Blog Category

Category: Elbows

Blog // Elbows
Categories
Elbows General

What is Cubital Tunnel Syndrome?

Read Blog
Cubital Tunnel Syndrome

The ulnar nerve runs along the ulna bone in the forearm before it enters the hand near the little and ring fingers. The ulnar nerve is one of the largest nerves in the human body, but it has almost no protection. This lack of protection makes the ulnar nerve very susceptible to damage. The most common problem with this important nerve is cubital tunnel syndrome.

Cubital tunnel syndrome is a medical condition that forms when there is too much pressure placed on the ulnar nerve. Constantly using your elbow to lean against a hard surface or bending the elbow for an extended period of time are the two most common causes of cubital tunnel syndrome. While these actions may not seem very serious, they are able to cause damage because the ulnar nerve has almost no padding to protect against direct pressure and stretching. It is also possible to develop cubital tunnel syndrome because of an anomaly in the anatomy of your elbow.

It is very easy to spot the signs and symptoms of cubital tunnel syndrome. The medical condition will cause severe pain and numbness in the elbow. You will also likely experience some tingling, weakness and loss of feeling in your ring and little fingers. These issues with the elbow and fingers can make it difficult to close your hand to hold objects. While these symptoms can occur at any time, they will become more severe if the elbow is bent for an extended period of time.

You will need to get properly diagnosed with cubital tunnel syndrome before beginning treatment. The condition can usually be diagnosed with a simple physical examination by our doctor. A nerve test and electromyography may also be done to confirm the diagnosis and look for any serious nerve damage.

Once you have been diagnosed with the condition, it will be time to start treating it. The first thing everyone with cubital tunnel syndrome should do is avoid any actions or activities that place too much pressure on the ulnar nerve and elbow. You must avoid placing your elbow on a hard surface at all times. You may also need to wear a splint at night if you are known to bend your elbow while sleeping.

If these lifestyle changes are not enough to reduce your painful symptoms, then you may need to undergo surgery. The ulnar nerve will be released and moved to the front of the elbow during a cubital tunnel surgery. You may also need to get a portion of your bone removed during the surgery. The surgery will increase the size of the cubital tunnel, which decreases the pressure placed on the ulnar nerve.

Cubital tunnel syndrome surgery is very effective at reducing your painful symptoms. It will likely take several weeks before you see an improvement in your symptoms. Physical therapy can be used to speed up the recovery process, but complete recovery from the surgery will likely take several months.

If you have cubital tunnel syndrome, our trusted doctor can help you at Arora Hand Surgery, conveniently located in Warren, Macomb, West Bloomfield, and Howell. Contact us to schedule your consultation and learn more about your treatment options.

Categories
Elbows General Treatments

Which Treatment for Tennis Elbow (Lateral Epicondylitis) is Right for Me?

Read Blog
tennis elbow

Tennis elbow (lateral epicondylitis) is a painful medical condition that is caused when the tendons in your elbow become inflamed and overworked. Despite its name, many people get tennis elbow without ever playing the sport. Any repetitious motion of the arm and wrist that is performed almost every day can potentially cause tennis elbow. This condition is also commonly called lateral epicondylitis.

It is very easy to know if you are currently suffering from tennis elbow. The pain will radiate on the outside of the elbow, and it may also travel down the forearm to the wrist. This will make it very difficult to turn doorknobs, shake hands and hold round objects. Painters, plumbers, cooks and recreational racket sport players are at a much higher risk of developing tennis elbow because of the repetitive stress placed on the hand, wrist and forearm.

Treating your tennis elbow in a timely manner is the best way to quickly eliminate the pain. Ignoring your painful symptoms will only make the problem get worse over time. If you are suffering from tennis elbow (lateral epicondylitis) or if you suspect you may have the condition, then it is important to seek treatment as soon as possible.

In the vast majority of cases, we start with conservative measures. These may include changes in certain activities, anti-inflammatory medications, a brace, steroid injections, shockwave treatment and physical therapy. The exercises used in physical therapy may gradually strengthen and stretch the muscles in your forearm. Our doctor can give you recommendations on how to perform your necessary job tasks without harming your inflamed elbow tendon.

