Ulnar Tunnel Syndrome affects the ulnar nerve located between the little finger and the wrist. It is one of the three main nerves that extend downwards from the neck to the arms, hand and the little finger. It ensures sensation in the forearm, palm and the fourth and fifth fingers of the hand. This nerve is in fact a part of the brachial plexus and can be constricted at any point in the arm or the hand resulting in pain. Overuse of the hand may subject this nerve to excessive pressure resulting in pain, weakness and/or other types of discomfort. The condition is also known as Guyon’s Canal Syndrome as the ulnar nerve passes from the wrist to the little finger through the Guyon canal. This syndrome commonly affects cyclists whose hands tend to get pressed against the handle bars resulting in ulnar nerve compression.
Causes
- Compression of the ulnar nerve
- Overuse of the hand
- The tissues near the ulnar nerve become swollen or thickened
- Injury to the elbow, hand or wrist
- Fractures or trauma
- Development of a ganglion (hard bump) on a tendon which can pressurize the ulnar nerve
- Nerve entrapment near the elbow or wrist joint
- Diabetes
- Presence of cysts/Arthritis or bone spurs near the elbow joint
- Repetitive flexing or bending movement of the elbow
- Leaning on the elbow for long duration may pressurize this nerve
- Previous dislocations may result in nerve entrapment
Symptoms
- Pain in the little finger or middle finger or both
- Feeling of needle pricks in the finger
- Numbness, weakness or tingling sensation
- Loss of motor function of the hand muscles
- Loss of gripping capacity of the hand
- Intrinsic muscle wasting may occur in some cases
Diagnosis
- A detailed physical examination by the orthopedic doctor which would include a variety of physical tests to assess the range of motion of the hand/wrist/elbow
- Analysis of the patient’s medical history
- Conducting EMG (electromyography) to check nerve transmissions in the hand
- X-rays can help detect bone spurs, Arthritis or displacements
Treatment
- Providing adequate rest to the affected hand and finger.
- The elbow should be kept straight most of the time
- Application of ice packs at regular intervals
- Use of splint, particularly at night, to provide support to the finger/hand or the elbow
- Prescription of anti-inflammatory drugs or pain killers
- Physical therapy can help restore muscle strength and functioning
- Surgical treatment to relieve pressure on the ulnar nerve
- Use of specific gloves to prevent pressure on the nerve
The orthopedic surgeons at OrthoTexas provide effective treatment for Ulnar Tunnel Syndrome.
