Ulnar Neuropathy

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Ulnar Neuropathy (or Cubital Tunnel Syndrome)

The ulnar nerve is one of three main nerves in the arm. It originates in the cervical spine and extends down into your hand. Ulnar neuropathy is irritation of the ulnar nerve due to compression or entrapment of the nerve most commonly affecting the elbow. A timely diagnosis is imperative to minimize functional impairment, limb weakness, loss of dexterity and pain.

Causes of Ulnar Neuropathy

The causes of ulnar neuropathy can vary, but often include some damage to the ulnar nerve. Causes may include:

  • Long-term pressure on the elbow or palms of hands
  • Elbow fracture
  • Elbow dislocation
  • Severe twisting of the elbow
  • Repetitive flexing of the elbow joint throughout the day
  • Pressure on the nerve caused by swelling or injury of nearby structures in the arm

Symptoms of Ulnar Neuropathy

The most common symptoms of ulnar neuropathy include:

  • Abnormal sensations in the little finger and part of the ring finger, usually on the palm side
  • Loss of coordination of the fingers
  • Numbness or decreased sensation
  • Pain
  • Tingling, burning sensation
  • Weakness and clumsiness of the hand

Pain or numbness may awaken you from sleep. Activities such as tennis or golf may make the condition worse. Other activities that might make the pain more intense due to increased compression of the nerve include:

  • Holding the telephone
  • Resting your head on your hand
  • Crossing your arms over your chest
  • Placing hands on top of the steering wheel and driving for prolonged amounts of time
  • Using the computer for extended periods of time

Diagnosis of Ulnar Neuropathy

To diagnose ulnar neuropathy, Dr. Harron will obtain a thorough medical history from you including specific details about any injuries you may have had. It is also helpful to provide a time frame for onset of pain. During the examination, Dr. Harron will determine if you display:

  • Claw-like distortion in hand (in severe cases)
  • Difficulty moving the fingers
  • Wasting of the hand muscles (in severe cases)
  • Weakness of hand flexing

He may prescribe the following tests to include:

  • Blood tests
  • Imaging scans
  • MRI of the neck
  • Nerve ultrasound
  • Nerve conduction tests
  • Recording of the electrical activity in muscles (EMG)
  • X-rays

At Harron Neurosurgery, we believe an accurate and timely diagnosis of disease or conditions will offer our patients the best long-term outcome.

Treatment of Ulnar Neuropathy

At Harron Neurosurgery, we use a conservative approach in treating ulnar nerve compression. The goal of treatment is to restore the use of your hand and arm as quickly as possible. Primary treatment of neuropathy includes medications such as NSAIDs either prescribed or over-the-counter. A nerve pain medication such as gabapentin can be used to help calm the irritated nerve. A splint may be offered as a solution to prevent further injury of the elbow and to relieve symptoms.

Second, a corticosteroid injection placed into the affected area may be offered to relieve pain. The purpose of the injection is to reduce the swelling and pressure on the compressed nerve.

Surgical Treatment for Ulnar Neuropathy

Surgery for ulnar neuropathy is reserved for patients who have extremely limited use of arm and hand along with muscle weakness or wasting as a result of nerve compression. The goal of surgery is to relieve the pressure on the nerve and, after recovery, pursue physical therapy exercises to restore or maintain muscle strength.

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