Ulnar neuropathy is damage to, irritation of, or compression of the ulnar nerve. It is also known as cubitial tunnel syndrome. This can occur anywhere along the nerve but most commonly occurs at the elbow. Pressure is placed on the ulnar nerve each time the elbow is bent. The space the nerve travels through at the elbow is narrow and the action of bending the elbow can pull the ulnar nerve into the bony groove of the cubital tunnel causing irritation in the ring and little fingers.
Symptoms of ulnar neuropathy include:
- Numbness and tingling of the ring and little fingers
- Numbness and tingling along the back and side of the hand
- Difficulty manipulating the hand or fingers
These symptoms will often can come and go, and can be exacerbated by everyday actions such as:
- Holding a phone
- Typing at a computer
- Holding a steering wheel
- Crossing arms over the chest
- Resting on your arm when sleeping
- Repetitive actions requiring elbow bending at work
Ulnar neuropathy is often caused by repetitive flexion of the elbow. It can also be caused by an injury to the elbow such as a fracture or dislocation. An injury in the region of the elbow may be the cause for the compression, such as a fracture, dislocation, direct blow or severe twisting of the elbow. Pressure on the nerve while performing jobs requiring repetitive flexing of the elbow joint throughout the day may also cause ulnar nerve compression.
A physical assessment and imaging tests such as an MRI or ultrasound are used to diagnose ulnar nerve compression. Most patients will also require a nerve conduction study and EMG to confirm the diagnosis. MRI of the spine is often necessary to rule out a spinal cause of the symptoms.
Treatment comprises of conservative and surgical treatment options.
Conservative treatment options aim to reduce pain and associated symptoms. If conservative treatment is unsuccessful then surgery may be required. Treatment options include:
- Pain medication
- Surgery to release the compressed nerve