How bilateral ECV confirmed Ulnar Nerve Compression and bilateral symptoms-only CTS-like got better/resolved
Hi all,
As I found a lot of useful information on this forum, and got a reply from Jeremy on a post of me a year ago I decided to post a follow-up (for the inital post please view one of the cubital tunnel syndrome posts, I think it was started by "makeson"). The most important info is that I had bilateral nightly numbness in all my fingers, no pain involved and no daytime symptoms.
I did not want to get surgery but I did the following:
As previous examination could only confirm an ulnar entrapment at the elbow, my neurologist prescribed physical therapy. The physical therapy consisted of massaging and some "soft electric stimulation". This had little effect and no lasting effect what so ever. I read online that elbow braces are often used at night for ulnar nerve compressions, so I asked the PT. She said she "was not fond of them", so I ordered them myself (great choice on Amazon, where I bought them). This helped a lot with helping me maintaining normal posture while sleeping. The frequency of numbness dropped from 90% to +-30% within some weeks, I kept an excel with the distribution of symptoms for several months.
I visited my family doctor again and asked for another referral to another PT, as I was not happy with the first one not being fond of the thing that helped me.
There I hit the jackpot. He was the first one to ask me specific diagnostic questions regarding my sport activities, my posture etc. He began with dry needling around my back/shoulder/elbow/forearm *but not my wrist*. This helped a lot. He also showed some specific stretching exercises and an exercise (dumbell pullover) to stretch further, and advised me start working my pulling motions more than my pushing motions in the gym. There were in total 10 sessions over 10 weeks. I wore the braces at night during. I wore the braces for 2 months more afterwards although my symptoms were completely resolved, no numbness what so ever, so from 30% to almost 0%-1%/
A month or two ago I went on a holiday for a week and did not wear my braces. My hands did not go numb expect when I slept on my elbow in a weird way (I have a heavy upper torso), but then only in my pinky/ring finger. I continued not to wear them and now I have +- once a week an occurrence of numbness in my left hand ring/pinky at night shortly but only when I sleep on it.
Other information: I lost 14 kg (from 106kg to 92kg, all fat) during that period and almost entirely gave up alcohol, and also changed my training regime. I specifically removed chin-ups/pull-ups.
I think I will still have to watch out in order to keep it at bay, but the way how to manage it is clear for me. I asked my PT about a possible cause for the dual symptoms, and he mentioned something about a "bulk" (don't know the English word) of veins/nerves in the elbow that are always differently distributed person by person and together with my tight muscles/posture/sleeping position/lifting that caused the symptoms I noticed.
I hope the above story is readable, if any of you have questions I will try to follow up on this thread. It not, I hope this helps somebody somewhere as it really got me worried a year ago!
It sounds very much like ulnar nerve trouble at the elbow rather than CTS of course. It's always dificult with multiple interventions to know which one, or which combination, actually resulted in improvement, or indeed whether the problem resolved itself and al the 'treatments' were coincidental and just happy to take the credit but my general view in the individual case is that as long as the symptoms have improved it doesn't really matter very much what made made the difference. JB
Thanks for the follow up. It does seem highly likely that the main problem was the ulnar nerve at the elbow and that one way or another you have changed your habits and build to alleviate the problem without requiring surgery. The best evidence I have seen suggests that about half of cases of UNE might resolve with conservative (ie non-surgical) management so you would fall into that group. It's hard to be sure in an individual case exactly which of several interventions have really made the difference, and some cases do resolve even if you do nothing so it might be pure conicidence - though any professional is usually willing to take the credit for fixing something - me included :-) It's hard to know quite what the physio was talkig about regarding the anatomy of the elbow - yes everyone is slightly different in structure - even identical twins are no longer really identical once they get past the stage of being just a few cells in the wonb because we all grow and develop with slightly different environmental conditions. However the main feeatures of human anatomy are fairly consistent across most individuals. The ulnar nerve at the elbow is almost always situated in the ulnar groove when the arm is straight or slightly flexed for example. On bending the elbow to 90 degrees or more however some ulnar nerves will pop out of the groove and some will not - so there you have an example of both consistency and variability. JB
Addition: It only occurs now when I sleep on my *elbows* and bend them in a certain position, and only very brief light numbness in my pinky/ring. I may have phrased it otherwise.