About Ulnar Nerve
Ulnar Nerve is one of the main three main nerves that pass through the arm. The Ulnar nerve courses from the neck down to the arm and into the wrists. It originates from the brachial plexus and from there it goes down the medial side of the upper part of the arm. When at the elbow it passes though the medial epicondyle and enters the forearm and this is where the nerve can be palpated and is most vulnerable to various forms of injuries of which compression is the most common. The Ulnar Nerve then courses down through to the forearm and into the wrist and ends at the Guyon’s canal.
The ulnar nerve innervates or supplies blood and nourishment to the muscles of the anterior forearm which are the flexor carpi ulnaris and flexor digitorum profundus. These muscles facilitate movement of the hands and help in flexion and adduction of the hand and wrist. The flexor digitorum profundus facilitates flexion of the fingers.
What Is Compressed Ulnar Nerve?
As stated above, the Ulnar Nerve is mostly likely to get injured or compressed at medial elbow. Ulnar nerve is the second most common likely nerve to get compressed or entrapped. This compression of ulnar nerve may lead to various symptoms along with limited use of the hand such as persistent numbness and tingling in the fingers, especially the ring and little fingers. There may also be muscle weakness associated with this as a result a Compressed Ulnar Nerve. The symptoms are gradual in onset and with time get worse.
Now coming to the question as to why the Ulnar Nerve gets compressed, the ulnar nerve when passing through the elbow passes through a narrow tunnel. The pressure in this tunnel through which the ulnar nerve passes is very low when the elbow is at rest. This pressure on ulnar nerve considerably increases when the elbow is in a bent up position but the increase in pressure is not much so as to harm the nerves in anyway. Certain activities causing repetitive stress injuries like playing tennis or badminton where one has to use the elbow a lot, and certain medical conditions like an elbow fracture or even normal aging leads to the increased pressure on the ulnar nerve at the medial elbow causing what is termed as compressed ulnar nerve.
Prolonged Compression of the Ulnar Nerve leads to various symptoms such as numbness and tingling in the hands and fingers along with muscle weakness which affects the functioning of the hands significantly.
What Are The Symptoms Of Compressed Ulnar Nerve?
Now we know that the ulnar nerve may get compressed or entrapped due to activities, underlying medical conditions like arthritis, or a medical condition like a fracture or surgery to the elbow. When the ulnar nerve gets compressed it may give rise to a variety of symptoms. These symptoms may develop over a period of time or in some cases may develop out of the blue. To begin with, an individual with compressed ulnar nerve will have an ache or pain in the inner aspect of the elbow or forearm. This will followed by a sensation of pins and needles along with numbness and a burning sensation along the elbow. This will make it difficult for the individual to utilize the elbow for various activities in a normal fashion. When the area of symptoms is deeply palpated there will be an area of tenderness along with significant increase in symptoms experienced.
In cases where there is severe Compression of the Ulnar Nerve, the individual will experience weakness of the hand and fingers which will make it difficult for him or her to grip and grasp objects and they may drop objects frequently from their hands. For sportsmen it may become difficult to grip the tennis or badminton racquet firmly and will dent their performance significantly. In cases, where there is a contribution of inflammation to the symptoms then the individual will feel the symptoms worsening at night or first thing in the morning. In some cases, neck or upper back pain may also be felt due to Compressed Ulnar Nerve.
Prolonged Compression of the Ulnar Nerve may lead to symptoms of weakness and wasting or atrophy of the muscles innervated by this nerve and ultimately affect the way the hand functions and impair the ability of the affected individual to carry out activities of daily living normally.
How Is Compressed Ulnar Nerve Diagnosed?
In order to diagnose compressed ulnar nerve, the patient will be carefully examined by a sports physician. Slight tapping of the nerve at the medial elbow will reproduce the symptoms suggesting compressed ulnar nerve. In order to rule out other conditions causing the symptoms, the physician will perform various tests along with radiological studies in the form of x-rays, MRI and CT scan of the elbow. The best way to diagnose Compressed Ulnar Nerve is by way of EMG and Nerve Conduction Studies. The nerve conduction studies will definitively confirm the diagnosis of Compressed Ulnar Nerve.
What Is The Treatment For Compressed Ulnar Nerve?
Once Compressed Ulnar Nerve is diagnosed, the first line of treatment is to rest and avoid any activities that may aggravate the condition including playing sports. This is then complemented by utilization of NSAIDs in the form of ibuprofen or Tylenol to calm down the pain and inflammation. Additionally, the patient will be given a splint to wear it at nighttime to immobilize the part of the hand where the nerve is compressed to allow the nerve to heal. In patients where Compressed Ulnar Nerve is causing disabling symptoms and the condition has been longstanding then surgery may be recommended to release the Compressed Ulnar Nerve.
What Is The Recovery Time From Compressed Ulnar Nerve?
The most important question that an individual or a sportsman asks a physician is how long does it take to recover from compressed ulnar nerve and return to their respective sports. The recovery time for Compressed Ulnar Nerve depends on the severity of the condition and how long the nerve has been compressed.
If surgery is not required for relief of symptoms then the recovery time can be as quick as one to two weeks. If surgery is required to decompress the ulnar nerve then the recovery time may be prolonged to as much as four weeks.
In case if the patient has undergone transposition of the nerve which is a fairly complicated surgery for treatment of Compressed Ulnar Nerve then it may take more than 6 to 8 weeks for complete recovery before the patient can return back to their respective sports or activities of daily living without any reproduction of symptoms of Compressed Ulnar Nerve.
- American Society for Surgery of the Hand. (n.d.). Cubital Tunnel Syndrome https://www.assh.org/handcare/condition/cubital-tunnel-syndrome
- MedlinePlus. (2021). Ulnar Nerve Dysfunction https://medlineplus.gov/ency/article/000789.htm
- OrthoInfo. (2021). Ulnar Nerve Entrapment at the Elbow (Cubital Tunnel Syndrome) https://orthoinfo.aaos.org/en/diseases–conditions/ulnar-nerve-entrapment-at-the-elbow-cubital-tunnel-syndrome