Ulnar nerve entrapment, also known as cubital tunnel syndrome, Guyon’s canal syndrome, bicycler’s neuropathy, handlebar palsy, or tardy ulnar palsy, is a condition in which the ulnar nerve becomes compressed or stretched. This can cause pain, numbness, and tingling as well as weakness in the hand. Ulnar nerve entrapment can be treated conservatively, but if this fails, surgery may be needed to correct the problem.
Causes of Ulnar Nerve Entrapment
There are several causes of ulnar nerve entrapment. It can often be seen in cyclists who lean on their handlebars for long periods of time, or in workers who frequently use hand tools. It can be the result of the following:
- Direct pressure. Placing direct pressure on the ulnar nerve can press on the nerve and cause it to be entrapped. Pressure can be caused by leaning the arm on a chair arm. This direct pressure on the nerve can lead to a feeling that the arm and hand are asleep.
- Stretching. If you keep your elbow bent for an extended period of time such as when sleeping, the ulnar nerve can stretch behind the elbow and cause symptoms.
- Position. The ulnar nerve cannot stay in position at times and can go back and forth as the elbow or wrist is moved. There is also a chance that the soft tissue over the nerve can thicken and prevent the nerve from working properly.
Common Symptoms
Ulnar nerve entrapment is often described as feeling as though your hand or arm fell asleep or that you hit your funny bone. This condition can cause a variety of symptoms including:
- Weakness in the hand
- Tenderness in the hand and elbow joint
- Sensitivity to cold temperatures
- Tingling in areas of the hand such as the palm, fourth and fifth fingers
- Loss of sensation in the hand
Treatment Options
To diagnose ulnar nerve entrapment, a physical exam and review of your medical history will be done. In addition, a nerve conduction study may be ordered to check the function of your muscles and nerves. Imaging tests such as an X-ray or MRI may be done to show images of the muscles, bones, and nerves.
Once a diagnosis is made, your doctor will recommend treatment options. Conservative treatment often consists of the following:
- Activity modification. Avoid any activities that worsen the condition and cause symptoms to appear. You will also want to avoid leaning on the wrist or elbow.
- Therapy. Occupational therapy may be an option to consider. This type of therapy involves using exercises designed to strengthen the ligaments and tendons in the elbows and hands. The therapist may help you learn techniques that take pressure off the ulnar nerve to prevent pain and other symptoms.
- Medication. Over-the-counter medication such as ibuprofen may be used to help with pain and inflammation.
- Splint. A splint may be placed on the arm to keep the elbow immobilized.
If conservative treatments do not help to minimize symptoms and pain, ulnar release surgery may be recommended. This nerve decompression surgery can be done at the elbow or wrist to decompress the nerve at that location.
If you need help with ulnar nerve entrapment, contact Dr. Eric H. Williams to discuss treatment options for your condition. Dr. Williams can help you find relief from your pain and symptoms, and answer any questions you may have. To schedule an appointment, call our office at (410) 709-3868 or fill out our contact form online.
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