If conservative measures do not work, surgery may be the best option. Generally speaking, in order to qualify for surgery, you must have not responded to conservative treatments, and you must have had symptoms for at least six months. Surgery is considered to be the last resort for tennis elbow (lateral epicondylitis) sufferers. During this procedure, the problematic tendon tissue is skillfully removed. The techniques used during surgery will depend on the unique situation, but it is always an outpatient procedure and requires months of rehabilitation and physical therapy to fully recover.

During a consultation at Arora Hand Surgery, our doctor can assess your condition and come up with a personalized treatment for you that aims to relieve you of your symptoms. Contact us today to schedule an appointment at our office in West Bloomfield, Howell, Warren, or Macomb.

Categories
Elbows General

Addressing Cubital Tunnel Syndrome for a Better Quality of Life

Read Blog
Cubital Tunnel Syndrome

Cubital tunnel syndrome, or ulnar nerve entrapment, is a condition affecting the ulnar nerve. This is the nerve that extends from the forearm to the neck. Along the way, it passes through the cubital tunnel, which is near the inner part of the elbow. Muscles, bone and ligaments all form the tunnel. In cubital tunnel syndrome, the ulnar nerve gets compressed in the tunnel.

What are the Symptoms?

The most common symptoms of cubital tunnel syndrome are numbness and tingling in the hand and fingers. Such symptoms are most common in the ring and little fingers, and they tend to be intermittent. These symptoms are most likely to occur if the patient keeps their elbow bent during activities like driving or talking on the phone.

In some cases, the numbness wakes patients in the middle of the night. The patient may also feel as if their fingers are “falling asleep.” In severe cases, cubital tunnel syndrome can also impair coordination and weaken the muscles. The patient will start to have trouble performing such activities as typing or playing an instrument.

If the patient does not get treatment and/or the condition persists a long time, they may experience actual wasting of the hand muscles. Since this is not reversible, the patient should see our team if they have symptoms and/or have had symptoms for over six weeks.

How is Cubital Tunnel Syndrome Treated?

A person usually starts with various home remedies, many of which involve resting the affected arm. For example, they may avoid activities that require bending their elbows for a long time. Before going to bed, they may wrap a towel around their arm to make sure it stays straight while they sleep.

When such measures don’t work, our team at Arora Hand Surgery can come up with a customized treatment plan for you. This may involve the use of a splint, hand therapy and/or surgery, depending on the situation. Surgery is usually only recommended for severe cases of cubital tunnel syndrome. The patient will almost always need some type of physical therapy during their recovery.

During a consultation at Arora Hand Surgery, Dr. Arora and his team can assess your condition and come up with a personalized treatment that aims to give you a better quality of life.  Contact our West Bloomfield, Howell, Warren, or Macomb office today to schedule an appointment to learn more about your treatment options!

Categories
Elbows General Treatments

How To Treat A Broken Elbow

Read Blog

How a broken elbow is treated depends largely on the type of injury. Treatment could involve nothing more than applying a splint to the arm and keeping it elevated as much as possible. On the other hand, it could involve surgery to repair not only damaged bones, but damaged blood vessels and nerves.

Treatment will also depend on your age. As an example, children and adults usually injure their elbows in different ways, and they also heal differently.

Medication

If you have broken your elbow, at some point you will almost certainly require medication. Oral medications are frequently used for mild pain, whereas injections may be needed for pain that is moderate to severe – this type of medication can be delivered directly into the joint. If the elbow needs to be re-set, you will probably require a sedative to help you relax while the doctor re-sets the bone.

Re-setting the bone not only puts it back into its correct position, but it will also go a long way toward relieving pain. Frequently, broken bones can cut blood vessels and nerves, or press on them. Re-setting the bones stops this sort of damage. Medications can be provided during the re-setting process, as well as afterward to help with pain relief as healing progresses.

Surgery

If you have a compound injury (an injury in which at least one of the bones at your elbow is protruding through the skin), you may need an operation. With this type of injury, there is a good chance that blood vessels and nerves have been damaged. Additionally, the bone and surrounding tissue will need to be cleaned before the bone is put back in place, in order to prevent infection.

Draining

If the elbow joint is filled with fluid, it can be drained. This will relieve pain and pressure.

