Ulnar Nerve Entrapment

Ulnar Nerve Entrapment Overview

The ulnar nerve, one of three main nerves in the arm, travels from the collarbone through the inside of the upper arm and passes through the elbow joint. The nerve then travels through the arm muscle and into the hand where it ends in the little finger area. The ulnar nerve allows the little finger to move and allows a portion of movement in the ring finger. Ulnar nerve compression can occur in several places along its path, most commonly on the inside of the elbow. When it becomes compressed in the elbow area, ulnar nerve entrapment occurs and numbness and tingling becomes present in the hand and fingers.

The exact cause of ulnar nerve compression is unknown, but it is believed that prior elbow fractures, bone spurs, cysts and elbow swelling contribute to the condition.

Symptoms of Ulnar Nerve Entrapment

Ulnar nerve entrapment commonly causes pain, numbness, tingling and a “falling asleep” sensation in the little finger and ring finger. These symptoms are greater when the elbow is in a bent position in many cases. Some patients may also experience weakening of grip, muscle wasting and finger coordination difficulty. Once muscle wasting has begun, it cannot be reversed. It is very important to visit a doctor at the onset of ulnar nerve compression symptoms for this reason.

Diagnosis of Ulnar Nerve Entrapment

In order to diagnose ulnar nerve entrapment, Dr. Waterman will discuss the patient’s general health and medical history at the beginning of a consultation. After discussing these items, Dr. Waterman will perform a physical examination of the arm, elbow and hand by tapping on the nerve at the funny bone, checking for strength and feeling in the hands and fingers and checking to see if the ulnar nerve slides out of place when the elbow is bent.
Treatment of Ulnar Nerve Entrapment

Non-Surgical

Dr. Waterman typically recommends physical and occupational therapy as the first treatment option in many patients. The therapy program will strengthen the ligaments and tendons located in the elbow and hands. If ulnar nerve compression is more severe, anti-inflammatory medications may be recommended to reduce inflammation, leading to a reduction in pain.

Surgical

Dr. Waterman may recommend surgery if there is severe ulnar nerve compression, muscle weakness or if non-surgical measures did not alleviate the symptoms. There are two procedures commonly used to treat ulnar nerve entrapment, one at the elbow and one at the wrist. The most common procedure utilizes an incision at the elbow and a nerve decompression is performed. The nerve is moved from its original location behind the elbow to a new location at the front of the elbow. The wrist approach is similar, but nerve decompression is performed through a wrist incision.