Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
An ulnar nerve injury (sometimes called an ulnar nerve lesion) can cause pain and numbness in your arm. Your arm might also feel weak if you hurt the nerve.
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What Is The Ulnar Nerve?
How Nerves WorkNervesare structures that help information travel between your brain and your body. They carry important signals that let you feel sensations and make movements.
How Nerves Work
Nervesare structures that help information travel between your brain and your body. They carry important signals that let you feel sensations and make movements.
When it leaves the brachial plexus, the ulnar nerve travels down the arm. It sends information to some of the muscles of the forearm and hand and gives sensation to parts of the hand.
Symptoms of Ulnar Nerve Injury
If you injure your ulnar nerve, you may have symptoms of pain, weakness, and abnormal sensation. Ulnar nerve lesions (injuries) also are evaluated on the basis of whether they occur above (proximal) or below the elbow (distal), which may affect how you experience symptoms.
Tingling and Numbness
Numbness and tingling (paresthesia) are signs that the ulnar nerve signals are being interrupted.
This can happen when there is pressure or inflammation around the nerve. The location of the paresthesia is not always the same place where there is a problem that is causing ulnar nerve dysfunction.
For example, in the case of cubital tunnel syndrome (the most common location for paresthesia in the hand), the ring and small finger are affected. However, the location of pressure on the nerve is near the elbow joint.
Pain
The pain from a nerve condition usually comes with numbness and tingling. It will usually feel like a burning sensation that travels along the path of the nerve. People with nerve pain often described it as shooting or like an electric shock.
Weakness
When nerve function is affected, the brain has a harder time telling muscles to move.As a result, those muscles can get weak. If you hurt your ulnar nerve, you might have trouble doing certain activities or strength maneuvers.
For example, you may have difficulty pinching or grasping objects.If you have nerve compression that lasts a long time (chronic), the muscles in your arms can waste away (atrophy).
Who Is at Risk for Ulnar Nerve Lesions?There’s a higher risk of ulnar nerve lesions in pregnant people and those diagnosed withdiabetesor rheumatoidarthritis. Some people have an occupational risk because of repetitive elbow and wrist motions. Bicyclists have a higher risk ofGuyon’s canalneuropathy.Not every person with an ulnar nerve injury or condition affecting nerve function will have the same symptoms.
Who Is at Risk for Ulnar Nerve Lesions?
There’s a higher risk of ulnar nerve lesions in pregnant people and those diagnosed withdiabetesor rheumatoidarthritis. Some people have an occupational risk because of repetitive elbow and wrist motions. Bicyclists have a higher risk ofGuyon’s canalneuropathy.Not every person with an ulnar nerve injury or condition affecting nerve function will have the same symptoms.
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Ulnar Nerve Injury Causes
Ulnar nerve injuries can happen along any point of the nerve.Sometimes, the damage is from anacute injury, which is sudden and traumatic.
Other times, ulnar nerve problems come from a chronic, long-standing condition that causes the nerve to stop working over time. In some cases, this can lead to “clawing” deformity of the hand and related loss of function and grip.
Cubital Tunnel Syndrome
The ulnar nerve wraps directly behind the humerus bone along the back of the elbow joint.Cubital tunnel syndromeis the chronic compression of the ulnar nerve behind the elbow.
The condition is categorized as compression neuropathy of the upper extremity. It’s the second most common type of compression neuropathy, aftercarpal tunnel syndrome.
The actual location of compression of the ulnar nerve in people with cubital tunnel syndrome can vary but can include the ligaments, blood vessels, and tendons.
Guyon’s Canal Syndrome (Handlebar Palsy)
Guyon’s canal, also called the ulnar tunnel, is a location within the wrist that contains the ulnar nerve.Compression of the ulnar nerve in this spot can be fromfractures to the small bonesof the wrist organglion cystsin the wrist.
One of the most common reasons for nerve compression in Guyon’s canal is so-called “handlebar palsy.”
This condition is common in cyclists and happens if the nerve gets pinched against the bones of the wrist and the handlebar of a bicycle, leading to pain and numbness.
