The ulnar nerve is one of the primary nerves located in the arm, and the largest unprotected nerve in the body. The nerve is connected to the little finger and ring finger. When this nerve becomes irritated or pinched, the condition is known as ulnar nerve entrapment. Patients in the greater Atlanta, GA area that have experienced ulnar nerve entrapment can receive the help they need with Dr. Steven Bailey at The Hand Center at Crawford Plastic Surgery.
What Is Ulnar Nerve Entrapment?
Ulnar nerve entrapment occurs when the ulnar nerve of the arm becomes compressed, damaged, or irritated. When this occurs, patients experience pain, numbness, and weakness along the hand, wrist, and arm. Ulnar nerve entrapment is most common at the elbow, though it's also possible for the nerve to be affected at the wrist.
Symptoms of Ulnar Nerve Entrapment
Some of the most common symptoms of ulnar nerve entrapment include:
- Numbness or tingling of the pinky and ring fingers
- Weakness in the hand
- Tenderness in the hand and elbow
- Changes in grip strength
In some cases of prolonged ulnar nerve entrapment, it's possible for the muscles of the hand to waste away.
Causes of Ulnar Nerve Entrapment
One of the most common causes of ulnar nerve entrapment is keeping the elbow bent for long periods of time. This includes keeping the elbows bent during sleep. Repetitive motions that result in a bent elbow can also irritate the ulnar nerve over time, as can leaning on the elbow.
Prior elbow injuries, swelling of the elbow joint, arthritis, and bone spurs around the elbow can all cause or contribute to ulnar nerve entrapment.
Types of Ulnar Nerve Entrapment
There are two common types of ulnar nerve entrapment based on where the nerve issues arise.
- Cubital Tunnel Syndrome: When ulnar nerve entrapment occurs at the elbow, it's most commonly the result of cubital tunnel syndrome. The cubital tunnel is supposed to allow passage of the ulnar nerve around the bone and structures of the elbow, though various issues can lead to nerve impingement.
- Guyon's Canal Syndrome: When ulnar nerve entrapment occurs at the wrist, it's most commonly the result of Guyon's canal syndrome. As with the cubital tunnel, Guyon's canal normally allows for passage of the nerve, though impingement may occur for a variety of reasons.
Ulnar Nerve Entrapment Diagnosis
To diagnose ulnar nerve entrapment, we typically use a combination of X-rays and nerve conduction tests. X-rays will help determine the nature of the nerve entrapment and what structures may be causing it. Nerve conduction tests will help determine how well the ulnar nerve is functioning and where along the arm the impingement is taking place.
Treatment of Ulnar Nerve Entrapment
Non-surgical treatments are a common first step when treating ulnar nerve entrapment. This will typically involve the use of a brace or splint for the elbow, non-steroidal anti-inflammatory drugs (NSAIDs), and exercises that help improve the position of the ulnar nerve.
If surgery is required, the ideal surgical procedure will depend on nature of the patient's ulnar nerve entrapment.
- Cubital Tunnel Release Surgery: This surgery increases the size of the cubital tunnel in order to relieve pressure on the ulnar nerve.
- Medial Epicondylectomy: This surgery involves the removal of part of the medial epicondyle, which is part of the humerus located near the elbow. The procedure similarly reduces pressure on the ulnar nerve.
- Ulnar Nerve Anterior Transposition: This surgery changes the position of the ulnar nerve, placing it in front of the medial epicondyle to avoid nerve entrapment.
Recovery after Ulnar Nerve Entrapment Surgery
Following surgery for ulnar nerve entrapment, patients will wear a brace or splint for a few weeks to keep the elbow still and ensure proper healing. This will be followed by physical therapy to restore flexibility and use of the elbow joint. Exercises will then be recommended to increase the strength of the elbow and arm.
Contact The Hand Center at Crawford Plastic Surgery to learn more about ulnar nerve entrapment and the treatment options available.