Tunnel neuropathy of the ulnar nerve treatment. Causes of ulnar nerve neuropathy and its treatment

Lately everything more people are faced with pathology such as neuritis ulnar nerve. This disease is an inflammatory process that affects peripheral nerve fibers. And the ulnar nerve, which runs very close to the skin, is easily injured during normal activities. As a result, severe pain occurs, the performance of the arm 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 in addition to traumatic injury, the cause of inflammation can 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 elbow joint.

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

Symptoms

The ulnar nerve is responsible for innervation of the little finger and ring finger, for the work of the adductor muscles thumb flexing the wrist, adducting and abducting all fingers. Therefore, its defeat immediately affects the functioning of the hand. Manifestations of neuritis depend on the degree and location 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 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 hold a sheet of paper between his thumb and forefinger, or clench his hand 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 is an infectious disease, 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 the load helps to 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 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 to 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 method treatment. 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 a large and index finger. 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 physiotherapy will also help prevent nerve damage.

Ulnar nerve neuritis– a fairly common phenomenon, ranking second in frequency of the disease among other types of neuritis. The ulnar nerve is one of the main nerves brachial plexus, which performs two functions: motor and sensitive.

When it is damaged, both functions are impaired to one degree or another. The ulnar nerve is most vulnerable in the area of ​​the elbow joint, and even simple compression (with prolonged support of the elbows on a table, armrests of chairs, etc.) can lead to its damage and inflammation. Reason ulnar neuritis Injuries, wounds, and infectious diseases can also serve. How to identify and treat ulnar nerve neuritis, we will consider further.

Symptoms of ulnar nerve neuritis

Ulnar nerve damage can be diagnosed by the following signs:

• with the arm extended forward, the hand hangs down, resembling a “clawed paw”;
• a feeling of numbness and tingling between the ring finger and little finger, which spreads along the ulnar edge of the hand to the wrist;
• weakness of the hand muscles (impossible to grasp and hold an object);
• when clenching your fingers into a fist, the third, fourth and fifth fingers do not bend completely;
• when the hand fits tightly to the table, the little finger is removed from the surface, and it is also impossible to spread and bring the fingers in this position;
• cyanosis, impaired sweating, local decrease in skin temperature in the area of ​​the affected nerve.

In advanced stages of the disease, the hand on the injured arm begins to lose weight, become deformed, and the muscles atrophy.

Treatment of ulnar nerve neuritis

If you notice the first signs of ulnar nerve neuritis, you should immediately contact a neurologist, because in this case, only timely treatment will be the key to success.

First of all, if the ulnar nerve is damaged, a special splint is applied to the hand and forearm. The hand is fixed in a position of extreme straightening in the wrist joint (the fingers are half bent), and the forearm and hand are suspended on a scarf.

As a rule, on the second day after applying the fixing bandage, they begin physical therapy exercises to restore lost functions of the arm. Exercise therapy for ulnar nerve neuritis includes the following exercises:

1. Place your arm bent at the elbow on the table so that the forearm is perpendicular to the table. Alternately lower your thumb down and raise your index finger up, and vice versa.
2. The hand is in the same position. Forefinger lower down, and raise the middle one up, and then vice versa.
3. With your healthy hand, grab the main phalanges of the four fingers - from the index to the little finger. Bend and straighten the main and then middle phalanges.

Each exercise is performed 10 times.

You can also perform gymnastics in water by immersing your hand in a basin of warm water.

Along with this, a massage is performed to relieve pain and accelerate nerve conduction and sensitivity. Massage begin with cervicothoracic region spine, and then the entire limb is massaged using kneading, rubbing and vibration techniques.

Physiotherapeutic methods (electrophoresis, ultrasound, etc.) are used to eliminate pain and restore muscles. Also complex therapeutic measures includes taking vitamins B, C and. Good results are achieved at .

In cases where the condition does not improve long time(1 – 2 months), carried out surgical intervention. This may be suturing the nerve trunk, neurolysis of the ulnar nerve, or other surgical methods.

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 the movements of the ring and little fingers, and numbness in this area.

Etiology of damage to the ulnar nerve: compression of the nerve in the area of ​​the elbow joint (long-term 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 abducting the fingers.

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 of the 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.

Instructions

The ulnar nerve is most vulnerable in the area of ​​the elbow joint. Often this disease occurs in those who have the habit of resting their elbows on a hard surface, as well as when the elbow joints are in a bent position for a long time (for example, office workers). The risk of getting sick increases if the room is damp or cold.

Predisposing factors for the development of neuritis are chronic endocrine diseases(diabetes mellitus, thyroid disease), chronic intoxication(alcoholism), mercury, lead poisoning, etc. Also, neuritis can develop after infections (herpes, diphtheria, malaria, etc.), in the presence of fractures and bruises in the elbow joint and forearm.

The main signs of ulnar nerve neuritis are weakness of the hand - the patient cannot make a fist, the 3rd, 4th fingers and little finger remain straightened, and cannot hold objects with his fingers. Also disturbing is numbness and pain between the little finger and ring finger of the hand, as well as in the area of ​​the ulnar edge of the hand to the wrist. The small muscles of the hand gradually atrophy, and it takes on the appearance of a “clawed paw.”

The skin of the hand under the little finger may acquire a bluish tint, become thinner, small abscesses or ulcers often form, and in men may disappear hairline. There are also several simple ways check the functioning of the ulnar nerve. If you press your palm to the table and try to move your little finger, this will cause difficulty, and in this position it is also difficult to spread your fingers. Another way is to hold a piece of paper between two fingers; this cannot be done if you have neuritis.

Treatment of ulnar nerve neuritis should begin as early as possible, as it can lead to complete atrophy hand muscles. First, the cause of the inflammation is determined, with infectious diseases antibiotics are prescribed for viral origin neuritis is treated with antiviral therapy. It is also necessary to remove predisposing factors (for example, the habit of leaning on the table with your elbows and hypothermia).

From medications are appointed vascular drugs to improve blood circulation and dilate blood vessels, B vitamins, painkillers. A plaster cast is applied to the forearm and hand area, the fingers should be bent and the hand should be fixed in the wrist joint. The forearm and hand are supported by a scarf.

Physiotherapeutic procedures, physical therapy, treatment with mud baths, acupuncture and massage are also widely used; it is recommended for all patients Spa treatment. In some cases, surgery is performed (for example, suturing a nerve after injury).

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 at various levels of damage, 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 of the 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 osteo-fibrous canal formed by the internal epicondyle of the shoulder, olecranon 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 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 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:

• sensitive 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 back surface the sensitivity of these fingers 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;
• 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 face obvious reason such symptoms.

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 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.

As for medications, they first resort to non-steroidal anti-inflammatory drugs (Diclofenac, Ibuprofen, Nimesulide, Meloxicam and others). These drugs can reduce pain syndrome, swelling in the area of ​​the nerve and adjacent formations, 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 successful operation nessesary to use medications(vitamins, products that improve nervous 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 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 of peripheral nerves. Clinic, basics of diagnosis and treatment” (from 5:45):