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Elbows General

5 Common Conditions that May Require Elbow Surgery

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A doctor examines a patient's elbow in this image. Common conditions that may require elbow surgery are tennis elbow, golfer's elbow, cubital tunnel syndrome, fractures, and olecranon bursitis.

Most elbow pain is temporary, but persistent pain or discomfort that affects your quality of life may require elbow surgery.

We treat several common conditions that may require elbow surgery at our southeast Michigan offices. Make an appointment to see our elbow surgeon in Macomb Township, Warren, Howell, or West Bloomfield for the following treatments or a diagnosis of your condition.

Cubital Tunnel Syndrome Surgery

Cubital tunnel syndrome occurs when there is too much pressure on the ulnar nerve, which runs along the ulna bone in the forearm and enters the hand near the pinky and ring fingers.

Causes of cubital tunnel syndrome include leaning on hand surfaces or bending the elbow for an extended period of time, or you may develop cubital tunnel syndrome due to an anomaly in the anatomy of your elbow. If you have this condition, you may experience severe pain and numbness in the elbow, as well as tingling or weakness in your ring and pinky fingers. It may become difficult to close your hand.

The first line of treatment for cubital tunnel syndrome is to avoid the action that is causing the pain. Using pain relief medications and wearing a splint at night may help as well.

When self-treatment does not help, cubital tunnel syndrome surgery may be recommended. The goal is to relieve the pressure by releasing and moving the ulnar nerve to the front of the elbow or increasing the size of the cubital tunnel.

Tennis Elbow Surgery & Other Treatment Options

Known as tennis elbow, lateral epicondylitis is a painful condition involving the tendons that attach to the bone on the outside (lateral) part of the elbow. The tendon’s attachment to the bone degenerates, which places increased stress on the area.

People who repeatedly use their elbow and arm muscles may be susceptible to tennis elbow, such as painters, plumbers, and butchers.

Tennis elbow can usually be treated with rest, pain medication, Botox injections, or the use of a brace. Tennis elbow surgery may be recommended in more extreme cases.

Elbow Fracture Examination & Treatment

Elbow fractures may occur due to a fall or direct impact. Pain, swelling, bruising, and stiffness in and around the elbow suggest a possible fracture. A snap or pop at the time of injury may be felt or heard as well.

Types of elbow fractures include:

  • Olecranon fractures
  • Fractures of the distal humerus
  • Radial head and neck fractures of the elbow

Depending on the type of injury and its severity, treatment options for elbow fractures include splint immobilization, casting the elbow, physical therapy, surgery to realign the bone fragments, and external fixation to stabilize the fractures.

Olecranon Bursitis Surgery & Assessment

The olecranon is the pointy bone at the tip of the elbow. A small sac of fluid called a “bursa” covers the tip of this bone. Sometimes this area gets irritated and the body makes extra fluid inside the sac, causing a big “balloon” that looks like a golf ball to form at the tip of the elbow.

Causes of olecranon bursitis include hitting the elbow on an object, overuse of the elbow, systemic diseases, and medical procedures.

It’s usually not painful, but it sometimes becomes infected. Remedies include using a splint and compression to rest the bursa, using elbow pads, using antibiotics to clear the infection, having cortisone injections, or drawing fluid out of the bursa with a needle in a procedure known as aspiration.

Olecranon bursitis surgery may be required if other remedies are not successful.

Golfer’s Elbow Treatment

Golfer’s elbow causes and treatments are similar to that of tennis elbow, but there are some differences between the two conditions.

The primary difference is the source of the inflammation. With tennis elbow, the outside of the elbow and forearm areas are inflamed, but with golfer’s elbow, inflammation is on the inner side of the arm and elbow.

Likewise, tennis elbow stems from damage to an outside tendon, and golfer’s elbow is associated with damage to an inner tendon.

Golfer’s elbow is more formally called medial epicondylitis, and it is sometimes referred to as baseball elbow or suitcase elbow.

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Conditions Elbows General Hands

Cellphone Overload: How to Avoid Hand and Elbow Pain

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It's important to give your hands a break from cellphone use in order to avoid hand and elbow pain. If you are experiencing pain in your hands, wrists, or fingers, make an appointment to see hand surgeon Dr. Avery Arora.

Have you ever used your cellphone for so long that your hands became numb, your fingers stopped functioning properly, and you gave up on mentally blaming autocorrect? If so, it was probably slightly comical at the time. If this happens repeatedly, however, soon enough it won’t be funny anymore. If you do use your phone frequently, it’s important to know how to hold your phone to avoid hand and elbow pain.

If you don’t, eventually you could be dealing with something worse than just sore thumbs, uncooperative fingers, and a really hot ear.

Ways to Avoid Hand and Elbow Pain when Using Cellphones

1. Try using text-to-speak, at least every now and then.

2. Use a cellphone stand so you can set the phone on a table or desk instead of holding it. When you do, you can use any finger you want to play those games and give the other fingers a break.

