General information regarding ulnar nerve entrapment
Ulnar nerve entrapment or ulnar nerve compression syndrome happens when the ulnar nerve in the arm becomes irritated or compacted.
The ulnar nerves is part of 3 main nerves in the arm, it travels from the neck down into the hand and can be confined in several areas.
The ulnar never injury symptoms can happen on any nerve that experiences pressure, it can happen on the elbow, the wrist as well as the fingers.
At times the ulnar nerve can get compressed at the wrist and this begins to affect the collarbone and spinal cord in the neck.
When this occurs it is called as the “cubital tunnel syndrome”. A person can experience a bump and it will have a shock like feeling.
The ulnar nerve entrapment can cause the little finger and the half of the ring finger to experience pain or numbness; this is due to the fact that the ulnar nerve is the one responsible for the little muscles in the hands.
If something bad occurs to the ulnar nerve the fine movements of the hands are affected including some of the bigger muscles in the forearm causing a person to have trouble with their grip.
The main reason for the ulnar nerve entrapment can be due to a number of factors, researchers are saying that it is vulnerable to compression at the elbow and when it is not protected this can lead to pain.
What are the common causes of compression?
Ulnar nerve injury symptoms can be felt when one bends t heir elbow, the ulnar nerve will stretch around the boney ridge of the medial epicondyle.
Once the nerves are irritated due to the fact that the elbow has been bent for long periods of time this can lead to the painful symptoms.
In order to avoid suffering from this, people need to avoid sleeping with their elbows bent; this can only aggravate the symptoms of the ulnar nerve compression.
Some people on the other hand experience a nerve slide from behind the medial epicondyle while their elbow is bent.
This can lead to the sliding back and forth and will irritate the nerve.
In order to avoid this sensation people have to avoid leaning on their elbow for long periods of time.
A direct hit on the elbow can also cause electric shock sensation and numbness in the little and ring fingers.
When suffering from this arm injury prior fracture and dislocations can occur in the elbow area, if not treated well this can lead to bone spurs. Swelling of the elbow joint and cysts near the elbow joint can also occur.
When one is already suffering from these symptoms, it is advisable that they avoid any repetitive or prolonged activities that will require them to bend the elbow or flex to prevent further damage.
Other symptoms of ulnar nerve entrapment will include feelings of falling asleep due to the pressure in the ring finger and the little finger.
Numbness can also occur in the area and these symptoms can come and go until ulnar nerve release surgery is done.
The ulnar nerve is a nerve that’s near the ulna bone. Unlike other nerves, this nerve is not protected and therefore prone to injuries and damage. Ulnar nerve can interfere with the hand motion, because it runs from the shoulders to the fingers and also facilitates communication between the hand and brain.
Damage can occur when there is entrapment of the nerve, causing a compression. This can lead to hand dislocation or a even a broken arm. Injuries that occur due to compression of the ulnar nerve can lead to a number of syndromes. They include the following:
Cubital nerve syndrome
This syndrome is caused when the ulnar nerve path is interfering along the cubital tunnel which is on the edge of the elbow. Cubital nerve syndrome has the following symptoms:
- Tingling and pain in the small and ring finger.
- General muscle weakness of the hand.
If these symptoms are persistent there are a number of ways to be diagnosed. They include X-rays, nerve test or just by observation of the symptoms. Treatment also varies with the seriousness of the damage. In most cases its recommended that you use anti-inflammatory medication or avoid circumstances that can lead to more pain in your elbow. In serious cases surgery must be performed on the patient.
Guyon’s Canal Syndrome
Guyon’s tunnel is a path in the wrist in which the ulnar nerve passes through. The syndrome is caused by compressing the wrist on a hard object e.g a desk. This in turn compresses the ulnar nerve and therefore pain, numbness or a tingling effect is experienced on the wrist.
Other ulnar nerve injury symptoms include:
- Lack of coordination of the fingers.
- Burning sensation.
compressed ulnar nerve exercises
After the compression of the ulnar nerve, exercise is highly recommended. There are different types of exercises depending on the part of the hand. Here are some of the exercise.
1.Spreading of Fingers
This helps prevent numbness and tingling of the fingers and allows finer flexibility of the fingers after ulnar nerve damage.