Splints, Slings and Casts

Splints are used for a variety of elbow injuries. They are usually made from plaster, and placed on the back of your arm in order to hold your elbow in a fixed position. Usually, the splint will extend from your hand to your shoulder, so that the hand cannot turn and the elbow will not bend, possibly preventing a fracture from healing or further dislocating the elbow.

You may also require a sling so that your arm can rest. You may be asked to remove it when you are at home, and elevate your arm in order to alleviate the swelling.

In most cases, you will not be fitted with a cast. This is because casts cover the arm completely, and if there is swelling under the cast, it could damage blood vessels and nerves.

Follow Up

Some joints can be fairly “forgiving” as they heal. The elbow, however, will not forgive and could heal badly, causing you to experience discomfort down the road. So make sure to follow your doctors advice to the letter if you are diagnosed with a broken elbow, and also be sure to keep any follow up appointments that are scheduled.

If you have any specific questions, please visit one of our offices or contact us at our offices in West Bloomfield, Howell, Warren, or Macomb.

Categories
Elbows General

What Are Overuse Injuries of the Elbow? – Michigan Hand and Wrist Surgery

Read Blog

The human body can only take so much. When you are constantly repeating an action that puts stress and pressure on a part of the body, such as the elbow, it will eventually break down. The body needs time to heal, and if you do not give it that time, the problems and the pain will only get worse down the line.

How Do the Injuries Occur?

Whenever someone does the same motions repeatedly without enough rest, it causes the tendons and ligaments in the elbow to work harder than they are meant to work. Unless someone is able to give the elbow time to rest, they could suffer from an overuse injury. Athletes who are repeatedly using the same motions for throwing are susceptible to this type of injury. It can also affect those who have an occupation that requires repetitive motion of the elbow. Its important to note that children are at a high risk because their bodies are not able to handle the same amount of stress as an adult.

What Are the Symptoms?

Some of the most common symptoms of an overuse injury in the elbow include pain and tenderness in the affected area. In addition, the elbow could swell, which can limit mobility. Some patients also report a numb feeling or a tingling sensation in the elbow. The joint may also start to make popping sounds when it is moved.

Treatment Options

It is best to catch potential overuse injuries as early as possible, as they will be easier to treat. In the beginning, it is often possible to remedy the situation with plenty of rest for the affected area. The doctor may also prescribe anti-inflammatory medications, and they may advise you to put cold compresses on the elbow to help with swelling. Physical therapy is another option to try. To help the elbow rest, the doctor may want you to use a splint or a brace on the elbow.

These methods can be effective in treatment. However, those who do not respond to these options may need to talk with their doctor about surgery. The same is true for those who have a severe condition. The surgery can help to remove some of the inflamed areas, which should alleviate the pain. The healing time for the surgery will vary by patient, so you will need to speak with your doctor about what to expect and your overall prognosis after the surgery. They will also let you know what types of therapy can help you get your strength and range of motion back.

Do Not Ignore the Problem

Your elbows are very important joints and if they have issues, it will affect your ability to do many of the things that you now take for granted. If you notice issues with your elbow, start by resting the area, but make sure you make an appointment with the doctor to get a proper diagnosis. The earlier you realize that you are suffering from an overuse injury the sooner you will be able to make changes and start to heal.

If you would like to schedule a consultation with a Michigan Hand and Wrist Surgeon, please contact us at either (248) 485-8300 or (734) 943-3838.

Categories
Elbows General

Funny Bone Facts – Arora Hand Surgery

Read Blog

The so-called funny bone is actually not a bone. And when you whack it on something, it really is not all that funny. So what is the “funny bone,” and why does it cause so much discomfort when you hit it?

Actually, the funny bone is the ulnar nerve. This is a nerve that extends all the way from your neck to your hand, sending impulses to your hand and your forearm. It terminates at the point where your pinky finger and your ring finger join.

Why the Discomfort?

The ulnar nerve, like all the other nerves in your body, is protected by ligaments, muscles and bones throughout most of its length. However, when it reaches the elbow, it passes through the cubital tunnel. At that point, its only protection is fat and skin, and that makes it highly vulnerable to impact. When you hit it, the nerve comes up against the bone and becomes compressed. That is what causes the tingling, numbness and pain that shoots down your forearm, through your hand and into your fingers.

