Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Cell Phone Elbow?

Last Tuesday, this tweet from @AllergyNotes caught my eye.

Call cubital tunnel syndrome a “cell phone elbow” and you make the front page of CNN.com: http://bit.ly/RaXrt and http://bit.ly/TTRfg

Cubital tunnel syndrome I know, but I had not heard it called “cell phone elbow.”  The first link is to the Cleveland Clinic Journal of Medicine article (full reference below).  It is an excellent article and well worth reading.  The second link is to CNN news article picking up the “cell phone elbow” line.

Cubital tunnel syndrome is a nerve compression syndrome (like carpal tunnel syndrome).  In the case of cubital tunnel syndrome, the nerve involved is the ulnar nerve and the location is at the elbow.  From the article

… the ulnar nerve as it traverses the posterior elbow, wrapping around the medial condyle of the humerus. When people hold their elbow flexed for a prolonged period, such as when speaking on the phone or sleeping at night, the ulnar nerve is placed in tension; the nerve itself can elongate 4.5 to 8 mm with elbow flexion……..

As with other nerve compression syndromes, the clinical picture is representative of the nerves enervation.  In the case of the ulnar nerve, this involves numbness or paresthesias in the small and ring fingers.   There may also be numbness of the dorsal ulnar hand which will NOT be present if the ulnar nerve  compression is in the Guyon’s canal at the wrist level (distal ulnar nerve compression).  If the compression is chronic enough, the symptoms progress to hand fatigue and weakness.  The small intrinsic muscles of the hand are important in hand strength needed to open jars.   More from the article

Chronic and severe compression may lead to permanent motor deficits, including an inability to adduct the small finger (Wartenberg sign) and severe clawing of the ring and small fingers (a hand posture of metacarpophalangeal extension and flexion of the proximal and distal interphalangeal joints due to dysfunction of the ulnar-innervated intrinsic hand musculature). Patients may be unable to grasp things in a key-pinch grip, using a fingertip grip instead (Froment sign).

It may be an old joke (Patient: Doctor, it hurts when I do this.  … Doctor: Well don’t do it.), but in the case of cubital tunnel syndrome it fits.  Prevention is key.  Prolonged extreme flexion of the elbow (elbows bent tighter than 90 degrees) is not kind to the ulnar nerve.  Switch hands or use a head set or blue tooth.

REFERENCES

Q:What is cell phone elbow, and what should we tell our patients?; Cleveland Clinic Journal of Medicine May 2009 vol. 76 5 306-308 (doi: 10.3949/ccjm.76a.08090); Darowish, Michael MD, Lawton, Jeffrey N. MD, and Evans, Peter J MD, PhD

Cubital Tunnel Syndrome: eMedicine Article, Feb 9, 2007; James R Verheyden, MD and  Andrew K Palmer, MD

*This blog post was originally published at Suture for a Living*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »

Commented - Most Popular Articles