Chiropractic management of a patient with ulnar nerve compression symptoms: a case report

Abstract

Objective: The purpose of this case report is to describe chiropractic management of a patient with arm and hand numbness and who was suspected to have ulnar nerve compression. Clinical Features: A 41-year-old woman presented with hand weakness and numbness along the medial aspect of her right forearm and the 3 most medial fingers. The onset of symptoms presented suddenly, 3 weeks prior, when she woke up in the morning and assumed she had "slept wrong." The patient's posture showed protracted shoulders and moderate forward head carriage. Orthopedic assessment revealed symptomatic right elevated arm stress test, grip strength asymmetry, and a Tinel sign at the right cubital tunnel. Intervention and Outcome: The patient was treated using chiropractic care, which consisted of manipulative therapy, myofascial therapy, and elastic therapeutic taping. Active home care included performing postural exercises and education about workstation ergonomics. She demonstrated immediate subjective improvement of her numbness and weakness after the first treatment. Over a series of 11 treatments, her symptoms resolved completely; and she was able to perform work tasks without dysfunction. Conclusion: Chiropractic treatment consisting of manipulation, soft tissue mobilizations, exercise, and education of workstation ergonomics appeared to reduce the symptoms of ulnar nerve compression symptoms for this patient.

The Effects of Physiotherapy in the Treatment of Cubital Tunnel Syndrome: A Systematic Review

“…One paper focused on the surgical treatment of CuTS caused by anconeus epitrochlearis, and one evaluated the effectiveness of electrostimulation after traumatic ulnar nerve injury. Finally, 11 articles were included in the final review comprising 3 RCT-type studies [ 13 , 29 , 30 ] ( Table 1 ) and 8 case-series-type studies [ 20 , 21 , 22 , 23 , 31 , 32 , 33 , 34 ] ( Table 2 ).…”

“…In all case series [ 21 , 22 ] and case reports [ 20 , 23 , 31 , 32 , 33 , 34 ], subjects were clinically and neurophysiologically diagnosed with CuTS (four studies clinically and neurophysiologically; four studies only clinically). In eight case studies, 24 subjects ranging in age from 17 to 71 years were examined and treated.…”

“…In eight case studies, 24 subjects ranging in age from 17 to 71 years were examined and treated. The gender of the subjects was determined in six of the eight papers [ 20 , 23 , 31 , 32 , 33 , 34 ]. Studies by Oskay et al and Shen et al [ 21 , 22 ] failed to specify gender.…”

“…The most frequently evaluated symptom was pain (six of the eight papers) [ 20 , 21 , 22 , 23 , 33 , 34 ]. Symptom provocation tests (five of the eight papers) [ 20 , 21 , 31 , 32 , 34 ] and functional limitations of the upper extremity (five of the eight papers) were also frequently assessed [ 21 , 22 , 23 , 32 , 34 ]. Muscle strength was assessed in three of the eight papers [ 21 , 23 , 31 ].…”

“…Symptom provocation tests (five of the eight papers) [ 20 , 21 , 31 , 32 , 34 ] and functional limitations of the upper extremity (five of the eight papers) were also frequently assessed [ 21 , 22 , 23 , 32 , 34 ]. Muscle strength was assessed in three of the eight papers [ 21 , 23 , 31 ]. Range of motion was assessed in two papers [ 20 , 32 ] as was the severity of paraesthesia [ 20 , 31 ].…”