Carpal Tunnel and Ulnar Nerve Entrapment

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Dr. Pouratian has a great deal of experience performing surgeries carpal tunnel syndrome and ulnar nerve entrapment (also called cubital tunnel syndrome) for patients in Dallas. These two conditions are caused by pinched nerves. Pinched nerves can result in pain and other neurological symptoms.

A nerve can get pinched at any point in its path. Most often, people think about pinched nerves in the spine. However, nerves can also be pinched in the arms or legs. The most common type of pinched nerves are in the wrist (median nerve) and elbow (ulnar nerve).

Carpal Tunnel Syndrome

In the wrist, the median nerve can get pinched and is called carpal tunnel syndrome. Symptoms can include numbness, tingling, and pain in the thumb, index and middle fingers as well as thumb and index finger weakness. Symptoms tend to get worse at night, with the hand “falling asleep” at night. Classically, patients state that their symptoms get better when they wake up and shake out their hand. Symptoms can also get better by wearing a wrist brace at night, to prevent bending the wrist and pinching the nerve.

Ulnar Nerve Entrapment

In the elbow, the ulnar nerve can get pinched (called cubital tunnel syndrome). Symptoms can include numbness, tingling, and pain in the pinky and ring fingers. Weakness is usually noted in the pinky, with atrophy (or wasting) around the pinky as well as in the space between the index finger and thumb. Symptoms tend to get worse at night, with the hand “falling asleep” at night. Like carpal tunnel syndrome, patients state that their symptoms get better when they wake up and shake out their arm. Symptoms can also get better by wearing an elbow splint (or ulnar splint), to prevent bending the elbow and pinching the nerve.

Who Is at Risk?

While office workers are very susceptible to developing carpal tunnel syndrome, many other professions are also at risk. Anybody that participates in activities that involve repetitive finger use can develop carpal tunnel syndrome. Vibrations, extreme wrist motions, and high-force activities can also lead to this condition.

Ulnar nerve entrapment, or cubital tunnel syndrome, usually develops in people who engage in repetitive activities that bend or flex the elbow for prolonged periods of time. Athletes often present with this condition, as do people who frequently talk on cell phones. Bone spurs or fractures can also cause cubital tunnel syndrome.

Your Consultation

Your consultation with Dr. Nader Pouratian is a crucial step in getting the right treatment for carpal tunnel syndrome or ulnar nerve entrapment. Dr. Pouratian will discuss your medical history, medications, general health, and allergies. He will also examine the affected hand or elbow.

To develop a thorough understanding of your risk factors, Dr. Pouratian will ask you about your work environment, lifestyle, and recreational activities. With this knowledge, he can create a proper treatment plan to address your condition.

Treatment Options

Typically, to resolve carpal tunnel and ulnar nerve entrapment, non-surgical treatment options are explored before a surgical solution is considered. Initial non-surgical management includes using a wrist or elbow brace both at night and during the day. Sometimes, targeted injections can be used as well as a minimally invasive solution.

If symptoms progress or if there is clear weakness or atrophy, nerve decompression surgery should be considered. The goal of surgery is to increase the space through which the nerve is traveling and reduce the “pinching.” The cost of these procedures will be discussed during your consultation.

For carpal tunnel syndrome, surgery involves making a small incision on the wrist and opening the covering of the median nerve (the flexor retinaculum). The surgery is brief and can be extremely helpful. There is a risk of injuring the nerve, causing thumb weakness, but this is rare.

For ulnar nerve entrapment, an incision is made on the elbow, where the nerve is decompressed in the region of the “funny bone.” If the nerve moves around a lot, we will sometimes move the nerve to a new, more stable position.

Recovery and Healing

Recovery following carpal tunnel syndrome surgery can require working with a hand therapist and avoiding certain types of hand movement for several weeks. Heavy lifting should be avoided during healing and recovery.

The recovery process after ulnar nerve entrapment surgery takes about six weeks in total. Stitches are removed during a follow-up appointment around ten days after the date of surgery.

Scheduling a Consultation

Those experiencing the symptoms of carpal tunnel or ulnar nerve entrapment in Dallas should arrange a consultation with Dr. Nader Pouratian. To schedule your consultation, contact our office today.