Nerve compression surgery is a surgical procedure to reduce pain and restore nerve function when physical therapy and other non-surgical treatments fail and symptoms become severe. The pressure on the nerves is reduced by making small incisions in the ligaments surrounding the nerve.
There are three main nerves, namely ulnar, median and radial, starting from the neck vertebrae and extending to the hand. Nerves are like "electrical wires" that carry messages between the brain and muscles. If a nerve is not working well, it can take a long time to treat and heal.
The doctor will want to know the patient's medical history and general health. The doctor examines the hand and elbow area to determine which nerve is compressed where, and checks for loss of feeling and strength in the hands and fingers. He moves the neck, elbow, and wrist to see if different positions cause symptoms, and examines whether the ulnar nerve slips while the elbow is bent.
Imaging tests provide detailed pictures of dense structures such as bone. Therefore, most nerve entrapments cannot be seen on X-ray, but the doctor may take an X-ray of the elbow or wrist to see where bone may be pinching the nerves.
Nerve conduction studies can help determine how well the nerve is working and where it is pinched. Nerve conduction studies measure signals circulating in the nerves of the arm and hand. A low-intensity electric current is delivered from the fingertips or areas of skin over the nerves, and the nerve's function is measured by recording the current from another part of the skin.
During nerve conduction studies, the nerve is stimulated in one place and the time it takes to give a response is measured. Several places along the nerve are tested, and the area where the response takes too long may be where the nerves are pinched. Nerve conduction studies can also determine whether nerve compressions are also causing muscle damage. During the procedure, small needles are inserted into some of the muscles controlled by the nerve. Thus, it can be understood whether there is a problem in the muscles and the nerves coming to these muscles.
Ulnar Nerve Compression (Cubital Tunnel Syndrome)
The ulnar nerve provides the work of some muscles in the hand and gives sensation to the little finger and half of the ring finger. It progresses from the neck to the hands and can be compressed in many places such as the elbow and wrist. The most common site of nerve compression is the elbow.
Numbness and tingling sensations in the hands and fingers are common symptoms of ulnar nerve compression. Usually these symptoms disappear after a while. It is more common in situations that require bending the elbow, for example while driving a car or holding the phone. Weakening of the hand grip and difficulty in finger coordination may occur. These symptoms are usually seen in more severe cases of nerve compression.
If the nerve compression did not cause muscle wasting and the symptoms are not intolerable, the doctor will first recommend non-surgical treatments. If symptoms are new, the doctor may prescribe medication to reduce swelling around the nerve and relax the nerve. Some doctors may recommend exercises to prevent stiffness in the arm and wrist and relieve symptoms.
In most cases, symptoms can be relieved by reducing pressure on the nerve by detecting and preventing activities that cause compression. However, if non-surgical methods do not improve symptoms or if the nerve compression causes muscle weakness or damage in the hand, nerve compression surgery may be needed.