An Overview of Ulnar Nerve Entrapment
There are several nerves that travel down the arm. One of these nerves is called the ulnar nerve. This long nerve travels from the collarbone, through the inside of the upper arm, and passes around elbow in a structure of tissue called the cubital tunnel. Sometimes this nerve can become compressed, or entrapped, as it passes around the elbow and travels through this tunnel of tissue. The ulnar nerve is responsible for bringing sensation to the pinky and ring finger, and controlling fine motor muscles in the hand; therefore, deficits relating to these functions can develop subsequent to compression.
Ulnar nerve entrapment, also known as cubital tunnel syndrome, occurs when the ulnar nerve becomes compressed or entrapped. Patients with this condition may experience symptoms of pain, weakened grip, and decreased sensation in the pinky and ringer fingers. Symptoms may be worse at night. The cause of compression is not fully understood, but prior elbow fractures, cysts, swelling of the elbow joint, and bone spurs likely contribute to development of this condition. Some people may confuse the symptoms with arthritis of the elbow.
Symptoms of Cubital 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 and grip objects. Finger coordination may also become difficult (for example, typing or playing the piano).
Many times, patients will confuse cubital tunnel syndrome with carpal tunnel syndrome because they have similar symptoms; however, these two conditions involve different nerves (in the case of carpal tunnel, the median 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
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, non-steroidal 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 the condition.
There are two surgical approaches to treat ulnar nerve entrapment: one is at the elbow and the other is at the wrist. 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. This is an out-patient procedure using 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.
For more resources on ulnar nerve entrapment, or to determine the correct treatment option for your case of cubital tunnel syndrome, please contact the office of Dr. Peter Millett.