You’ve likely heard of carpal tunnel syndrome. This common form of nerve entrapment affects between 1 and 3 people per 1,000 each year. Carpal tunnel syndrome is relatively well known. But the second most prevalent entrapment neuropathy, ulnar nerve entrapment is less so. It affects between 19 and 20 people per 100,000 people per year. Though it may be less common, it’s certainly no less painful and presents similar symptoms as carpal tunnel syndrome.
If you’re suffering from pain, numbness, tingling, or weakness in your hand or fingers, it could be a result of entrapment of the ulnar nerve. Keep reading to learn more about this condition, and how our St George hand and wrist surgery experts can help.
What is Ulnar Nerve Entrapment?
Like carpal tunnel syndrome, ulnar nerve entrapment is a type of entrapment neuropathy. This means that they are conditions in which a nerve becomes entrapped or compressed between two other structures within the body. In most cases, these structures include bones or ligaments.
Ulnar nerve entrapment is a type of compressive neuropathy in which the ulnar nerve, one of three main nerves in your arm, which runs from your neck into your hand, becomes compressed or trapped. This nerve is responsible for sending electrical signals to the muscles of your hand and forearm. It also provides sensation to your ring and little fingers, or your fourth and fifth fingers on each hand, as well as to the underside of your forearm and part of your palm.
Because the ulnar nerve runs for the length of your arm and into your hand, entrapment can occur at a couple of places. This includes both the wrist and the elbow. Ulnar nerve entrapment is also sometimes known as Guyon’s canal syndrome, Tardy ulnar palsy, Bicycler’s neuropathy, or cubital tunnel syndrome. This condition can occur at any age but is more common in individuals over the age of 40.
What Causes Ulnar Nerve Entrapment?
While most entrapment neuropathy cases, including carpal tunnel syndrome, occur as a result of repetitive motion, ulnar nerve entrapment can also be caused by direct trauma. An injury to your elbow, including a fracture or dislocation, can lead to cubital tunnel syndrome, or ulnar nerve entrapment. Some bone and joint diseases, including bone spurs and arthritis, can lead to entrapment as well.
There are a number of repetitive motions that can cause nerve entrapment over time as well. Often, these involve motions that require an individual to keep their elbows bent at an angle while resting their elbows on a hard surface. Cyclists may be more prone to developing ulnar nerve entrapment, which is one reason why it’s sometimes called bicycler’s neuropathy.
Ulnar nerve entrapment at the wrist may be a result of direct trauma, such as a fall, which causes the nerve to become trapped or pinched between bone and ligament. Some repetitive motions that can lead to nerve entrapment at the wrist include using hand tools, leaning on a cane to walk, doing excessive push-ups and other exercises that put pressure on the wrists, and cycling.
Signs and Symptoms
There are a number of common symptoms that can indicate that a person is suffering from ulnar nerve entrapment. These symptoms may arise slowly as a nerve becomes compressed, or suddenly if the compression is the result of an injury.
Often, the first signs is tenderness, numbness, or weakness in the hand. This symptom will occur whether the entrapment occurs at the wrist or elbow. The individual may have trouble bending their fingers or making a fist or may feel weakness when trying to grip something in their hand. Tingling in the fourth and fifth fingers and in part of the palm of the hand is also common. Additional symptoms may include tenderness or tingling in the joint of the elbow, as well as sensitivity to cold temperatures.
Getting a Diagnosis
After an individual notices pain, tingling, or numbness, they should visit their doctor as soon as possible. He or she will ask some questions about their pain and may also perform additional tests to diagnose ulnar nerve entrapment. This includes an EMG, or electromyography, or NCS, or nerve conduction study. These tests allow them to see how the nerves and muscles in the arm are functioning.
Depending on the severity of the injury or condition, your doctor may also order an MRI, ultrasound, or MR neurography, a type of MRI that provides enhanced images of your nerves.
Treatment Options
Treatment options for entrapment of the ulnar nerve include both surgical and nonsurgical procedures. In more minor cases, nonsurgical options like occupational therapy to strengthen the ligaments may help reduce pain and compression. Over-the-counter medications can be used to help with the pain as well. A splint may also be necessary to prevent the bending of the elbow, which puts additional pressure on the trapped nerve.
In some cases, surgery may be necessary to treat ulnar nerve entrapment. Surgical intervention can help to relieve pressure on the nerve, reducing pain and preventing additional damage. After hand or wrist surgery, physical therapy is likely to be needed as well. This will help the patient regain full range of motion in their wrist and/or elbow.
How St George Hand and Wrist Surgery Can Help
Ulnar nerve entrapment is a painful, often debilitating condition. It can make it difficult to do routine tasks that require you to bend your elbow. Even in minor cases, it can prevent you from enjoying hobbies like cycling. It can even keep you from holding and carrying items with your hands.
Ulnar nerve entrapment is unlikely to heal on its own. For that reason, it’s important to see a doctor as soon as you experience pain, numbness, or tingling. They can help you get a diagnosis, which is the first step in choosing the right treatment option and can help to prevent additional injury and pain.
Our St George hand and wrist surgery experts can help you get to the root of your pain, and find a solution to help you get pain-free. The hand surgeons at Intermountain Healthcare’s Southwest Orthopedics and Sports Medicine specialty clinic specialize in providing the highest quality care, with kindness and compassion. Whether you’ve already been diagnosed with a hand and wrist condition or are still looking for a diagnosis, we are here to help. Schedule an appointment today to get started.