabolic processes;
• acceleration of regeneration;
• restoration of motor function;
• prevention of muscle atrophy.

Physiotherapeutic methods are indicated only after acute pain and inflammation have been relieved.

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

Neuropathy can be treated with exercise. This helps prevent muscle atrophy, improves local metabolic processes and helps to quickly restore motor activity.

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

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

Prognosis and prevention

Treatment of neuropathy takes from three months to six months, however, noticeable relief of the patient’s condition occurs a few days after starting to take the drugs.

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

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

Prevention of neuropathy of the elbow and wrist consists in the absence of strong monotonous repetitive loads. Helps improve the condition of nerve fibers regular intake vitamin complexes.

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

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

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

Neuritis, including the ulnar nerve, are pathologies of an inflammatory nature, involving the peripheral parts of the NS. The disease covers both nerve fiber, and a lot of nerves. The severity of the damaging effect is interconnected with the root causes of the emerging pathological conditions.

There is a relationship between the location of the nerve and the negative conditions that cause neuritis, therefore they are distinguished:

• damage to the ulnar nerve;
• tibial;
• radial;
• femoral and many other nerves.

Regardless of which nerve is affected, there are basic symptoms characteristic of each neuritis. This:

• pain symptoms in the area where the damaged nerve fiber is located;
• altered sensory perception;
• muscle weakness in certain areas.

Ulnar nerve neuropathy covers most population. Among all inflammations of nerve tissue, this takes an honorable second place.

Various circumstances simultaneously predispose to inflammation localized in the ulnar nerve, so the cause is possible:

• with general or local long-term exposure to cold on a certain area or the entire body;
• because of various kinds infections: influenza, brucellosis, measles, herpes and many others;
• from the traumatic effects of both the nerve fiber itself and the area bone tissue where it is localized. As a result, the nerve becomes pinched and inflammation develops. For example, if there is neuritis of the ulnar nerve fiber, damage to the joint, fractures of the internal condyle with the epicondyle of the humerus may be diagnosed;
• when the vessels are affected, local microcirculation is disrupted, which leads to disruption of the trophism of nervous tissue;
• due to hypovitaminosis conditions, if the body lacks vitamin and microelement components;
• from intoxicating effects, including alcohol, salt compounds of heavy metals;
• for endocrine disorders: sugar type diabetes, thyroid dysfunction;
• because of structural anomalies bone and muscle canal, in the cavity part of which there is a nerve fiber. It is congenital or can be acquired;
• due to the compressive effect of nerve bundles during sleep, improper sitting on a chair, when a person suddenly changes body position, or due to damage due to surgery. Pathology often manifests itself from long work with emphasis on the elbow;
• due to osteochondrosis, hernial changes in the discs located between the vertebrae.

About symptoms

Ulnar nerve neuritis is characterized by the fact that the patient feels that the arm is numb, then convulsive manifestations are observed, which indicates inflammation of the ulnar nerve tissue. Pronounced carpal pathological processes, especially on the fingers. There is pronounced tension between the area of ​​the little finger and the ring finger; the fingers do not always move apart.

There is a direct connection between neuritis and its symptoms from the degree of functional overload affecting the ulnar nerve and its innervated zone.

Nerve neuritis is characterized by the following symptoms:

• altered sensory perception in the form of paresthesia manifestations (the patient feels as if his elbow is tingling) or numbness, pain, loss of touch is also possible;
• movements of the affected upper limb are poorly expressed, and paralysis is possible. The patient has difficulty bending his fingers and cannot move them. Such symptoms occur not only due to the fact that innervation is reduced, but also due to impaired tissue nutrition;
• due to impaired trophism skin the affected area is cyanotic, swollen, hair falls out locally, and nail fragility is increased.

A characteristic sign in a patient with ulnar nerve neuritis is that his hand hangs down and he cannot bend his fingers into a fist. Visually, the third and fourth fingers are in a bent position, and the lateral abduction of the little finger is pronounced.

When the patient's symptoms are based on painful sensations with impaired motor activity, but no autonomic type of disorders are observed, then this is ulnar nerve neuralgia. Soreness with numbness is typical for the ring and little fingers.

This is how this neuropathy manifests itself, before its treatment, diagnostic measures are necessary.

About diagnostics

Eat different methods, revealing this ulnar nerve. For example, the patient is asked to place his upper limbs on a hard surface so that his palms are straightened downwards and he should try to scratch this plane a little with his little finger. Naturally, he doesn't succeed.

In the areas where the ulnar nerve runs, there is a high probability of a destructive process with the development. This zone localized under the collateral type of ligament.

About treatment

Before treatment, you need to find out the main root cause that caused this neuropathy. When this is an infectious pathology, an antibacterial, antiviral type of drug is prescribed.

If the cause is a violation of microcirculatory processes in the vessels with their narrowing, then treatment of ulnar nerve neuritis is carried out with vasodilator drugs.

When neuritis occurs due to injury, treatment consists of fixing the upper limb. In order to eliminate the inflammatory process, therapy in the form of non-steroidal anti-inflammatory drugs is prescribed. If you experience severe pain, the doctor will prescribe analgesics.

For ulnar nerve neuropathy, additional treatment is carried out vitamin preparations Group B also use anti-swelling agents.

With this disease, the patient is unable to hold various things in his hand; wrist drooping occurs with the development of atrophy. Therefore, the doctor places a splint on the straightened hand with bent fingers and forearm. The arm should be fixed at an angle of 80°. The upper limb remains in this form for a couple of days, then the patient is prescribed classic massage with therapeutic exercises.

• sick upper limb you need to lower it into the water and press with the other hand on the finger phalanges, trying to straighten them;
• lift each finger;
• make bilateral movements of the fingers in a circle;
• raise and lower straightened fingers (except for the thumb);
• do wrist rotation;
• raise and lower the hand;
• rest your fingers on the bottom surface; when pressing, you need to bend and straighten them;
• Something soft is placed on the bottom surface; the patient must lift this object. It is advisable to change objects in size and shape.

After 14 days, the doctor will add physiotherapeutic procedures in the form of:

• hydrocortisone ultraphonophoresis;
• electrophoresis administration of novocaine, lidase;
• pulse currents, UHF;
• muscle electrical stimulation.

In order for the hand to recover faster, it is massaged, working on all the finger phalanges. Massage procedure will eliminate congestion. Circular movements and finger abductions will give excellent results.

When the inflammatory process develops due to a compression cause with the development of a tunnel type of syndrome, drugs are injected into the musculoskeletal region of the canal. To relieve swelling, pain, inflammation is prescribed hormonal type means with painkillers.

If the nerve fiber is compressed, then it is possible surgery, with which nerve tissue stitched together, some cases are corrected using the plastic method.

About the forecast

If the pathology is detected in a timely manner, the prognosis for the patient is favorable. The treatment course will be approximately 60 days.

After a person has recovered, one must be careful:

• avoid hypothermia;
• do not get injured;
• If there is a concomitant pathology, then it must be treated.

Therapeutic measures for any inflammation should not be delayed, otherwise permanent remissions are possible.