How is ulnar nerve entrapment diagnosed?
Dr. Mazzara will conduct a full medical history, covering prior injuries, current symptoms and activities that make the condition better or worse. A physical exam will follow, checking muscle strength of the hand, fingers and arm. Dr. Mazzara may tap on the nerve in the funny bone to test patient sensation and will feel the arm while in motion to see if the nerve slides out of place when the elbow is bent. The patient’s hand strength and ability to feel light touch in the little finger and ring finger is evaluated.
What is the treatment for ulnar nerve entrapment?
Anti-inflammatory medications and night time bracing are recommended by Dr. Mazzara as the first treatment options for ulnar nerve entrapment. Non-steroidal anti-inflammatory medicines may help reduce swelling around the nerve. Wearing a splint during the day, to immobilize the joint, may also be recommended.
How to treat ulnar nerve entrapment with surgery?
If non-surgical methods have not alleviated pain or improved the patient’s condition, Dr. Mazzara may need to perform surgery to take pressure off the nerve. There are several surgical options when treating ulnar nerve compression at the elbow. The simplest is call an ulnar nerve decompression in situ. In this procedure, the ligament over the ulnar nerve is released but the nerve is not moved out of its normal position. A second option is called a medial epicondylectomy where the ligament over the nerve is released and the bone upon which the nerve rests, he medial epicondyle, is partially removed. This can be performed for patients who may also have elbow pain from medial epicondylitis. A third option is called a subcutaneous ulnar nerve transposition. In this procedure, the ulnar nerve is released from the cubital tunnel and moved (transposed) to a location outside of the tunnel just under the skin where it is no longer compressed. This is an excellent option many individuals but is especially reliable in throwing athletes who may have nerve irritation from their sports related activities. A fourth option is an ulnar nerve transposition with a submuscular positioning of the nerve. Dr. Mazzara often performs this procedure in patients with more severe nerve damage or who may have other surgery for cubital tunnel syndrome which may have failed or where the condition has returned over time.
Patients are expected to allow for some early healing to occur for a week after surgery but are then encouraged to use the arm as tolerated after that. A return to normal activities is encouraged by at least 6 weeks.
For more resources on ulnar nerve entrapment or cubital tunnel syndrome, please contact the orthopedic office of Dr. James Mazzara, elbow specialist, serving patients living in Manchester, South Windsor, Enfield, Glastonbury and surrounding Hartford Connecticut communities.