2023-10-20 11:14:00
Ulnar impingement syndrome causes and treatment
Tennis, yoga, pilates, golf, etc.
Overloading wrist joints with repetitive use
Applicable to 50% of patients with pain without trauma
Initially, treatment is possible with drugs and injections.
If left untreated for too long, surgery may be required.
Jaeseong Lee, professor of orthopedics at Chung-Ang University Hospital, is treating a patient with ulnar impingement syndrome. Provided by Chung-Ang University Hospital
Mr. Kim (32), an office worker, alternates between tennis and Pilates every day following work. After completing this exercise, which is popular among young people, he was proud of his sense of accomplishment when he uploaded a photo confirming ‘Owunwan (exercise completed today)’ on his social networking service (SNS). Then one day, as the pain in his wrist suddenly became more severe, he went to the hospital. As a result of the examination, Mr. Kim was diagnosed with an unfamiliar disease called ‘ulnar impingement syndrome’, which is caused by worn out cartilage in the wrist.
As the number of young people called the ‘MZ generation’ who enjoy sports such as tennis, yoga, Pilates, and golf increases, the number of people in that age group visiting hospitals with wrist pain is also increasing. In particular, the diagnosis rate of ulnar impingement syndrome, which is caused by repeated wrist movements, is increasing. Lee Jae-seong, a professor of orthopedic surgery at Chung-Ang University Hospital, said, “The prevalence of patients in their 20s and 30s is increasing as the number of people enjoying sports that frequently twist their wrists, such as tennis, yoga, pilates, golf, and table tennis, is increasing.” “More than 50% of patients who come in complaining of chronic wrist pain without any specific trauma are diagnosed with ulnar impingement syndrome,” he said.
Ulnar impingement syndrome is a representative degenerative disease in which the cartilage wears away due to repeated overload on the wrist joint, causing pain. A complex of ligaments and cartilage tissue provides a cushioning effect between the ulna, a bone that protrudes from the wrist on the side of the little finger, and the carpal bone, which is made up of the palm and wrist bones. However, if you frequently twist your wrist, the cartilage in the triangular fibrocartilage complex wears away, causing pain.
When observing the wrist of a patient with ulnar impingement syndrome through an arthroscope, the triangular fibrocartilage was worn away and a hole was created in the center (left photo). After performing ulnar shortening surgery to reduce the length of the ulna, you can see that the length of the radius on the inside of the forearm and the ulna on the outside have become the same. Provided by Chung-Ang University Hospital
When this disease occurs, pain is felt even when performing everyday movements such as turning a doorknob, wringing out a mop, or typing. In addition to sports that primarily utilize the wrist, it is easy to impact that area when hammering. This is because if you hold a hammer and hit a hammer while the gap between the ulna and the wrist bone is narrowed, the wrist bends towards the ulna and a strong impact force is transmitted to the joint when it hits an object. Additionally, ulnar impingement syndrome is more likely to occur when the ulna is relatively longer among the two bones that make up the forearm, the ulna and radius.
Many structures function in detail on the ulna side of the wrist, so to diagnose ulnar impingement syndrome, it must be differentiated from abnormalities in other structures. If you feel pain when your wrist is bent toward the ulna towards your little finger, or if you feel pain when you press the concave area between the wrist bones on the side of your little finger, you may suspect this disease. In hospitals, diagnosis can be made through physical examination, such as palpation, and imaging tests.
If ulnar impingement syndrome is diagnosed relatively early, it can be treated through drug/injection treatment and rehabilitation treatment. But the most important thing is to try to reduce the load on the ulna side of the wrist. In particular, you should avoid twisting your joints by making rotational movements with your wrist bent outward. You should also regularly exercise to increase the strength of your forearm, the part between your elbow and wrist.
If ulnar impingement syndrome is left untreated, the pain will become so severe that the wrist cannot be moved, making surgery unavoidable. If the condition of the joint is relatively good, it can be treated only with ulnar shortening surgery to shorten the length of the ulna, but if left for a long time, the cartilage may be completely damaged and surgery to fix the joint itself may be necessary. If this happens, you will not be able to move your wrist normally even following surgery.
Professor Lee Jae-seong said, “We often see cases where the pain gets worse while exercising using the wrist and the pain gets worse and the patient visits the hospital late.” He added, “Even if there is no particular injury, when rotating the wrist or doing push-ups, the wrist is on the ulnar side. “If this pain persists, it is important to quickly visit a hospital and receive appropriate treatment at an early stage,” he said.
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