Ulnar nerve dysfunction
Neuropathy - ulnar nerve; Ulnar nerve palsy; Mononeuropathy; Cubital tunnel syndromeUlnar nerve dysfunction is a problem with one of the nerves that travel from the shoulder to the hand, called the ulnar nerve. It helps you move your arm, wrist, and hand.
Causes
Damage to one nerve, such as the ulnar nerve, is called mononeuropathy. Mononeuropathy means there is damage to a single nerve. Diseases affecting the entire body (systemic disorders) can also cause isolated nerve damage.
Mononeuropathy
Mononeuropathy is damage to a single nerve, which results in loss of movement, sensation, or other function of that nerve.
Read Article Now Book Mark ArticleCauses of mononeuropathy include:
- An illness in the whole body that damages a single nerve
- Direct injury to the nerve
- Long-term pressure on the nerve
- Pressure on the nerve caused by swelling or injury of nearby body structures
Ulnar neuropathy is also common in those with diabetes.
Diabetes
Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.
Read Article Now Book Mark ArticleUlnar neuropathy occurs when there is damage to the ulnar nerve. This nerve travels down the arm to the wrist, hand, and ring and little fingers. It passes just under the surface of the skin near the elbow. So, bumping the nerve there causes the pain and tingling of hitting your funny bone.
When the nerve is compressed in the elbow, a problem called cubital tunnel syndrome may result. The ulnar nerve can also get compressed in the wrist and less often, at other parts of the arm.
When damage destroys the nerve covering (myelin sheath) or part of the nerve itself, nerve signaling is slowed or prevented. When the nerve fibers themselves (axons) are injured, this may cause a more severe problem.
Myelin sheath
Myelin is an insulating layer, or sheath that forms around nerves, including those in the brain and spinal cord. It is made up of protein and fatty ...
Read Article Now Book Mark ArticleDamage to the ulnar nerve can be caused by:
- Long-term pressure on the elbow or base of the palm
- An elbow fracture or dislocation
Fracture
If more pressure is put on a bone than it can stand, it will split or break. A break of any size is called a fracture. If the broken bone punctures...
Read Article Now Book Mark ArticleDislocation
A dislocation is a disruption of the normal position of the ends of two or more bones where they meet at a joint. A joint is the place where two bon...
Read Article Now Book Mark Article - Keeping the elbow bent for a long time or repeated elbow bending, such as with repetitive movements at work, or cigarette smoking
In some cases, no cause can be found.
Symptoms
Symptoms may include any of the following:
- Abnormal sensations in the little finger and part of the ring finger, usually on the palm side
- Weakness, loss of coordination of the fingers
- Claw-like deformity of the hand and wrist
-
Pain, numbness, decreased sensation, tingling, or burning sensation in the areas controlled by the nerve
Numbness
Numbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...
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Pain or numbness may awaken you from sleep. Activities such as tennis or golf may make the condition worse.
Exams and Tests
Your health care provider will examine you and ask about your symptoms and medical history. You may be asked what you were doing before the symptoms started.
Tests that may be needed include:
- Blood tests
- Imaging tests, such as MRI to view the nerve and nearby structures
MRI
An arm MRI (magnetic resonance imaging) scan uses strong magnets to create pictures of the upper and lower arm. This may include the elbow, wrist, h...
Read Article Now Book Mark Article - Nerve conduction tests to check how fast nerve signals travel
Nerve conduction tests
Nerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve. This test is done along with electromyography (EM...
Read Article Now Book Mark Article - Electromyography (EMG) to check the health of the ulnar nerve and the muscles it controls
Electromyography
Electromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles.
Read Article Now Book Mark Article - Nerve biopsy to examine a piece of nerve tissue (rarely needed)
Nerve biopsy
A nerve biopsy is the removal of a small piece of a nerve for examination.
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Treatment
The goal of treatment is to allow you to use your hand and arm as much as possible. Your provider will find and treat the cause, if possible. Sometimes, no treatment is needed and you will get better on your own.
If medicines are needed, they may include:
- Over-the-counter or prescription medicines (such as gabapentin and pregabalin)
- Corticosteroid injections around the nerve to reduce swelling and pressure
Your provider will likely suggest self-care measures. These may include:
- A supportive splint at either the wrist or elbow to help prevent further injury and relieve the symptoms. You may need to wear it all day and night, or only at night.
- An elbow pad if the ulnar nerve is injured at the elbow. Also, avoid bumping or leaning on the elbow.
- Physical therapy exercises to help maintain muscle strength in the arm.
Occupational therapy or counseling to suggest changes in the workplace may be needed.
Surgery to relieve pressure on the nerve may help if the symptoms get worse, or if there is evidence that the nerve isn't improving with conservative treatment.
Outlook (Prognosis)
If the cause of the nerve dysfunction can be found and successfully treated, there is a good chance of a full recovery. In some cases, there may be partial or complete loss of movement or sensation.
Possible Complications
Complications may include:
- Deformity of the hand
- Partial or complete loss of sensation in the hand or fingers
- Partial or complete loss of wrist or hand movement
- Recurrent or unnoticed injury to the hand
When to Contact a Medical Professional
Contact your provider if you have an arm injury and develop numbness, tingling, pain, or weakness down your forearm and the ring and little fingers.
Prevention
Avoid prolonged pressure on the elbow or palm. Avoid prolonged or repeated elbow bending. Casts, splints, and other appliances should always be examined for proper fit.
References
Craig A. Neuropathies. In: Cifu DX, ed. Braddom's Physical Medicine and Rehabilitation. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 41.
Jobe MT, Martinez SF, Weller WJ. Peripheral nerve injuries. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 62.
Katirji B. Disorders of peripheral nerves. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 106.
Patterson JMM, Novak CB, Mackinnon SE. Compression neuropathies. In: Wolfe SW, Pederson WC, Kozin SH, Cohen MS, eds. Green's Operative Hand Surgery. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 28.
Ulnar nerve damage - illustration
The ulnar nerve originates from the brachial plexus and travels down arm. The nerve is commonly injured at the elbow because of elbow fracture or dislocation. The ulnar nerve is near the surface of the body where it crosses the elbow, so prolonged pressure on the elbow or entrapment of the nerve may cause damage. Damage to the ulnar nerve may involve impaired movement or sensation in the wrist and hand.
Ulnar nerve damage
illustration
Ulnar nerve damage - illustration
The ulnar nerve originates from the brachial plexus and travels down arm. The nerve is commonly injured at the elbow because of elbow fracture or dislocation. The ulnar nerve is near the surface of the body where it crosses the elbow, so prolonged pressure on the elbow or entrapment of the nerve may cause damage. Damage to the ulnar nerve may involve impaired movement or sensation in the wrist and hand.
Ulnar nerve damage
illustration
Review Date: 6/13/2024
Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.