ULNAR NEUROPATHY

Ulnar Neuropathy refers to a disorder that occurs when the ulnar nerve passes through some form of damage. The ulnar nerve travels from the shoulder to the hand and helps move the arms, wrists, and hands. The nerve also helps to send sensory information about touch, pain, and temperature.

Ulnar Neuropathy may occur when the ulnar nerve faces entrapment with resultant numbness and tingling. Compression of the ulnar nerve may also lead to inflammation-causing neuropathy.

What’s the Signs and Symptoms of Ulnar Neuropathy?

The symptoms of ulnar neuropathy may get worse when activities that stretch or put pressure on the elbow or wrist occur while the signs come on gradually.

Symptoms of ulnar neuropathy include:

1- Claw-like deformity on the wrist and fingers 

2- Weakness of the hand that makes it hard to pick up items or perform tasks such as writing or buttoning a shirt.

3- Loss of coordination of the fingers

4- Numbness and tingling in the little finger and part of the ring finger

5- Pain, numbness, decreased sensation, tingling, or burning sensation in the arm, elbow area, and wrist

6- Rarely, muscle loss in the little and ring fingers may occur

What’s the Causes of Ulnar Neuropathy?

Ulnar Neuropathy usually occurs when the triceps muscles face overuse and repetitive stress. Stressed and overused triceps muscles cause inflammation, which in turn may lead to entrapment of the ulnar nerve.

Activities that stretch the ulnar nerve at the elbow, or put a lot of pressure on the elbow, can lead to ulnar neuropathy. Sleeping with the elbows bent for long periods can also cause or worsen symptoms of ulnar neuropathy.

Other factors that may cause ulnar neuropathy include:

1- Complications from surgeries to treat shoulder fractures

2- Accidents and blunt trauma

3- Arthritis and broken bones

4- Diabetes

5- Repeated elbow bending as in the case of cigarette smoking

6- Deformities 

7- Malnutrition which leads to loss of fatty protection across the elbow and other joints

What’s the Risk Factors for Ulnar Neuropathy?

People who partake in activities or jobs that require a lot of elbow or wrist pressure or stretching are most at risk of ulnar neuropathy. These individuals include construction workers, bicyclists, tennis players, weight lifters, and cigarette smokers. Ulnar Neuropathy also affects more than women.

How do Specialists Diagnose Ulnar Neuropathy?

The specialist may recommend several exams during the physical test to evaluate the individual’s symptoms. Diagnostic tests that may occur to determine ulnar neuropathy in an individual include:

1- Blood tests

2- Nerve conduction exams to check how fast nerve impulses travel

3- Ultrasound

4- Imaging tests, such as MRI to view the nerve and the surrounding structures

5- Electromyography to measure how well signals travel through the nerve to stimulate muscles

What’s the Treatment Options for Ulnar Neuropathy?

The treatment options for ulnar neuropathy include surgical and non-surgical procedures. The goals of these treatment options are to enable the individual to make use of the arm and hand as much as possible.

Non-surgical Procedures for Ulnar Neuropathy include:

1- Use of Non-steroidal anti-inflammatory drugs (NSAIDS) and corticosteroid injections to relieve the pain and swelling.

2- Physical therapy exercises to help maintain arm strength and improve flexibility. The individual also learns to perform tasks in new ways that are less likely to irritate the ulnar nerve.

Surgical procedures for Ulnar Neuropathy may prove necessary when non-surgical procedures don’t work. 

Physicians use Ulnar nerve decompression as a surgical procedure to explore the region around the elbow the ulnar nerve passes through and remove anything that may compress the nerve and cause problems. Compression can occur around the triceps muscle in the upper arm, the bony groove in the elbow or in other passages through the muscle in the forearm. Ulnar nerve decompression explores these three areas and removes any constrictions that are trapping the nerve.

What’s the Possible Complications of Ulnar Neuropathy?

Permanent muscle loss may occur when severe ulnar neuropathy happens. Other complications may include Permanent deformity of the hand, loss of sensation in the hand or fingers, and partial or complete loss of wrist and hand movement.

References

 Mackinnon SE, Novak CB. Compression neuropathies. In: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, Cohen MS, eds. Green’s Operative Hand Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 28.

“Ulnar nerve dysfunction: MedlinePlus Medical Encyclopedia”  medlineplus.gov. Retrieved 2016-07-22.

Robertson, Chad; Saratsiotis, John (June 2005). “A Review of Compressive Ulnar Neuropathy at the Elbow”. Journal of Manipulative and Physiological Therapeutics. 28 (5): 345.

American Academy of Orthopaedic Surgeons. Ulnar Nerve Entrapment at the Elbow (Cubital Tunnel Syndrome). (https://orthoinfo.aaos.org/en/diseases–conditions/ulnar-nerve-entrapment-at-the-elbow-cubital-tunnel-syndrome/) Accessed 1/5/2022.