Guyon canal syndrome

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Guyon’s canal syndrome refers to the irritation of the cubital nerve, or ulnar nerve, in the wrist, in the channel formed between the pisiform bone and the unciform apophysis.

Like all syndromes characterized by nerve compression,  Nervenia method is particularly indicated.

Symptoms

Guyon’s canal syndrome generally begins with the sensation of tingling in the last two fingers of the hand, ring and little finger. The onset is usually nocturnal, but if it is neglected it can gradually worsen, leading to constant tingling, weakness in the fine movements of the hand until the paralysis of the last two fingers, which results in the so-called blessing hand because it recalls the position of the hand used by the religious prelates in the act of blessing the crowd.

People who perform manual work with a prevalence of fixed and repetitive movements or positions often suffer from this disorder; this is why it is considered, in most cases, a disease of a professional nature, for example musicians and goldsmiths.

To synthesize the main symptoms of Guyon syndrome are:

  • reduced sensitivity of the hand or only the last two fingers;
  • difficulty and pain by performing some movements with the wrist and with the hand;
  • claw hand: typical deformity of the hand in the case of Guyon’s syndrome.

Causes

Guyon’s canal syndrome originates when the ulnar nerve is compressed and / or irritated in the Guyon’s tunnel or canal.

The main causes lead to Guyon canal syndrome may be due to:

  • Compression of the ulnar nerve
  • trauma;
  • arthritis of the wrist;
  • thickening of the Guyon’s canal;
  • inflammations of the synovial sheaths;
  • vessel abnormalities;
  • cysts;

Much more frequently than you think, you can have problems even when the ulnar nerve is compressed along its course through the arm starting from the cervical spine and not in the Guyon’s canal. This is a fundamental aspect to keep in mind both in the therapeutic decision and in the case of any conservative or surgical treatment in the case of Guyon’s canal syndrome. When the cause of ulnar nerve irritation is not in the Guyon canal, local conservative physiotherapy treatments or surgery are doomed to failure, because they focus more on symptoms than on causes. Precisely for this reason it is necessary to rely on the experts of Nervenia who are specialized in finding the real cause of nerve problems.

Diagnosis

In a first phase the diagnosis of the Guyon canal syndrome is clinical, that is based on the story that the patient makes of his disorders, referring to more or less persistent tingling on the fourth and fifth finger. At a later stage, a hypotrophy (decrease in volume) of the hypotenar eminence can be seen, followed by the classic position of the blessing hand or claw hand. It is really important, in the diagnostic phase, to distinguish Guyon’s canal syndrome from ulnar artery stenosis which can give similar symptoms but of vascular and non-nervous origin.

Care

The treatment of Guyon canal syndrome, as in the case of carpal tunnel syndrome, generally consists of a series of pain therapy at the wrist, infiltrative therapy with cortisone and surgery.

In Nervenia guidelines, for the treatment of Guyon’s canal syndrome it is essential to examine and test the entire pathway of the ulnar nerve from the cervical to the wrist both clinically, through palpation and neurodynamic tests, and instrumentally by examining the speed of nerve conduction.

The diagnosis of Nervenia, much more thorough than the normal diagnoses, serves to define how much the symptoms are actually due to the passage of the ulnar nerve in the Guyon canal and how much they are due to irritations and compressions of the ulnar nerve at the cervical level or along the arm . These tests allow you to intervene in two distinct but complementary ways:

  • on nerve compression or irritation, through neurodynamics and radiofrequency instrumental physiotherapy,
  • on the ability of the nerve to restore its ability to correctly transmit impulses with neuromodulation and, specifically, with deep nerve stimulation (DNS), the instrumental therapy used in a unique and advanced way by Nervenia.

An important application of this combination of treatment occurs in the post-surgical phase where the stimulation of the ulnar nerve becomes fundamental to reduce the symptomatology quickly and to avoid the permanence of residual disorders and the risk of relapses after the operation.