Cubital Tunnel Syndrome

Cubital Tunnel Syndrome

This condition is caused by a compression or stretching of the ulnar nerve as it passes beneath the cubital tunnel located at the inner side of the elbow. According to the Injury classification system, this syndrome usually develops because of a misalignment issue therefore is considered  a level 1 injury with associated nerve entrapment. Chronic injuries at the elbow may also narrow the nerve passage due to the scar/fibrotic tissue at the superficial fascia and by the osteophytic bone formation from the underlying bones.

 This condition causes radiating pain toward the forearm and hands with associated pins and needles and numbness at the last two fingers with possible weakness with hand grip.

 

Mechanism of Dysfunction

The main predisposing factor for the development of this condition is a dysfunction misalignment of the proximal ulna by either creating a direct nerve pressure or by narrowing the flexor retinaculum canal. Is commonly seen in individuals that involve in arm throwing activities/sports.

 

Assessment Protocol

The entire upper r extremity biomechanical chain must be evaluated as part of the elbow analyses as per the neurological and mechanical influences of the spine, shoulder, and hand.

Clinical assessment of the key elbow joints with specific attention to the evaluation of the ulna.

Neurological examination

 

 X-ray analysis

Lateral Xray view is essential to check the alignment of the ulna in relationship with the humerus

Anterior – Posterior (AP) X-ray ankle view is essential for identifying the specific ulna misalignment pattern of dysfunction responsible for this syndrome

MRI analysis

Important exam to verify the level of narrowing of the nerve passage and the degree of nerve inflammation.

 

Treatment protocol

Restore the biomechanical alignment of the Humerus – Ulna joint

Ulnar Neuromobilization techniques may be used once the direct compression of the nerve is reduced.

Specific therapeutic essential oils are applied to reduce nerve inflammation and enhance healing.

Depending on the level of nerve compromised and chronicity of the misalignment a minimum of 6 weeks up to 12 weeks of treatment care may be necessary to resolve this deformity.

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