What Causes a Pinched Nerve in The Elbow?

elbow hurts

A number of things can put pressure on the nerves in the body which lead to a pinched nerve (compression). Bone, cartilage, muscles, and tendons could all press on one or more of the nerves in and around the elbow joint. Tumors, cysts, and a buildup of fluid are other causes of nerve compression.

Other things that can lead to a pinched nerve in the elbow are sleeping with a bent elbow or leaning on a desk or table. A common cause of pinched nerves in the elbow is operating machinery and pulling levers repeatedly. Playing sports that involve throwing, such as baseball or javelin, put the nerves in the elbow at risk.

When a nerve is compressed in the elbow it will not function properly and it will suffer damage. The nerve will not be able to send signals which results in a loss of movement and sensory feeling. A nerve is similar to a telephone cable and needs to be in good condition in order to communicate.

Before looking at the best course of action when you have a pinched nerve in elbow, it’s useful to look at what nerves run through the elbow. The ulnar, median, and radial nerves all run down the arm passing through the elbow. When any of these nerves are compressed, it will lead to symptoms developing.

Ulnar Nerve

Ulnar Nerve diagram

The ulnar nerve runs from the neck and travels down the arm, through the elbow near the ulnar bone. The nerve continues to travel down the forearm and it terminates in the hand.

The ulnar nerve controls some of the muscles in the hand, little finger, and ring finger to allow movement. The ulnar nerve provides sensory innervation to the little finger and part of the ring finger.

This nerve often gets compressed in the elbow due to its lack of protection leading to a condition called cubital tunnel syndrome.

Cubital tunnel syndrome leads to symptoms including numbness and tingling in the hand and fingers. Muscle weakness in the hand is also a possibility when the ulnar nerve is pinched in the elbow.

Median Nerve

median nerve diagram

The median nerve runs from the upper arm and passes through the elbow where it enters the forearm. The nerve continues to the wrist where it travels through the carpal tunnel before entering the hand. The median nerve innervates muscles in the forearm and controls some hand movement.

When the median nerve gets pinched in the elbow it’s known as pronator teres syndrome (PTS). Symptoms associated with PTS include tingling or numbness in the forearm and grip may be affected. Lower arm pain is experienced by patients when the median nerve is pinched in the elbow.

Radial Nerve

radial nerve

The radial nerve originates from the neck and runs down the underside of the upper arm. As the nerve nears the elbow, it passes through the radial tunnel, which is made up of tendons, muscle, and bone. The nerve controls the tricep muscles and it’s responsible for finger and wrist extension.

The radial nerve has some sensory function and controls sensation in some areas of the hand.

When the nerve gets pinched in the radial tunnel it leads to a condition called radial tunnel syndrome. Symptoms of radial tunnel syndrome include aching and pain in the elbow, forearm, and hand. Forearm and wrist muscle weakness is another common symptom of radial tunnel syndrome.

If you have any symptoms such as tingling, numbness, or muscle weakness you should consult your physician at the earliest opportunity. Early diagnosis of a pinched nerve increases the chances of recovery. Qualified physicians are able to diagnose nerve damage, manage the symptoms, and offer treatment options.

If a pinched nerve in the elbow is left untreated it may lead to permanent damage and long-term symptoms.

Diagnosis

elbow xray

In order to diagnose a pinched nerve a physician will need to do some investigation. The physician will ask the patient about their symptoms and carry out a physical examination. If an immediate diagnosis cannot be made, some tests are carried out to identify the site, and cause, of the pinched nerve.

Imaging tests including MRI, CT, and ultrasound scans are used to look at nerve damage and its causes. The images will detect nerve compression as well as what is putting direct pressure on the nerve.

X-rays are useful to look for facture damage or bone spurs which compress nerves in the elbow. X-rays will not see the nerve, but the surrounding tissue and bone is visible.

There are a number of neurological tests that are used by physicians to diagnose nerve compression. Electromyography is carried out to check electrical activity in the muscles and to test nerve cells. If the electrical activity is abnormal, it points to nerve damage which is then treated.

Nerve conduction studies are an effective way to check whether a nerve is pinched in the elbow. The strength and speed of the signals sent by the nerves is measured with electrode patches on the skin. If the signal speed is slow or weak it indicates that the nerve has suffered damage.

Treatments For Pinched Nerves in The Elbow

cortisone elbow

Wearing an elbow brace or splint to keep the joint straight is used to treat nerve compression. Keeping the elbow joint straight whilst sleeping reduces the chances of nerve compression. Braces and splints are particularly effective for treating cubital tunnel syndrome.

Anti-inflammatory drugs such as naproxen sodium and ibuprofen are used to reduce swelling. Taking down the swelling relieves the direct pressure that’s being put on the nerve. Physicians may use corticosteroid injections to reduce inflammation and to alleviate pain associated with a pinched nerve.

Physiotherapy may help some patients with a pinched nerve in the elbow. Stretching and strengthening exercises help to relieve the pressure that’s compressing the nerve. Changing sleeping position and modifying the way you do things is another way to take pressure off your nerves.

If non-invasive treatments do not ease the symptoms of a pinched nerve in the elbow there are surgical options. The aim of the surgery is to decompress the nerve and prevent future compression.

Cubital Tunnel Release

Cubital Tunnel Syndrome

cubital tunnel release is carried out to increase the size of the cubital tunnel to give the ulnar nerve more room. The ligament at the top of the tunnel is cut before being divided. Pressure on the nerve is reduced and as the division heals, the cubital tunnel is made larger to reduce the chances of nerve compression.

Ulnar Nerve Transposition

ulnar nerve transposition

When the ulnar nerve is trapped in the cubital tunnel a surgeon is able to carry out ulnar nerve transposition. The surgeon makes a new tunnel from flexor muscles in the forearm and the nerve is relocated there. This procedure takes pressure off the ulnar nerve and relieves the symptoms of a pinched nerve.

Relocating the ulnar nerve on the new tunnel may prevent it from getting pinched in the future.

Medial Epicondylectomy

medial epicondylectomy

On the inner side of the elbow joint there’s a bony lump called the medial epicondyle. When the medial epicondyle puts pressure onto the ulnar nerve it leads to compression. A medial epicondylectomy is carried out to reduce pressure and alleviate symptoms associated with cubital tunnel syndrome.

The surgeon will open up an incision near the elbow and move the ulnar nerve out of the way. The medial epicondyle is then cut away to give the ulnar nerve more room. The procedure allows the nerve to move freely when the elbow is at an angle without it being compressed.

Radial Tunnel Surgery

surgery

To relieve the pressure on the radial nerve a surgeon will carry out radial tunnel surgery. The surgeon will make an incision near the elbow and continuing down the forearm. The surgeon will move away any soft tissue and look for areas where the radial nerve is trapped.

If a part of the radial tunnel is pinching the nerve it will be cut away. The surgeon will check all parts of the radial tunnel during the the procedure as the nerve may be compressed in more than one place.

Widening the radial tunnel is an effective way to alleviate pressure on the nerve and prevent it from getting pinched in the future.

It’s worth noting that all surgery carries risks and patients are made aware of these before having an operation. Risks associated with surgery include infection and permanent nerve damage.

Final Thoughts

If the pinched nerve is diagnosed accurately and the appropriate treatment is administered, patients should have no long-term problems. A nerve could get pinched at any time and symptoms will develop quickly. Seeking medical advice and following it is the best course of action when you have a pinched nerve in elbow.

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