Incorporating Nerve-Gliding Techniques in the Conservative Treatment of Cubital Tunnel Syndrome
Received 28 May 2003; received in revised form 1 July 2003
Objective
To discuss the diagnosis and treatment of a patient with cubital tunnel syndrome and to illustrate novel treatment modalities for the ulnar nerve and its surrounding structures and target tissues. The rationale for the addition of nerve-gliding techniques will be highlighted.
Clinical Features
Two months after onset, a 17-year-old female nursing student who had a traumatic onset of cubital tunnel syndrome still experienced pain around the elbow and paresthesia in the ulnar nerve distribution. Electrodiagnostic tests were negative. Segmental cervicothoracic motion dysfunctions were present which were regarded as contributing factors hindering natural recovery.
Intervention and Outcomes
After 6 sessions consisting of nerve-gliding techniques and segmental joint manipulation and a home exercise program consisting of nerve gliding and light free-weight exercises, a substantial improvement was recorded on both the impairment and functional level (pain scales, clinical tests, and Northwick Park Questionnaire). Symptoms did not recur within a 10-month follow-up period, and pain and disability had completely resolved.
Conclusions
Movement-based management may be beneficial in the conservative management of cubital tunnel syndrome. As this intervention is in contrast with the traditional recommendation of immobilization, comparing the effects of both interventions in a systematic way is an essential next step to determine the optimal treatment of patients with cubital tunnel syndrome.
aPost-doctoral research fellow, Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Australia; Department of Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, University of Leuven, Belgium.
bPrivate practitioner and Associate Lecturer, Department of Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, University of Leuven, Belgium
cProfessor, Department of Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, University of Leuven, Belgium
Submit requests for reprints to: Michel Coppieters, PhD, Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, QLD 4072 St Lucia, Australia
Sources of financial support: All equipment was provided by the Department of Rehabilitation Sciences and the Department of Kinesiology, University of Leuven, Belgium. No additional funding was obtained.
ABSTRACT