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Suggest Treatment For Cubital Tunnel Syndrome

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Posted on Wed, 5 Nov 2014
Question: Hi
Thanks for looking at my question. It concerns cubital tunnel syndrome (‘CTS’) which I have in both elbows (confirmed by ulnar nerve conduction tests at my local hospital).
CTS causes me problems while in bed. I tend to bend my arms in my sleep and then I wake up with numb, ‘paralysed’ hands (also sometimes ‘tingling’, though not painful). The hand-numbness quickly departs when I straighten my arms. For about 12 months now, almost every time I wake up, one or both hands is very numb.
This has been disturbing my sleep quite badly: I wake prematurely with numb hands and believe this is the cause of my waking (‘so that’ I can move position and fix the problem!). The resultant sleep deprivation is problematic; additionally, I am concerned about the possibility of increasing nerve damage to my hands (given that the ulnar nerve entrapment is occurring severely, night after night).
My GP recently gave me two tight, tubular, elasticated fabric bandages to pull over my elbows when I go to bed in the hope that this would resist (though of course not entirely prevent) my tendency to bend my arms at the elbows while sleeping. I have tried using these bandages for four nights and they do seem to help somewhat. But – to finally get to my question! - there has been a peculiar side-effect of using the bandages and this is what I would like your advice on please.
On every occasion I’ve used these bandages, I have woken with ‘puffed-up’ or swollen hands. Not painful, just swollen. The swelling dissipates in an hour or two after taking the bandages off. I would like advice on whether or not I can safely continue using the bandages over my elbows while sleeping, given the swelling of my hands they cause. If the swelling is harmless, I would be keen to carry on using the bandages (every night from now on).
I should mention that the veins in the pits of both my elbows and in my forearms are very prominent (‘stick out’ a lot!). Presumably these veins are being compressed by the tight bandages and I wonder whether this is the cause of the hand-swelling.
If you think, in view of the hand-swelling, using these bandages to control nocturnal arm movements is inadvisable, I would be grateful for any suggestions you might have for alternative ways I can discourage my arms from bending while sleeping (I make sure that my arms are straight when I go to sleep, but unfortunately, the message doesn’t seem to have got through to my unconscious mind that they need to remain extended throughout the night!).
Thanks very much for your help with this.
Regards
XXXX
doctor
Answered by Dr. Shoaib Khan (1 hour later)
Brief Answer:
Learn proper technique; check on B12 levels

Detailed Answer:
Hello sir and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. To start off with, I would like you to know that we advise most of our patients to remove their elastic bandages before going to bed and to wear them as soon as they get out of it. This is because the main purpose of an elastic bandage is to reduce swelling and promote healing.

There is a certain way to tie your bandage, and when wrapped too tight it can result in a disruption in circulation which in turn results in the swelling. So the swelling that you are experiencing could be an indication of an improper technique. For this reason, I would request you to visit your doctor or a physiotherapist and learn the right technique.

I appreciate your attitude of being open to suggestions, and here are a few I have:

-Poor vascular health can usually result in a presentation similar to yours, and working in this field I have found many (not all) individuals who report to me with such an issue to have a deficiency in vitamin B12 levels. For this reason I would recommend a check on your serum vitamin B12 levels and if found to be deficient, initiation of a good supplement that contains vitamin B1, B6 and B12

-I would also advise (if possible) a mild change in the angle of your bed. To raise the end of your bed where your feet lie by about 10-15 degrees so blood circulation is promoted towards the upper region of your body to prevent any circulatory issues with the upper arms. At the same time please make sure you do not raise that end of the bed too much, as this can result in a greatly reduced level of blood circulation to the lower extremities

I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help you.

Best wishes sir.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (1 hour later)
Dear Dr XXXXXXX
Thank you very much for your swift, comprehensive and very helpful reply, which I much appreciate. I shall follow up the suggestions you made. This is the first time I have made use of HealthCare Magic and I’m impressed!
Thank you again for your time.
Kind regards
XXXX
doctor
Answered by Dr. Shoaib Khan (5 hours later)
Brief Answer:
It was my pleasure entirely

Detailed Answer:
Hello once again XXXXXXX

I am happy I could be of assistance. I am always available tp help, so please do not ever hesitate to write to me anytime. Just ask for me in your query, and the team of Healthcaremagic will direct your query to me, although I hope and pray you do not a doctors assistance ever, and experience a blissfully beautiful and healthy life hereafter.

Best of luck sir.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

Answered : 9409 Questions

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Suggest Treatment For Cubital Tunnel Syndrome

Brief Answer: Learn proper technique; check on B12 levels Detailed Answer: Hello sir and welcome. Thank you for writing to us. I have gone through your query with diligence and would like you to know that I am here to help. To start off with, I would like you to know that we advise most of our patients to remove their elastic bandages before going to bed and to wear them as soon as they get out of it. This is because the main purpose of an elastic bandage is to reduce swelling and promote healing. There is a certain way to tie your bandage, and when wrapped too tight it can result in a disruption in circulation which in turn results in the swelling. So the swelling that you are experiencing could be an indication of an improper technique. For this reason, I would request you to visit your doctor or a physiotherapist and learn the right technique. I appreciate your attitude of being open to suggestions, and here are a few I have: -Poor vascular health can usually result in a presentation similar to yours, and working in this field I have found many (not all) individuals who report to me with such an issue to have a deficiency in vitamin B12 levels. For this reason I would recommend a check on your serum vitamin B12 levels and if found to be deficient, initiation of a good supplement that contains vitamin B1, B6 and B12 -I would also advise (if possible) a mild change in the angle of your bed. To raise the end of your bed where your feet lie by about 10-15 degrees so blood circulation is promoted towards the upper region of your body to prevent any circulatory issues with the upper arms. At the same time please make sure you do not raise that end of the bed too much, as this can result in a greatly reduced level of blood circulation to the lower extremities I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications, I would be more than happy to help you. Best wishes sir.