Ulnar neuropathy is a condition in which the ulnar nerve that runs down the length of the arm becomes compressed (entrapped) and/or irritated. The most common sites for entrapment are the elbow (the majority of cases) and the wrist. Nerve entrapment can result when the nerve becomes inflamed due to repetitive stress. A broken elbow or fracture can also put pressure on the nerve. Neurological symptoms resulting from the trapped nerve include weakness, numbness, muscle wasting (atrophy), and pins-and-needles sensation in portions of the lower arm controlled by the ulnar nerve (especially the little and ring fingers). Neuropathy refers to injury to the nerve. The ulnar nerve is also known as the funny bone nerve in the region of the elbow, along with other names including bicycler’s neuropathy, cubital tunnel syndrome and tardy ulnar palsy.
Since ulnar neuropathy takes a while to develop into the stage where the disease is noticeable, the occurrence of it is usually in middle-aged and older adults, rather than in children. The onset of the symptoms of ulnar neuropathy can be damaging to patients in that they could lose the use of an arm. Most common symptoms are numbness and tingling in the pinky and ring finger, and sometimes on the medial aspect of the palm. Pain is not as common in ulnar neuropathy as in Carpal Tunnel Syndrome. In severe cases, patients may develop weakness and muscle atrophy.
An exam of the hand and wrist can reveal ulnar nerve dysfunction in severe cases. Signs may include:
- Claw-like deformity (in severe cases)
- Difficulty in moving the fingers
- Wasting or atrophy of the hand muscles (in severe cases)
- Weakness of wrist and hand bending
The goal of treatment is to allow patients to use the hand and arm as much as possible. The cause should be identified and treated. Sometimes, no treatment is required, and patients will get better on their own.
Treatments may include:
- A supportive splint or elbow pad to help prevent further injury
- Corticosteroids injected into the area to reduce swelling and pressure on the nerve
- Over-the-counter analgesics or prescription pain medications to control pain (neuralgia)
- Other medications including gabapentin, phenytoin and carbamazepine, or tricyclic antidepressants such as amitriptyline or duloxetine to reduce stabbing pains
- Physical therapy exercises to help maintain muscle strength
- Occupational counseling, occupational therapy, job changes or retraining
- Surgery to relieve pressure on the nerve if the symptoms get worse, movement is difficult or there is proof that part of the nerve is wasting away. Surgical decompression or transposition (moving the nerve out of its canal) may be recommended if the symptoms are from entrapment of the nerve.