Ulnar Nerve Entrapment occurs when the ulnar nerve is compressed or irritated, often at the elbow (cubital tunnel syndrome) or wrist (ulnar tunnel syndrome). This compression can lead to disruption in nerve function, causing pain, numbness, and muscle weakness in the affected arm and hand. Factors contributing to this condition include repetitive motion, prolonged pressure on the nerve, and anatomical variations.
Clinical Evaluation
Physical Examination: To assess symptoms such as pain, numbness, and muscle weakness. Tinel's sign and elbow flexion tests may be performed.
Patient History: To identify activities or positions that exacerbate symptoms and any history of trauma or repetitive use.
Imaging and Electrophysiological Studies
Nerve Conduction Studies (NCS): To measure the speed of electrical impulses through the ulnar nerve and identify the location of compression.
Electromyography (EMG): To evaluate the electrical activity of muscles innervated by the ulnar nerve and detect any nerve damage.
Ultrasound: To visualize the ulnar nerve and detect any structural abnormalities or compression sites.
MRI: To provide detailed images of the soft tissues and nerve structures, particularly if surgery is being considered.
Tingling or numbness in the ring and little fingers.
Weakness in the hand, particularly in the grip and pinch strength.
Pain or discomfort along the inner side of the forearm and hand.
Worsening symptoms with activities that involve bending the elbow or resting the arm on a hard surface.
Muscle wasting in severe or prolonged cases.
Treatment for ulnar nerve entrapment aims to relieve pressure on the nerve and restore normal function.
Non-Surgical Treatments: Includes activity modification to avoid repetitive elbow movements or prolonged elbow flexion, wearing a splint or brace to keep the elbow straight, especially at night, and physical therapy exercises to strengthen and stretch the muscles around the elbow and wrist.
Medications: Anti-inflammatory drugs or corticosteroid injections to reduce inflammation and alleviate pain.
Surgical Treatment: In cases where non-surgical treatments are ineffective, surgical options may include ulnar nerve decompression, anterior transposition, or medial epicondylectomy, depending on the site and severity of compression.
Post-Surgery Rehabilitation: Physical therapy to regain strength and mobility, and to prevent recurrence of symptoms.