Ulnar Nerve Entrapment

///Ulnar Nerve Entrapment

What is Ulnar Nerve Entrapment?

There are three main nerves that travel up and down the arm, sending signals from the brain to the arm, hand and fingers. The ulnar nerve is one of these main message carriers that travel from the collarbone through the inside of the upper arm and through the elbow joint. The nerve then travels through the arm muscle, into the hand and ends in the little finger. The ulnar nerve allows a portion of the little finger and part of the ring finger to move. Ulnar nerve entrapment happens when the nerve is compressed or squeezed along its path. This happens most commonly on the inside of the elbow, causing numbness and tingling in the hand and fingers. Elbow specialist, Dr. James Mazzara, assisting Manchester, South Windsor, Rocky Hill, Glastonbury and surrounding Hartford communities who have this elbow injury with a modern and conservative treatment.

What causes ulnar nerve entrapment?

The ulnar nerve is vulnerable to compression at the elbow because it must travel through a narrow space with very little soft tissue to give it protection. However, in many cases, the cause of ulnar nerve entrapment, also called cubital tunnel syndrome, is unknown. There are a few contributing causes to ulnar nerve entrapment which may include:

  • Leaning on the elbow for long periods of time can put pressure on the nerve.
  • Fluid build up in the elbow can cause swelling.
  • In some people, the ulnar nerve slides out from behind the medial epicondyle (inside bump of the elbow) when the elbow is bent. Over time, this sliding back and forth may irritate the nerve.
  • A direct blow to the inside of the elbow can cause pain or an electric shock sensation called “hitting your funny bone.” Repeated injury of this nature can cause compression of the nerve.
  • Prior conditions or injuries such as bone spurs, elbow fractures, or cysts.

What are symptoms of cubital tunnel syndrome?

Often symptoms of ulnar nerve entrapment develop gradually. As symptoms progress, damage may occur and cause the following:

  • Hand weakness, especially in the little finger.
  • Numbness or tingling sensation in the pinky or ring finger. This symptom may worsen at night when sleeping.
  • Pain or a burning sensation in the elbow, palm or last two fingers.
  • Tenderness in the joint near the bony part of the of the elbow.
  • Loss of finger dexterity and coordination.
  • Symptoms made worse by cold.

Are you experiencing ulnar nerve entrapment symptoms?

There are two ways to initiate a consultation with Dr. Mazzara:

You can provide current X-rays and/or MRIs for a clinical case review with Dr. Mazzara.

You can schedule an office consultation with Dr. Mazzara.

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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 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, Rocky Hill, Glastonbury and surrounding Hartford Connecticut communities.

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