Ulnar Nerve Entrapment

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There are several nerves that travel through the arm—one nerve in particular is called the ulnar nerve.  This long nerve travels from the collarbone through the inside of the upper arm and passes through the elbow (through a grouping of tissue known as the cubital tunnel—also known as the “funny bone”).  From this point, just beyond the elbow, the nerve continues to travel down through the muscle of the arm and into the hand where it resides in the area of the little finger.

It is this specific nerve that allows the pinky finger to move all the way and the ring finger partially. It is a huge controller of the little muscles in the hand that help make fine movements.

Ulnar nerve entrapment occurs when the ulnar nerve becomes compressed or entrapped.  When this occurs, pain and the inability to move the little finger will be present.  It is not known what exactly causes the compression that entraps the ulnar nerve, but prior fractures of the elbow, cysts, swelling of the elbow joint and bone spurs are likely reasons. Some people may confuse the symptoms witharthritis of the elbow

Symptoms of Carpal Tunnel Syndrome

In addition to pain in the hand, pinky finger and ring finger, ulnar nerve entrapment can cause symptoms of tingling, numbness and a “falling asleep” feeling in the ring finger and little finger, especially when the elbow is bent. There may be an aching pain on the inside of the elbow. Oftentimes, it may be hard to move the fingers in and out or to hold or grip objects.  Finger coordination will also become difficult (for example, typing or playing the piano).

Many times, patients will confuse ulnar nerve entrapment with carpal tunnel syndrome because they have similar symptoms.  However, these two conditions involve different nerves (in the case of carpal tunnel, the medial nerve is affected). Carpal tunnel syndrome typically causes tingling in the thumb, index finger, and long finger.

If the nerve is very compressed or has been compressed for a long time, muscle wasting in the hand can occur. Once this happens, muscle wasting cannot be reversed. For this reason, it is important to see the doctor as soon as any of the symptoms are noticed.

Treatments for Ulnar Nerve Entrapment

Non-Surgical

Occupational and physical therapy is often a good starting place to strengthen the ligaments and tendons in the hands and elbows.  Depending on the severity of the entrapment, nonsteroidal anti-inflammatory drugs and pain relievers can be taken to help reduce pain and inflammation.  Wearing splints to help immobilize the elbow may also be recommended. Dr. Millett might also recommend surgery to treat your ulnar nerve neuropathy.

Surgical

There are two surgical approaches to treat ulnar nerve entrapment: one is at the elbow and the other is at the wrist.  Using arthroscopic surgery, Dr. Millett will make an incision at the elbow and perform a nerve decompression. During this time, the nerve is moved from its place behind the elbow to a new place in front of the elbow. This is the most common procedure to treat an ulnar nerve entrapment. If he performs the surgery at the wrist, the incision is made there and the decompression is performed. Both out-patient procedures use a minimally-invasive technique and in most cases, patients are able to resume their normal activities in about 6 weeks.  Dr. Millett has rehab manuals on this website to assist with post-surgical care.