Treatment for Pinched Nerves in an Elbow

woman standing in front of the kitchen countertop grasping at her elbows
Close-up of a woman holding her elbow. (Image: George Doyle/Stockbyte/Getty Images)

The main condition of the elbow that involves compression of a nerve is the condition known as cubital tunnel syndrome. Other names that describe this condition are tardy ulnar neuropathy and ulnar nerve compression syndrome. The ulnar nerve can become entrapped, or pinched, as a result of overuse activities, direct trauma and anatomic variations.

Treatment options are based primarily upon the severity of the condition, as there are risks that severe or chronic pressure upon the nerve can lead to permanent injury and resultant deficits.

Activity Avoidance

One of the easiest treatment options for ulnar nerve entrapment is to eliminate the activity that is causing the pressure on the nerve, which is usually repetitive flexion (bending) and extension (straightening).

People who sleep with their elbows constantly bent frequently complain of the symptoms associated with nerve entrapment of this type. Avoidance of this position can typically mitigate the symptoms and pressure.

Avoidance or alteration of activities such as repetitive flexion/extension and squeezing maneuvers, as seen in the operation of pneumatic guns on assembly lines, can reduce or eliminate the aggravation to the nerve as well as the symptoms.

Anti-Inflammatory Drugs

Because many of the causes of ulnar nerve entrapment involve activities that inflame and aggravate the nerve itself, the use of non-steroidal anti-inflammatory drugs, or NSAIDs, can be a valuable treatment option. By reducing the inflammation in the nerve as well as surrounding tissues, swelling will also be reduced and consequently a reduction in pressure upon the nerve will ultimately occur.

Steroid Injections

When instances occur in which the compression of the nerve is either too severe or too chronic for oral medications to afford any meaningful benefit, the use of injectable steroids (like cortisone) can provide significant relief.

Cortisone is similar to the steroids our body naturally produces; however, the injectable variety can be more concentrated. Injecting the steroid directly where it is needed offers significant benefits to the nerve and tissues by exerting its effect in a localized fashion, rather than waiting for the steroid to circulate throughout the body only to act locally.

Surgical Release

When the compression and symptoms are severe enough that conservative measures are ineffective, surgical release and occasion relocation of the nerve is the ultimate treatment.

The procedure typically involves the release of the bands of supportive tissues than commonly hold the nerve in its location within the groove of the distal upper arm bone (humerus). Many times, this is accompanied by somewhat of a relocation procedure, or transposition, whereby the nerve is literally removed from the bony groove and transposed into the adjacent soft tissue in such a way as to lessen any pulling or compressive forces exerted upon the nerve.

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