How Did It Get Its Name?

This is a matter that has been long debated. Some believe that the term is actually a pun, since the nerve runs along the bone known as the humerus, which, of course, sounds just lie “humorous.” Another school of thought is that the name is derived from the “funny” feeling that you get when you hit it. Regardless of the origin, though, our opinion is still that there really isnt anything all that “funny” about a blow to the ulnar nerve.

Could Matters Be Worse?

Yes, actually, they could. Imagine having the sensation of a blow to the funny bone that never goes away. Sometimes it happens, and the condition is known as cubital tunnel syndrome. This occurs when the ulnar nerve becomes obstructed, and then ends up being squeezed or pinched. Often, this is caused by sleeping with your arm folded under you. You get the same feeling as when you hit the funny bone – in other words, tingling, numbness and pain. The trouble is that it lasts longer, and eventually, it may not go away. If the irritation of the nerve is constant, numbness settles in, and the forearm and hand muscles weaken. Then, the ring and pinky fingers can end up curled into a claw-like position.

Treating Cubital Tunnel Syndrome

The most important thing you can do if you have cubital tunnel syndrome is to correct the posture that is causing the pressure on the ulnar nerve. Most often, the pressure is caused when you are sleeping, so putting a pillow under your arm before you go to sleep may offer some relief. If this doesnt help, then your doctor may consider splinting the elbow for a period of time. Hand therapy can also be helpful. In extreme cases, you may need surgery to open up the tunnel so that the nerve has more space, and the pressure on it is reduced.

Categories
Elbows General

Understanding Tennis Elbow Treatment and Causes

Read Blog

Many people diagnosed with “tennis elbow” are surprised to learn about their condition because they may not play tennis at all. In fact, most cases occur in non-tennis players! (Mayo Clinic, 2015).

Technically, it is known as lateral epicondylitis and it is when tendons that anchor the muscle to the bone in one area of the outer elbow degenerate. This degeneration creates a weakness at the point where the muscles join, and this causes pain whenever the muscles are put to use. So, you might experience pain in your wrist when you are gripping something or lifting it, and this would be due to tennis elbow.

Causes of Lateral Epicondylitis

Tennis players aren’t the only ones who can experience the discomfort of tennis elbow; it can be caused by many things. Generally, any activity that continually puts stress on the point where the tendon attaches the muscle to the outer elbow can lead to problems. Ongoing stress from grasping and swinging a tennis racket can be to blame, but so can almost any repetitive movement with a similar nature. For example, house painters, plumbers, and even butchers and weavers have often experienced tennis elbow.

It is entirely possible to have tennis elbow from a single incident of trauma to the muscle-tendon unit. For example, a hard hit to the outer elbow can cause inflammation that leads to weakening of this area, or a single instance of force or extreme stress can injure the tendons.

People of almost any age can experience it, but it is most common in those between the ages of 30 to 50.

Tennis Elbow Treatment and Signs

How can you tell if the pain you are feeling is tennis elbow? It is rare for someone with tennis elbow to feel pain with any movement of the elbow. Instead, your discomfort may range from a noticeable tenderness in the area around the elbow to a pain that occurs whenever you grip or lift. Pain tends to radiate outward from the elbow, up the arm and may even be experienced in the hand.

Any pain of this kind should be dealt with immediately, and a hand surgeon or expert should be your preferred medical provider for tennis elbow treatment. They will assess the situation and consider whether to use non-surgical treatment or to use a less conservative, surgical treatment immediately. Generally, surgery is the course chosen if the issue has left the patient incapacitated or in pain for more than six months.

Before surgical remedies are used, the patient will usually be treated with a range of options. The mildest is simply modification of activity or grip to relieve the problem and allow the tendon to strengthen. Anti-inflammatory medications, including steroid injections may be used. Braces are also considered a good approach as they support the muscle and allow healing of the tendon. Physical therapy can be useful as this will allow the area to be strengthened, and can include other modalities such as heat and ultrasound.

A last resort before surgery is shockwave treatment, though this is not always available. Surgery is used to remove the damaged tendon and trigger healing and strengthening. This would be followed up by further physical therapy to ensure full range of motion and strengthening.

