Ulnar nerve entrapment occurs when the ulnar nerve in the arm becomes compressed or irritated. The ulnar nerve is one of the three main nerves in your arm. It travels from your neck down into your hand, and can be constricted in several places along the way. Depending upon where it occurs, this pressure on the nerve can cause numbness or pain in your elbow, hand, wrist, or fingers.
Sometimes the ulnar nerve gets compressed at the wrist, beneath the collarbone, or as it comes out of the spinal cord in the neck. The most common place where the nerve gets compressed is behind the elbow.
When the nerve compression occurs at the elbow, it is called "cubital tunnel syndrome."
How is this treated?
If the symptoms are intermittent, without any associated muscle weakness, it can be initially treated with measures such as avoiding prolonged elbow bending positions, such as holdinga mobile phone or keeping elbow bent when sleeping at night.
These measures may provide some relief and allow recovery of the compressed nerve.
If the symptoms are not relieved with the above measures or if there is pain and if there is muscle weakness and weakness in the use of the hand, then surgery may be required to prevent further damage to the ulna nerve and to allow it to recover.
Surgical treatment consists of releasing the roof of the tunnel through which the nerve passes thus relieving all compression on the nerve. This is usually performed under a short general anaesthetic and as a day-case or a short stay procedure.
What is the recovery and prognosis like?
The pain usually settles down in a few days. The sensory improvement usually takes a few weeks. If there has been significant long term compression and nerve damage then then weakness may take upto 2 years to recover and can be quite unpredictable.
Nerves are very sensitive structures. If the compression is relieved and treated promptly recover is almost complete after surgery. However, the longer the nerve is compressed, the longer it takes for it to recover even after a successful surgery.
What the surgery achieves primarily is to stop the compression from getting worse.
Dr Vinod Kumar Cochin
Elbow surgeon cochin
Shoulder surgeon cochin
Ulna nerve compression at the elbow
Cubital tunnel syndrome can cause an aching pain on the inside of the elbow. Most of the symptoms, however, occur in your hand.
Ulnar nerve entrapment can give symptoms of "falling asleep" in the ring finger and little finger, especially when your elbow is bent. In some cases, it may be harder to move your fingers in and out, or to manipulate objects.
Numbness and tingling in the ring finger and little finger are common symptoms of ulnar nerve entrapment. Often, these symptoms come and go. They happen more often when the elbow is bent, such as when driving or holding the phone. Some people wake up at night because their fingers are numb.
Weakening of the grip and difficulty with finger coordination (such as typing or playing an instrument) may occur. These symptoms are usually seen in more severe cases of nerve compression.
If the nerve is very compressed or has been compressed for a long time, muscle wasting in the hand can occur. Once this happens, muscle wasting cannot be reversed. For this reason, it is important to see your doctor if symptoms are severe or if they are less severe but have been present for more than 6 weeks.