Arm curls helps your arm to function properly ,as well as ease the symptoms caused by ulnar nerve damage.
Turning the elbow and spreading your fingers enables the ulnar nerve to pass well through the elbow without any compression.
By maintaining proper posture and ensuring that the arm is well protected e.g by wearing a splint while sleeping, will ensure that such damage does not happen. People with certain diseases are prone to ulnar never damage e.g people who suffer from diabetes mellitus. Also people who spend long hours with bent elbows, may suffer from cubital nerve syndrome. The physical exercise mentioned above are recommended in such cases. When the arm or elbow suffers an injury, is fractured or even dislocated, symptoms of cubital nerve syndrome may be experienced and in such a case the patient is taken for surgery if the symptoms are severe and the arm’s functions are at risk. After surgery physical therapy is recommended for the patient, as well as the use of protective gear for the arm.
Ulnar Nerve Transposition is the most common surgical way to treat a trapped ulnar nerve. The ulnar nerve is one of three primary nerves of one’s arm. It passes from one’s neck down to his/her hand and it can also be tapered in different places during its path. Based on the position of its compression, it may cause severe pain in one’s elbow, hand, wrist and fingers. The state of compression of the ulnar nerve is known as the ulnar nerve entrapment.
The compression may occur anywhere like below the collarbone or in the neck region. The most common position of nerve compression is behind the elbow. On the other hand, the ulnar nerve entrapment refers to a condition in which the nerve becomes swollen due to injury to the hand or the elbow. The symptoms of ulnar nerve entrapment include the swelling and softness around the elbow and severe muscle weakness which results in decreased grip strength of the hand. This can be treated by surgical as well as non-surgical methods. The most commonly practiced option is the ulnar nerve transposition.
The ultra nerve transposition can be of three types. They are the subcutaneous and intramuscular transposition, sub muscular transposition and the anterior sub muscular transposition. Without performing the transposition it is practically not possible for the compression forces to be relieved from the ulnar nerve’s position. In case of the subcutaneous type of transposition, this nerve is placed in between the forearm and arm just below the sub-cutaneous fat. In order to maintain the position, a fascia flap is present above the transposed nerve of the skin. The primary advantage of adopting this technique is that there are negligible chances of scar formation and the compression at the place of transposition. But sometimes it so happens that in patients with scant subcutaneous tissue this may be vulnerable. The intramuscular transposition facilitates a properly vascularized position for this nerve.
Sub cutaneous transposition is a technique in which this nerve is placed in an inter-muscular interval. This is the place where the nerves usually run. In this technique, the nerve is placed in a vascular bed which is comparatively free from the scar formation. Moreover it provides a direct path from the position of arm to the forearm. There may be some complications as like the elbow contracture. Submuscular transposition has proved to be far better than the cubital tunnel surgery. The former has been considered as the best revision surgery in case of failure of this cubital tunnel surgery. This technique proves to be the most effective in case of moderate ulnar nerve compression.
The anterior ulnar nerve transposition is done using a non compressing fasciodermal sling. The medial intermuscular sling is considered as the fascial sling. This sling is used to provide a control to the posterior nerve subluxation. The approximate length of the fascial band is 1cm. The inter-muscular septum is divided and its free end has been sutured to the fascia. The complications in this technique include the injury of the medial cutaneous nerve. There are chances of recurrent compression to occur because of the proximal sutures. As compared to other techniques of transposition, this technique has shown more scarring.
Ulnar nerve compression syndrome
When it comes to ulnar nerve compression syndrome, this is a condition in which pressure is placed on the ulnar nerve as it passes along the inner aspect of your elbow. Your ulnar nerve starts from a number of spinal nerves that are in your neck and it will travel through your upper arm into your forearm, hand as well as the fingers. The work of the ulnar nerve is to supply sensation to an inner aspect of your forearm, your palm, your little finger as well as half of your ring finger.
A direct impact towards your elbow may result in ulnar nerve compression. In addition, inflammation and damage of the tissue that is adjacent to your ulnar nerve can place pressure upon the nerve, and when this happens, this is what we refer to as ulnar nerve compression syndrome. Excessive traction to your nerve can also cause this condition, and this is common in throwing athletes where their elbows are subjected to excessive force during a cocking phase when throwing. This is a condition that occurs more commonly in your dominant arm and especially in cases of an overuse injury. On occasions, this nerve trauma can affect both of your arms.