3. Make a conscious effort to regularly stretch and flex your fingers, wrists, and elbows.

4. If you talk on the phone for long periods of time, holding the phone up to your ear can cause discomfort at your elbow. To avoid this problem, try using:

  • A headset
  • The speaker option
  • A video calling app like FaceTime
  • Internet calling options such as Skype

What Could Happen: Carpal Tunnel Syndrome and Cubital Tunnel Syndrome

You might believe that the tingling in your hands due to cellphone use is just a temporary sensation, and it probably is. But if you don’t make conscious efforts to avoid hand and elbow pain when using cellphones, you could end up facing some very real issues.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is the result of swelling and pressure in a “tunnel” in the wrist, which consists of nine tendons and a median nerve.

Causes of this very common condition are unclear, but improper use of keyboards, tools, and even cellphones can increase CTS. Other examples of activities that can increase carpal tunnel syndrome include driving a motorcycle and playing a violin.

Individuals with CTS can experience tingling, a weaker grip, numbness, a tendency to drop things, and pain in the hand and wrist.

Cubital Tunnel Syndrome

Ever wonder why it’s far from funny when something hits your “funny bone”? To the contrary, it’s extremely painful. The truth is that what you feel comes from a nerve that runs behind a bone in the elbow through the “cubital tunnel.”

Pressure on the nerve can affect the blood supply to the nerve, causing arm pain and weakness in the hand. Direct pressure, such as leaning on your elbow, can compress the nerve and cause some of your fingers to “fall asleep.”

Both cubital tunnel syndrome and carpal tunnel syndrome are painful conditions that may lead you to seek medical treatment.

Contact Arora Hand Surgery for More Information

For more information about how cellphone use affects your hands, fingers, wrists, and elbows, explore the Procedures & Conditions pages of our website to learn more about symptoms you may be experiencing. If you’re regularly feeling pain or numbness in your hands or arms, contact one of our Arora Hand Surgery offices by phone or request an appointment online.

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Elbows General

What is Cubital Tunnel Syndrome?

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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.

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Elbows General

Addressing Cubital Tunnel Syndrome for a Better Quality of Life

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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
Conditions General

What to Know about Cubital Tunnel Syndrome

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Have you ever bumped into a piece of furniture and knocked your “funny bone” so that you feel immediate tingling pain? What we refer to as a funny bone isnt the bone itself at all. Instead, it is the ulnar nerve. It runs from the upper arm over the elbow and down to the lower arm through something called the cubital tunnel. As it wraps around the outer part of the elbow, it is especially susceptible to getting bumped, leaving pain, tingling, and numbness to the lower arm and hand.

Some people develop cubital tunnel syndrome, which is similar to carpal tunnel in the wrist, but affects this ulnar nerve specifically. When the nerve becomes compressed or inflamed, you will feel the same pain you would if you had bumped your funny bone, but in a more severe and ongoing basis. This is cubital tunnel syndrome and it can be caused by a few different issues.

Causes of Cubital Tunnel Syndrome

The main cause of cubital tunnel syndrome comes from pressure on the funny bone area. If you feel your elbow on the outside, you will notice a groove between two bone endings. This is where the cubital tunnel lies. If direct pressure is placed on this area, it can compress the nerve and you will start feeling tingling and numbness in the ring finger and pinky finger. Over time, the constant compression of the area can lead to inflammation on the ulnar nerve.

If you keep your elbow bent at an intense angle for a long period of time, this can overstretch the cubital tunnel and ulnar nerve until it becomes inflamed and swollen. This is most often a problem when people sleep at night.

For some people, there is something off with their anatomy and this leads to the ulnar nerve sliding over the bump of bone in the elbow. This repetitive motion will result in damage to the nerve and inflammation in the soft tissue around it.

The Symptoms of Cubital Tunnel Syndrome

The most common symptom will feel as if the ring and pinky fingers on the hand have gone to sleep. The experience of “pins and needles” is a regular complaint as well. It may worsen if you need to hold your elbow bent for a long time. Many people notice this when they hold their phone to their ear. This is often a common reason fingers go to sleep. Other symptoms besides the asleep feeling include:

  • Weakness in the hand
  • Clumsiness in the hand
  • Loss of strength
  • Loss of sensation in the hand

Sometimes, cubital tunnel syndrome can be treated by splinting the arm to keep it straight while you sleep. You may also need to go to therapy and learn ways to avoid putting pressure on your elbow. If the problem is severe, then you may need surgery to release tendons and relieve pressure on the ulnar nerve.

Cubital tunnel syndrome most often occurs when you put constant pressure or strain on the funny bone portion of the elbow, but it can be relieved with treatment.

Resources:

http://orthoinfo.aaos.org/topic.cfm?topic=a00069

Categories
Elbows General

Cubital Tunnel Syndrome

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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 

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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.