Local expertise can cure cubital tunnel syndrome

Tingling or numbness in two fingers of one hand (small and ring), signifies nerve compression behind the elbow. It’s called cubital tunnel syndrome, and is the second most common nerve entrapment problem in the arm after carpal tunnel syndrome ( involving the median nerve in the wrist). Untreated, it can lead to severe disability. If the sensory nerve function is affected, symptoms worsen when holding a telephone in your hand, resting your head on your hand, curling that hand under your body at night, or crossing your arms over your chest. If motor function is impaired, your hand becomes weaker, you may drop things, or have trouble coordinating your fingers  to type or play a musical  instrument. It is unclear how this problem develops, but it is very difficult to get rid of.

My husband developed this problem a year or so ago. We figured out what it was by using some of our terrific sports and rehabilitation medicine e-books, took the arms off his office chair and he tried to train himself to sleep with his arm extended rather than up under his chin. We later found a cubital tunnel elbow splint to immobilize it at 122° to reduce pain and numbness, but it did not get better. Oddly, while bouncing on a lymphatic rebounder (specially designed mini-trampoline)  he was symptom-free, but not for long. He needed a longterm solution, and did not want surgery so he took several sessions of massage therapy and chiropractic. These seemed to aggravate it.

Our ANP advised acupuncture. The first needle inserted in his opposite ankle had a surprising effect on the symptoms of the affected hand.  After a few more sessions the acupuncturist referred him to a local practitioner who combines sports medicine with chiropractic. This amazing man spent a lot of time pinpointing exactly where the nerve was entrapped – in two places actually.

Did you know you should have an arch across the back of each hand? If you extend your arms in front of you so that the backs of your hands are touching, then separate your elbows, letting the hands rotate downwards in a vertical position,  the backs of your hands should continue to press together. If they don’t, you have lost some of that natural arch. This was one test given.

dsc04766small1During treatments, the doctor uses a mix of chiropractic adjustments, massage, accupressure and trigger point release to make more room within the hand for the nerve to function freely. There is homework too. Initial treatment involved taping the portion of the hand closest to the wrist more tightly across the palm than the back, to model the arch.  My husband placed an elastic band placed around the fingers, and opened and closed them against the resistance to strengthen the muscles of the arch.  dsc04756small1Later on, he was asked to purchase a Dynaflex handheld gyroscope ($24.99) that you start with a string, and must move your hand in a circular motion to keep it going smoothly.  More recently he is using a stress ball to squeeze and release repetitively, again to strengthen the muscles. It is slow going but gradually the nerve function is returning and the hand is regaining its strength.

The doctor says many people have this problem but do not seek help until it becomes really serious, and then, it is much more difficult to treat. He is always researching and learning new techniques, and just took a workshop on new techniques for this condition.

We surely are fortunate to have people of this caliber and expertise to help us solve such thorny problems.

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