The good news is that there are many ways to deal with tennis elbow, and the first step is getting in touch with your qualified hand specialist or surgeon.

Categories
Elbows General

Cubital Tunnel Syndrome

Read Blog

cubital-tunnel-syndrome-figWhat many people call the “funny bone” really is a nerve. This ulnar nerve runs behind a bone in the elbow through a space called the “cubital tunnel” (Figure 1). Although “banging the funny bone” usually causes temporary symptoms, chronic pressure on or stretching of the nerve can affect the blood supply to the ulnar nerve, causing numbness or tingling in the ring and small fingers, pain in the forearm, and/or weakness in the hand. This is called “cubital tunnel syndrome.”

Causes

There are a few causes of this ulnar nerve problem. These include:

Pressure. Because the nerve runs through that “funny bone” groove and has little padding over it, direct pressure (like leaning your arm on an arm rest) can compress the nerve, causing your arm and hand—especially the ring and small fingers—to “fall asleep.”

Stretch. Keeping the elbow bent for a long time can stretch the nerve behind the elbow. This usually happens during sleep.

Anatomy. Sometimes, the ulnar nerve does not stay in its place and snaps back and forth over a bony bump as the elbow is moved. Repetitive snapping can irritate the nerve. Sometimes, the soft tissues over the nerve become thicker or there is an “extra” muscle over the nerve that can keep the nerve from working correctly.

Signs and Symptoms

Cubital tunnel syndrome can cause pain, loss of sensation, and/or tingling. “Pins and needles” usually are felt in the ring and small fingers. These symptoms are often felt when the elbow is kept bent for a long time, such as while holding a phone or while sleeping. Some people feel weak or clumsy. Loss of sensation and loss of strength or muscle in the hand is serious.

Diagnosis

Your doctor will be able to tell a lot by asking you about your symptoms and examining you. S/he might test you for other medical problems like diabetes or thyroid disease. A test called electromyography (EMG) and/or nerve conduction study (NCS) might be needed to see how much the nerve and muscle are being affected. This test also checks for other problems like a pinched nerve in the neck, which can cause similar symptoms.

Treatment

The first treatment is to avoid actions that cause symptoms. Wrapping a pillow or towel around the elbow or wearing a splint at night to keep the elbow from bending during sleep can help. Avoiding leaning on the “funny bone” part of the elbow can help also. A hand therapist can help you learn ways to avoid pressure on the nerve. When symptoms are severe or not getting better, surgery may be needed to relieve the pressure on the nerve.

This can involve releasing the nerve, moving the nerve to the front of the elbow, and/or removing a part of the bone. Your surgeon will talk to you about what is the right option for you and guide your care. Therapy sometimes is needed after surgery, and the time it takes to recover varies. Numbness and tingling may improve quickly or slowly, and it may take many months for the strength in your hand to improve. Cubital tunnel symptoms may not totally go away after surgery, especially if symptoms are severe.

View our Cubital Tunnel Syndrome PDF 

Bill Payment Made Easy

Pay on the Go!

Get on the List

Subscribe

Patient

Stories

Read All

Dr. Aroras office from my first call to schedule my appointment was friendly. Walking in the first day, I felt like I was in a nice atmosphere. Dr. Arora was EXCELLENT in taking great care of my hand injury. He was gentle and very understanding to the concerns I had about my hand. His expertise was admirable and I would recommend anyone with an injury to their hand to his office to be under his care. Because of him, I have healed faster than expected and will make an 100% recovery! Thank you Dr.

Jackie S.

I first thought I was going to have to have painful injections or surgery, but Dr. Arora suggested physical therapy may do the trick. I was doubtful, but I agreed to do it. Now, my pain is gone, and with the help of an ergonomic keyboard at work to keep my hands in the correct position, I am virtually pain free. The therapy strengthened my wrists and shoulders, and built more flexibility into my wrists.

Jerry T.

My experience with this doctor was positive from the outset. Dr. Arora was kind and spent a great deal of time with me. Staff was friendly. The office was nice and bright.

Ariel G.

Very friendly and helpful Great staff!!! Doctor Arora was very professional and did great work. I was very happy with everything!

L B.