Carpal and Cubital Tunnel Syndrome – Median and Ulnar Nerve Entrapment
The median and ulnar nerves are two of five nerves that innervate the muscle of the upper extremity. Of these five nerves, they are two of the three that traverse the entire length of the arm from the brachial plexus near the origin of the nerves at the neck to the tips of the fingers. At the elbow the ulnar nerve passes through a tunnel on the medial or inside of the elbow. This is known as the cubital tunnel and is commonly referred to as the “funny bone”, although it is a nerve. It can commonly be compressed in this area and cause pain as well as numbness and tingling extending into the small and ring fingers. This is referred to as Cubital Tunnel Syndrome As compression continues and worsens, people will often begin to have difficulties with strength in the hand and with maintaining a grip on objects.
Compression of the median nerve most commonly occurs at the wrist. This is referred to as Carpal Tunnel. This commonly causes pain in the hand especially in the base of the thumb (thenar mass). It can also cause numbness and tingling in the thumb, long finger and index finger. This is commonly worse at night.
Treatment of Nerve Compressions
Entrapment can often be successfully treated with non-operative measures. This can include observation, bracing and anti-inflammatory medications. If a reasonable course of non-operative treatment has failed then surgical interventions may be indicated.
Surgical treatment of nerve compression is usually done through a small incision at the wrist for the median nerve (carpal tunnel release) or elbow for the ulnar nerve (cubital tunnel release). Dr. Lenarz performs these procedures as an outpatient at the hospital or at a surgery center. No period of immobilization is required and recovery is usually quick, often with immediate symptom relief.