What is Ulnar Neuropathy?
Ulnar neuropathy is a condition in which the ulnar nerve, a major nerve that runs from the neck along the outside edge of the arm into the hand, becomes inflamed due to compression of the nerve. The inflammation causes tingling, numbness, weakness and pain primarily along the elbow, underside of the forearm, wrist or outside edge of the hand, extending towards the pinky and ring fingers. This condition is sometimes referred to as “handlebar palsy” or “bicycler’s neuropathy” since it is a common injury found in cyclists due to repetitive gripping of a bicycle’s handlebars.
What causes Ulnar Neuropathy?
Ulnar neuropathy is caused by inflammation due to compression of the ulnar nerve. This can occur from repetitive wrist or elbow movements, motions that continuously stretch the ulnar nerve (such as gripping a bicycle’s handlebars or leaning arms on a desk while using a computer) or from trauma to the nerve anywhere along the path of the nerve (although trauma most commonly occurs in the elbow or wrist). This is a common injury among cyclists due to the repetitive bumps and bounces that can irritate the ulnar nerve while riding. Certain medical conditions can also cause ulnar nerve inflammation or damage, such as diabetes, rheumatoid arthritis, and infections. Ulnar neuropathy is more likely to occur in men than women and is more likely in older adults since it typically has a gradual onset of symptoms.
What are the symptoms of Ulnar Neuropathy?
The primary symptoms of ulnar neuropathy include weakness, numbness, tingling and pain that occur along the elbow, the underside of the forearm, the outside edge of the hand and palm, or along the pinky and ring fingers.
How is Ulnar Neuropathy diagnosed?
Dr. Yakov Simkhayev will take a complete medical history and will perform a physical exam. The exam will involve various movements of the neck, shoulder, arm, elbow, wrist, hand and fingers to determine whether there is inflammation, tenderness, weakness, numbness, tingling or pain in various locations. Apparent weakness in the elbow or wrist indicates that the ulnar nerve may be inflamed. An MRI or ultrasound may be performed to visualize if there is a structural compression of the nerve. A nerve conduction study may also be performed to determine the extent of damage to the nerve.
When should I seek care for Ulnar Neuropathy?
If you experience weakness, numbness, tingling or pain in your elbow, along your forearm or in your wrist, hand or fingers, you should seek medical advice. Ulnar neuropathy is treatable, but if the condition is not properly diagnosed and activity that causes inflammation continues, permanent nerve damage can result.
What will the treatment for Ulnar Neuropathy consist of?
Once the cause of the condition has been determined, avoiding activities that cause injury to the nerve and resting the nerve so it can recover can provide relief. Physical therapy, including strengthening exercises and learning ways to properly position the arm, elbow, wrist and hand during certain activities is helpful. Nonsteroidal anti-inflammatory medications can alleviate pain and swelling caused by the condition. Surgery may be needed if the nerve inflammation is caused by a structural growth (such as a cyst) or damage to the nerve resulting from a trauma. If the condition is the result of repetitive activities, you may slowly return to regular activities once the nerve has healed. Using a splint, cushion or other orthotic device may provide relief from additional inflammation. You may need to modify your grip or change the way you perform specific activities in order to prevent re-injury. For example, if you are a cyclist, wearing padded gloves may prevent the repetitive trauma to the nerve that can come from bumps and bounces while riding or changing the position of the hands on the handlebars can avoid repetitive irritation to the wrist.
Which muscle groups/joints are commonly affected by Ulnar Neuropathy?
The ulnar nerve runs from the neck along the outside edge of the arm, through the elbow and wrist and into the hand and fingers. Ulnar neuropathy typically causes symptoms along the elbow, forearm, wrist, or outside edge of the hand and fingers, although compression of the nerve can occur anywhere along the nerve’s pathway.
What type of results should I expect from the treatment of Ulnar Neuropathy?
Most cases of ulnar neuropathy will reverse themselves with a period of rest from the activity causing the condition and slight changes to how the activity is performed when resuming activity. If the condition is a result of a structural growth the compresses the nerve or acute trauma to the nerve, surgery may be required to treat the condition and is generally successful at alleviating the neuropathy. If the condition is allowed to go on without treatment for too long, or activity is resumed too early before the nerve has a chance to heal, permanent nerve damage can occur.