Ulnar nerve entrapment

If it feels like you have a trapped nerve in your arm or a numb little finger, you may be experiencing trouble with your ulnar nerve. The ulnar nerve is one of the three large nerves that run from the upper arm through the forearm and into the hand. The two others are called the radial nerve and the median nerve.

In this article, we will only dive into ulnar nerve injuries, a susceptible nerve that can cause problems and symptoms when the space around it becomes too tight. As the nerve runs through the arm, the injuries can happen from the shoulder to the hand. However, the most frequent injuries occur around the elbow.

Symptoms

What is ulnar nerve entrapment?

Ulnar nerve entrapment – also cubital tunnel syndrome or ulnar tunnel syndrome – occurs due to compression or irritation of the ulnar nerve in a tight tunnel on the inside of the elbow. You may know the area as your “funny bone”.

It lies in a pocket near the elbow, which goes through to both the ring and little fingers. You know it well, as it is here that you will feel pain when you experience a traditional “elbow shock” when you bust your elbow into a hard surface. As such, it lies pretty exposed in your arm.

The ulnar nerve sends impulses to the muscles in the forearm and hand. These impulses include, among other things, the nerve signals that provide the ability to feel around the ring finger, little finger, and the part of the hand located below these fingers.

A typical ulnar injury happens when irritation occurs in the space in which the nerve runs, making it operate less smoothly. So, you are dealing with a trapped nerve in the elbow. Fortunately, it is an injury that is relatively simple to recover from. You can read more about this later.

Source: BSSH & Johns Hopkins

Ulnar nerve entrapment symptoms

It varies quite significantly when and how an ulnar injury can occur. Most people who experience the disorder will typically not know ​​how it happened or how they knocked their elbow. Simply put, people tend to experience it first when, e.g., they start to feel nerve pain in the hand or arm

The damage occurs – as previously mentioned – by the nerve getting pinched, which causes some irritating conditions. Typically, one will experience symptoms such as:

  • Numbness and tingling in the ring finger and little finger. These come and go but will happen more frequently when the elbow is bent. For instance, when they are on the phone.
  • A sleeping sensation in the ring finger and little finger. Again, this mainly happens with a bent elbow. In some cases, it can be hard to move your fingers.
  • It is challenging to grab objects as fingers are weak, and it feels like there is a trapped nerve in your hand. It can be tricky to keep regular finger coordination, making it harder to, e.g., type a keyboard or play the piano. These symptoms are usually more severe.
  • In severe cases, muscle wasting in hand can occur. Once this happens, muscle wasting is chronic. Therefore, you must see a doctor if your symptoms last for more than six weeks.
  • The shock-like sensation that happens, you knock the “funny bone” in your elbow, stems for the ulnar nerve. If you damage it, you may experience muscle weakness and lack sensation in your arm. This is known as ulnar nerve palsy.

Additionally, many people find it a big nuisance at night when lying in bed. A tip to reduce the pain and irritation is to let your hand hang outside the bed.

Source: Johns Hopkins & OrthoInfo

Causes

What causes ulnar nerve entrapment?

Typically, you will find that the ulnar nerve is most frequently pinched around the wrist and on the back of the elbow due to irritation. Therefore, ulnar ailments also cause wrist pain. As it often occurs due to knocks and shocks, several work-related causes are highlighted.

Jobs where you use different vibration tools such as drills, nail guns, etc., will often be decisive, as you experience frequent and powerful movements, which means that the nerve is exposed to consistent shocks over a long time. You will be particularly exposed as a person working with manual labour such as carpenters, painters, etc.

In addition, repeated movements in awkward working positions will also lead to ulnar nerve pain. This is not just an issue for people working in manual labour, but also office workers who sit in front of a screen every day with their elbows resting on hard surfaces. Repeated movements in a set-up that is not ergonomically proper for the body could cause ulnar injuries and nerve damage in their arm over time.

Hormonal fluctuations prove to be quite influential in developing ulnar injuries, as it often accompanies an accumulation of fluid in the body. Therefore, women are particularly vulnerable to the disorder as the risk increases during pregnancy.

Source: Johns Hopkins & Physio.co.uk

Treatment

Treatment of ulnar nerve entrapments

Ulnar nerve entrapments are common and will typically go away on their own. In the more severe cases, it may even take several weeks. While it may not seem too serious at first, it is crucial to take the right initiatives to avoid worsening it.

It is essential to give your arms rest and avoid any harmful activities. You can always use a headset when you are on the phone or avoid leaning on your arms. Additionally, it is good to try and avoid bending your arms excessively – both during the day and at night. It can be tricky, but you can help yourself by getting a splint through a therapist or wrapping a towel around your elbows at night to keep them straight. The pains you experience with ulnar nerve entrapment can be eased out through common over-the-counter medications such as paracetamol.

If it is caused by using a mouse, you should see whether you can change how you use the mouse or swap to an ergonomic mouse, such as RollerMouse. You may also have to take a closer look at your keyboard, as its tilt can be crucial for the strain on the wrist and fingers.

If the symptoms persist for more than three months, it will be time to consider surgery. The purpose of the operation is to give more space to the nerve so that it is no longer pinched and thus not exposed to pressure.

Source: BSSH

Ulnar nerve entrapment exercises

The condition occurs because the nerve can experience shocks and blows, which are difficult to prevent through exercises. Therefore, different exercise routines will typically only happen after an operation where one must regain muscle and strength. Here, you must set up a program in close collaboration with your doctor or physiotherapist.

The most important thing you can do to avoid or aggravate an ulnar injury is the following:

  • By avoiding shocks and blows to the elbow and forearm
  • By avoiding activities that require a bent elbow
  • By not doing fast, repetitive movements
  • By not leaning on your elbow or putting pressure on your arms
  • By ensuring a good ergonomic working environment at his workplace. Find inspiration to create your best set-up here.

Source: OrthoInfo

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