Ulnar nerve injury symptoms
The treatment for ulnar nerve compression in most cases is ulnar nerve physical therapy. A physiotherapist will carefully assess the factors that may have made a contribution to this condition developing in the patient. The physiotherapist will also correct these factors so that the condition does not arise in the future. The compliance of the patient will contribute towards the success of the treatment. Sufficient rest from the activities that increase your symptom is one of the conditions that will determine how successful your treatment will be.The signs and symptoms that are associated with ulnar nerve compression can develop all of a sudden or gradually and the symptoms are as follows. Pins and needles, pain or ache in your forearm and elbow, burning sensation and numbness are some of the symptoms that one should be wary of. Tenderness in your nerve when pressed is another symptom that a person should lookout for. In a more severe case, weakness in your hand can also happen and your fingers may also feel weak. To confirm such a diagnosis, an objective and subjective examination can be done and nerve conduction studies might also be needed.
This means that you should minimize activities that place a lot of stress on your forearm and elbow in order to eliminate ulnar nerve compression syndrome. A patient therefore needs to desist from activities such as racquet sports, throwing, opening cans, jars or doors, gripping activities, lifting or carrying. When you rest from such activities, your body will begin the process of healing and you will also prevent further damage to your tissue. You should not ignore any warning signals because doing so might make your condition chronic. Once you can be able to do the above activities without any pain, you should gradually return to them.
Symptoms and Treatment for Ulnar Nerve Injury
The ulnar nerve lies right below the ulna and is considered as the largest nerve that is not protected by any bone or muscle. That is the reason why this nerve is highly susceptible to injuries. The ulnar nerve extends to the little finger and is also adjacent to the ring finger. This nerve innervates several muscles in the forearm.
Arm Nerve Injury
Injury to the ulnar nerve can be due to various factors, such as a long term trauma to the nerve. This nerve causes the tingling sensation when the elbow is struck. Such type of injury is considered common. However, if the injury is more serious like dislocations or fractures, this will result to a sudden trauma. Compression of the nerve can also result to an injury. This compression can be due to prolonged pressure on one or both palms that normally occurs when performing improper crunches or while cycling.
Another leading cause of ulnar nerve compression syndrome is the prolonged typing on the computer. The injury occurs on the palm section of the nerve, where it gets trapped or pinched. This entrapment is also referred to as ulnar nerve neuropathy. As the position of the nerve on the elbow is superficial, it is vulnerable to pinching or entrapment. Repetitive stress on the nerve can also lead to inflammation along with other symptoms.
Ulnar Nerve Injury Symptoms
The severity of the injury may vary from one person to another. However, the symptoms are almost the same and these symptoms include the following:
- Abnormal sensations
- Burning with tingling sensation on the little finger
- Weakness of the hand
In extreme conditions, injury to the ulnar nerve may result to the following:
- Complete or partial loss of the sensation on the fingers or hands
- Hand deformity
- Impaired normal movement of the hand due to severe pain.
Treatment of Ulnar Injury
The first line of treatment for the injury is focused on pain reduction. For this, analgesics are normally prescribed. If the problem is accompanied with swelling and inflammation, corticosteroids can also be administered. The affected part, which is usually the elbow or the wrist, is padded in order to prevent further damage. The last alternative is ulnar nerve release surgery. This is done if no medications can relieve the pain. Exercise is also recommended in case the injury is minor. Apart from that, vitamin B supplementation is also advised to speed up the process of healing.
Preventing Ulnar Injury
In case you are working on the computer for several hours, make sure that you allow your wrist to rest in order to prevent ulnar nerve compression. You should also exercise your wrist to relax the nerve. As much as possible, avoid resting your head onto your elbows, as it could make the latter more susceptible to nerve compression. Another way to prevent the injury is to stretch your hands and arms every now and then. Take note that ulnar injury is uncommon but if you are suffering from it, you need to seek immediate medical assistance in order to prevent permanent damage to this elbow nerve.