ULNAR NERVE COMPRESSION (ULNAR NEUROPATHY)

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What is Ulnar Neuropathy?

Ulnar neuropathy can cause pain, tingling, and numbness in one or both hands. Ulnar Neuropathy results from the compression of the ulnar nerve, which commonly occurs at the elbow and in some cases, at the wrist.

The ring and pinky fingers generally start to feel numb, with patients usually feeling pain around the inside of the elbow and forearm.

Upper Extremity Specialists diagnose Ulnar Nerve Compression by combining clinical assessment and nerve conduction studies. In some cases, ulnar neuropathy may come after a direct injury to the elbow or a fracture in the same region.

What Causes Ulnar Neuropathy?

Ulnar Neuropathy arises from an increased pressure on the ulnar nerve, which passes through the small hollow of the elbow commonly known as the “funny bone.” Patient have a higher risk of developing Ulnar Neuropathy if they:

Lean on their elbow often, especially on hard surfaces

Leave the elbow bent for prolonged periods of time, such as while talking on the phone or sleeping with the arm left bent under the pillow

In some cases, Ulnar Neuropathy can result from an abnormal growth of bone in the elbow or from repeated intense physical activity such as sports that rely on throwing. Baseball pitchers, for example, have an increased risk of ulnar neuropathy due to the twisting motion required to throw certain pitches.

Early symptoms of ulnar neuropathy include:

Pain and numbness in the elbow

Tingling in the hand, wrist and pinky finger

If Ulnar Neuropathy advances, symptoms can also include:

Weakness in the fingers

An inability or decreased ability to pinch the thumb and pinky finger together

A weakened hand grip

Muscle loss in the hand

Claw-like deformity in the hand

How Does an Upper Extremity Specialist Diagnose Ulnar Neuropathy?

Hand and Wrist specialists may order tests such as a nerve conduction study and a test called electromyography. During an Electromyography procedure, specialists place electrodes into muscles and on the skin to measure the health of muscles and the nerve cells that control them, confirm the diagnosis, identify the area of nerve damage, and determine the severity of the condition. Cases of Ulnar Neuropathy typically do not require X-ray or MRI exams to diagnose.

How do Specialists Treat Ulnar Neuropathy?

Nonsurgical Treatment

In the early stages of Ulnar Neuropathy, your upper extremity specialist will most likely recommend non-steroidal anti-inflammatory medicine to reduce swelling around the nerve, such as ibuprofen.

Due to a somewhat higher risk of nerve damage, physicians will not typically resort to cortico-steroid injections to deal with Ulnar Neuropathy. Rather than injections, your upper extremity specialist will usually prescribe a brace or splint to wear while sleeping in order to keep the elbow in a proper position. Some physicians will also recommend specific exercises to help the ulnar nerve glide properly through the cubital canal. Performing these exercises regularly can help prevent stiffness in the arm and wrist, avoiding the need for eventual surgery.

Surgical Treatment

Unfortunately, while splints and physical therapy can sometimes have success relieving pressure from the ulnar nerve, effective long term relief tends to come from Cubital Tunnel Release Surgery. By cutting through some of the tissue constricting the cubital tunnel, the ulnar nerve can run smoothly through the elbow. Luckily, upper extremity specialists can perform Cubital Tunnel Surgery as a minimally invasive out-patient surgery, with patients able to go home the same day.

Surgical Recovery

Depending on the details of the surgery, your physician may send you home in a splint to wear for the first few weeks of recovery. If the surgery requires a submuscular transposition, that will extend the recovery time to between 3 to 6 weeks in a splint.

Additionally, your physician may prescribe a physical therapy course to help teach you exercises that will recover strength and motion in the joint.