Ulnar Neuropathy

Ulnar neuropathy, also known as ulnar nerve dysfunction or cubital tunnel syndrome, is an inflammation of the ulnar nerve, the nerve that runs from the shoulder to the hand and affects the forearm, wrist and fingers. When this nerve is damaged, often at the wrist or elbow, patients may experience pain, numbness, weakness and restricted thumb movement. Risk factors for the disorder include prior fractures or dislocations of the elbow, bone spurs, cysts or inflammation of the joint, and prolonged or repetitive use of the elbow in a flexed position.

Causes of Ulnar Neuropathy

Ulnar neuropathy occurs when an injury or illness causes damage to the the axon, a part of the nerve, or to the myelin sheath that covers the nerve. Such damage may result from:

  • A systemic disorder, such as multiple sclerosis
  • Prolonged pressure on the nerve
  • Elbow fracture or dislocation

Pressure on the ulnar nerve is sometimes caused by inflammation and swelling of adjacent areas of the body. A direct injury to the elbow, when the "funny bone" is hit, often causes some temporary symptoms of ulnar neuropathy.

Symptoms of Ulnar Neuropathy

Ulnar neuropathy commonly results in abnormal sensations in the pinky and ring finger, typically on the palm side of the hand, including:

  • Numbness or tingling
  • Pain or burning
  • Difficulty moving or manipulating the fingers
  • Weakness of the wrist or hand

In severe cases, patients may develop a claw-like deformity of the hand or wasting of the hand muscles. Some patients with ulnar neuropathy as awakened from sleep by pain of numbness. Certain sports that involve the arm and hand, such as golf or tennis, may worsen the condition. Driving may also exacerbate symptoms.

Diagnosis of Ulnar Neuropathy

The doctor may order a number of tests to make a definitive diagnosis of ulnar neuropathy. Depending on the patient's symptoms, these tests may include:

  • Blood tests
  • X-rays
  • MRI of CT scan of the neck
  • Nerve ultrasound
  • Nerve conduction tests
  • Electromyography (EMG)

The medical examination of the patient is an important diagnostic tool since the doctor is able to assess the degree of weakness in the hand and wrist, to pinpoint areas of abnormal sensation, and to note any muscle wasting or deformity.

Treatment of Ulnar Neuropathy

In some cases, ulnar neuropathy heals on its own and patients need only take over-the-counter medications for pain until the condition subsides. Where the problem is more severe or prolonged, treatments may include:

  • Corticosteroid injections
  • Supportive splint at wrist or elbow
  • Physical therapy exercises
  • Occupational therapy

In cases where symptoms worsen, or it is evident that muscle wasting is occurring, surgery is necessary to relieve pressure on the nerve.

Possible Complications of Ulnar Neuropathy

Though in most cases patients fully recover from ulnar neuropathy, on occasion patients may experience ongoing pain, loss of sensation, dysfunction, or deformity of the hand.

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