If you cycle, you may want to wear padded gloves when you’re gripping the handlebars to avoid compression. If padded gloves don’t help, changing your grip or changing to a different style of handlebars can often help with numbness and tingling that tend to occur when compression is applied.
Funny Bone
Thefunny boneis the name people use to describecontusion injuriesto the ulnar nerve behind the elbow. In this location, the ulnar nerve wraps behind the arm bone (humerus) just underneath the skin.
There is very little soft-tissue protection around the ulnar nerve in this location and, as a result, striking this part of the elbow against an object often causes sharp pain, tingling, and numbness along the ulnar nerve.This is the sensation that people describe when they say they “hit their funny bone.”
Traumatic Injuries
Traumatic injuries occur as the result of sudden, often violent damage to the nerve.
Some of the more common mechanisms include nerve contusion (bruising), lacerations, and concussive injuries:
Since the ulnar nerve is located close to the skin, direct trauma to the overlying skin and soft tissues can cause a contusion injury to the nerve.
How Ulnar Nerve Injuries Are Diagnosed
Nerve injuries can be tough to diagnose, depending on the cause. Finding the location of a nerve injury can be straightforward or more challenging.
The evaluation and treatment of nerve-related conditions is not always a simple one-step visit to a healthcare provider’s office. Sometimes, multiple providers work together to find the source of a nerve injury and determine the best treatment for the cause.
Your provider will ask you about your symptoms and do a physical exam to diagnose an ulnar nerve injury. The ulnar nerve very predictably provides sensation in the exact same area for almost everyone: the small finger and half of the ring finger.
Patterns of nerve function can help a healthcare provider to identify and treat an ulnar nerve lesion. Most people have the same nerve patterns in their bodies. In some cases, though, anatomical differences can lead to symptoms of weakness and paresthesia.
Tinel’s Sign
Many examination techniques are used to isolate and test nerve function. One specific test used to examine people with suspected nerve abnormalities is calledTinel’s sign.
Tinel’s sign is considered positive when the provider taps directly over the location of nerve abnormality and it re-creates symptoms of paresthesia and discomfort along the path of the nerve rather than at the specific location where the tapping takes place.
For example, in a person with cubital tunnel syndrome would, tapping behind the elbow joint directly over the ulnar nerve would re-create symptoms of paresthesia and pain in the ring and small finger, demonstrating a positive Tinel’s sign.
Other Tests
Other tests can be done to assess the ulnar nerve and the surrounding anatomy which could be causing compression or injury to the ulnar nerve.
While electrical studies can help find the source of a nerve condition, they involve placing needles into the skin and measuring an electrical current along the path of the nerve. The procedures can cause discomfort.
Treatment for Ulnar Nerve Injuries
The only way to treat an ulnar nerve injury successfully is to figure out exactly where the problem is. Often, symptoms of the nerve injury are not felt at the location of the damage to the nerve.
Trying to determine the location of the problem often takes some time and testing, but these steps need to take place before treatment.
Treatment for an ulnar nerve injury might include:
If a component of the compression on the nerve is the result of inflammation, treatments that reduce inflammation can be helpful.
Treatments for pain and inflammation commonly include:
Surgical treatments for ulnar nerve problems depend on the type of injury. When there is a direct injury to the nerves, such as a laceration, these injuries are often fixed soon after the trauma. If there is a broad area of damage to the nerve, nerve grafting may have to be done to reconnect healthy portions of the nerve.
A common treatment for people with cubital tunnel syndrome is to move the nerve from the back of the elbow to the front (ulnar nerve transposition). In the new position, the nerve is no longer under a lot of tension when the elbow is bent.
When there is compression on the nerve, surgical solutions are aimed at relieving the pressure and removing tension from the nerve. In some cases, this just requires removing pressure on the nerve in a minimally invasive surgical procedure. In other cases, it involves relocating the position of the nerve so that there is less tension on it.
Summary
If you injure your ulnar nerve, you may have pain, numbness, tingling, and weakness in your arm. It can be tricky to find out the cause of the injury because the symptoms you have may not be exactly where the problem is. Your provider can use different tests to figure out the source of the problem and recommend the appropriate treatment.
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