Elbow nerve compression

[crags]

I am a C6/C7 quad with serious ongoing elbow pain for years. Nothing overly problematic structurally, but all indications point to possible ulnar or radial nerve compression. EMG/nerve conduction studies are inconclusive in quads. MRI can be within normal limits for nerve issues. In fact, ulnar nerve excessive signal from the MRI is found in 60% of a symptomatic elbows according to a radiology journal article.

Am going for dynamic ultrasound study of the elbow which may show narrowing of the tunnels upon active flexion rather than a static position.

However, the surgeon just won't budge unless he sees a "slam dunk" test result. Personally, I feel he is stringing me along and has no intention of ever doing anything, regardless of how bad the results are.

Any quads with similar issues?

[Tetracyclone]

Gosh crags, I had a problem with cubital tunnel syndrome 12 years ago but I do not remember how it was diagnosed. I believe there was a Nerve conduction test and my Physiatrist felt it was conclusive. In fact, after the surgeon took care of it he told me the poor nerve was just hanging by a thread. I had to not use it much for 6 months and once I started back I could no longer climb stairs. This angered me especially because the pain was ignored by 2 PTs who continued to demand I "push through the pain". So I'm little help to you, but I do offer my sympathy and solidarity.

Mostly with medical problems I have found that we know our bodies best. If you can, find another surgeon.

[Bonnette]

I have ulnar nerve compression in three places: axilla, elbow and wrist. It's been many years since diagnosis (by clinical symptoms and EMG), but at that time the frontline treatment was simply to not bend or put pressure on the elbow. As a quad, those things might not apply to you. But surgeons back then, and perhaps still, are very reluctant to operate because the procedure can cause worse problems than the original condition - including arthritic changes and mechanical nerve damage (even causalgias, formerly known as reflex sympathetic dystrophy). If your symptoms are unbearable, surgery might bring some relief, but I was told to live with it if I could, never bending the elbow or allowing my arm to get into strange positions that put pressure on the nerve.

[SCI-Nurse]

You may have to get a second or third opinion on the need for arm nerve entrapment syndrome surgery.

(KLD)

[crags]

My experience is is that when you go for second or third opinions what do you do when the MD asks for previous records?

Start from scratch to avoid preconditioning the MD from a nonbiased review or risk getting caught being dishonest when he sends you for a test that you already had?

Or be honest upfront and then when you provide the records, there is an overwhelming tendency on the part of physicians to look at the name of the prior physicians seen, look at the diagnosis, and automatically assume that is/was the correct diagnosis. Especially, if you saw a physician whose supposed "reputation" was "good", but you know their handling of your case left much to be desired.

Then there is a subconscious tendency to label you as a doctor shopper, not resting until you get what you want.

It is very hard for an MD to put aside all records after review and start from scratch intellectually. If they cannot reach a diagnosis in 10 to 15 minutes, then it's on to imaging, and that is inconclusive, you're out of luck.

[crags]

For those that may experience this problem there are a few things to consider.

Nerve compression in the elbow often doesn't show up on MRI or even ultrasound in the extended arm position. Rather it comes out when the arm is flexed and the tunnel(s) is narrowed.

They can do the MRI in the flexed position. Additionally, they can do dynamic ultrasound, which can be used to trace several of the nerves in a variety of positions. One only go to YouTube and search for "dynamic ultrasound, elbow" and you can see all of the options available to the sonographer.

I'm going for one on Monday and I just hope the technician is as skilled as the one I watched. They generally like to pop the two most common nerves with the arm straight out.