Cubital Tunnel Syndrome Elbow Treatments With Low Level Laser Therapy
Cubital tunnel syndrome is very often compared to banging your elbow against the wall. That numbness and tingling sensation felt from the elbow down the forearm to the little fingers is quite remarkable. Even a simple and small bump can produce incredible symptoms in the fingers. Banging your funny bone is actually the compression of the ulnar nerve as it travels down the arm. The ulnar nerve is a thin and fragile nerve that is running behind the arm and cutting in between the space between the humerus and ulnar bone. The small groove and pathway is referred to as the cubital tunnel.
Banging your funny bone is a sensation that we all have felt. However some people develop tightness, stiffness, dull pain, weakness, burning, or tingling in their forearm and little fingers. The little and ring finger are controlled by the ulnar nerve. Any compression on that nerve on its path down to the hand can result in forearm, hand, or finger weakness or changes in sensation. Several common sites of entrapment occur in the upper arm, lower arm muscles, or in the palm of the hand. When the entrapment occurs in the palm of the hand it usually occurs at the tunnel of Guyon. The most common place of ulnar nerve entrapment at the elbow is where the ulnar nerve travels between the two muscle heads of the flexor carpi ulnaris muscle.
Cubital tunnel syndrome is also called Flexor Carpi Ulnaris Muscle Syndrome. A common cause of compression occurs between the two heads of the flexor carpi ulnaris muscle. When the muscle becomes overused or undergoes chronic repetitive stress on the inside of the elbow, the muscles spasm and compress the ulnar nerve. Bone spurs or arthritis in the elbow can also cause compression of the ulnar nerve.
Pressure is increased on the nerve with elbow flexion and wrist extension. The cocking motion of throwing dramatically increases the stress and compression of the ulnar nerve. People who work with their elbows flexed are at increased risk of developing Cubital Tunnel Syndrome.
Home treatment consists of rest and avoidance of activities. Throwing activities should be limited, in addition to repetitive arm movements. Gripping and grabbing movements cause contraction of the flexor carpi ulnaris muscle and should be limited. When typing, some people rest their elbows on a hard table, which can cause compression of the nerve. Rotating ice for 10 minutes on and 10 minutes off will help to decrease the inflammation and muscle spasms. A night splint that flexes the elbow to 45 degrees will also help.
Office treatments will continue to decrease muscle spasms and identify the location of nerve compression. When the compression is caused by spasming flexor carpi ulnaris muscle, treatment will consists of stretching and muscle therapy. Active release technique, Graston Technique, and massage therapy are very beneficial for nerve entrapment injuries. Additional physiotherapy modalities may be used for decreasing the inflammation.
Goals of the muscle therapies will be to increase flexibility of the upper arm, lower arm, wrist, and finger muscles. Many times these muscles have slowly tightened over time, which increases the likelihood of compression or entrapment of nerves. Massage therapy, Graston technique, or ART are excellent treatments addressing the fascial adhesions and scar tissue that develops in muscles. Those knots or bumps many people feel in their traps, quads, or forearm muscles are the result of scar tissue accumulation through years of overuse or repetitive motions. These muscle therapies are excellent treatments for helping to break up that scar tissue or fascial adhesions, which triggers the body's normal mechanisms to tear up the remaining scar tissue and repair the fibers properly.
Many nerve entrapment or compression injuries respond very well to class IV cold laser therapy. Cold laser therapies utilize specific wavelengths and frequencies to trigger cellular reactions within the body. Cold lasers are excellent treatments at decreasing inflammation and inflammatory cells in the tissue. With any injury the body releases these chemical markers to cause swelling to help initially protect the area from additional injury. In addition, swelling helps trigger the body's healing and repair processes. Unfortunately excessive swelling or chronic swelling slows the repair and regeneration process. Cold lasers help stop these inflammatory cells from being produced, which will ultimately lead to less swelling.
Low level laser therapy is an excellent treatment at increasing blood flow to the tissue. It causes vasodilation of the small arteries, which allows the arteries to open up to bring more blood flow to the injured tissue. More blood flow means more nutrients are brought to the injury site. The body will use these nutrients for repair along with the increased ATP or energy production that was stimulated by the laser. Specific frequencies of low-level laser stimulate ATP or energy production within a cell. When a cell has extra ATP, it utilizes that energy in the repair and regeneration process. The combination of increased blood flow and increased ATP leads to more repair in a shorter period of time.
Specific wavelengths of lasers have also been shown to increase nerve function and repair. Nerves are notorious for slow healing. Their unique structure for transmitting impulses makes it difficult for the nerve to repair itself. Low level laser therapy enhances the regeneration and repair of nerves to speed their healing processes. These enzymes are turned on at a high speed for their healing, which is why cold lasers are utilized for many nerve entrapment and nerve injuries, such as carpal tunnel or sciatic nerve compression.
Anti-inflammatory medication provides benefit in many cases. Additional treatment options include injection therapies or surgery, if conservative treatment fails.
Compression of the Ulnar Nerve at the Cubital Tunnel or Flexor Carpi Ulnaris Muscle can be treated with conservative treatment in most cases. Increased numbness, tingling, and muscle weakness relates to the severity of the injury. Treatment is always easier and quicker when the injury is smaller. Seek help from an experienced provider if you suspect you may be suffering from any nerve entrapment syndrome.