Ulnar Nerve Entrapment, also known as the Cubital Tunnel Syndrome, refers to a medical condition in which the ulnar nerve gets irritated or trapped. It is one of the three main nerves in the human arm that originates near the neck and runs down the entire length of the arm to the hand. The nerve provides sensation to the ring and the little finger besides enabling the arm muscles to form a grip. It may get compressed along this path, most commonly it happens at the collar bone, elbow joint or the wrist. The condition should be addressed with timely medical care as it may lead to muscle atrophy and physical disabilities.
Causes
- Formation of bone spurs along the path of the ulnar nerve
- Arthritis of the elbow joint
- Past instances of bone fractures or dislocations in the arm, hand, wrist or collar bone
- Repeated and excessive bending or flexing of the elbow joint may put the ulnar nerve out of place
- A direct hit or injury to the elbow joint
- Accumulation of joint fluid in the elbow may compress the nerve
- Bending the elbow or leaning on it for long can result in nerve entrapment. This happens because the ulnar nerve passes over the small bony ridge called medial epicondyle when the elbow is bent. Repeated activity may irritate it
- Some people have inherent structural problems which may make the ulnar nerve slide out of the cubital tunnel every time the elbow is bent.
- Prolonged resting of the elbow on the armrest of the chair
Symptoms
- Numbness in the hand, little finger and ring finger
- A tingling sensation may occur sporadically in the fingers and hand
- Flexing the fingers may become difficult
- Loss of grip or ability to hold objects
- The fingers may go numb or ‘fall sleep’ when the elbow is bent for a short stretch of time
Diagnosis
- Details of the patient’s symptoms, past injuries, lifestyle, occupational requirements, may be noted
- Physical tests may be conducted to check the level of strength and flexibility in the hand or wrist
- The elbow may be bent to check if the nerve moves out of its place
- X-ray imaging of the elbow, hand and wrist joint to assess the bone structure
- Nerve conduction tests may be carried out by stimulating the ulnar nerve at a particular point and recording its response. This helps to determine damage to nerve and muscles
Treatment
- Prescription of anti-inflammatory medicines to eliminate swelling in soft tissues around the nerve
- A soft padded elbow brace or splint can be worn at night to keep the arm straight while sleeping
- Specific exercises may be performed to guide the ulnar nerve to slide through the cubital tunnel when the elbow is bent
- Surgical treatment may be required if the patient does not show improvement with conservative methods. These may include the following:
- Cubital Tunnel Release- Surgical cutting of the ligament within the cubital canal to make more space for the ulnar nerve
- Ulnar Nerve Anterior Transposition- In this, the ulnar nerve is relocated from its original position to the front side of the forearm. This prevents it from sliding out of its position when the joint is moved
- Physical therapy may be recommended post-surgery to prevent stiffness in the arm
