What Is Ulnar Tunnel Syndrome?
The ulnar nerve is one of three major nerves in the peripheral nervous system that give your arm the ability to move and feel. This nerve starts at the brachial plexus and passes down the arm through the wrist and into the little finger (pinky) and small muscles of the hand. It controls feeling and movement in your ring finger and small finger, and is also responsible for controlling fine movement of the small muscles in your hand.
Ulnar nerve syndrome occurs when the ulnar nerve is compressed as it crosses the wrist into the hand (Guyon’s canal).
Signs & Symptoms
Symptoms of ulnar nerve syndrome typically develop over time and can often be worse in the morning. The most common signs that the syndrome has occurred include:
- Numbness in the ring and little fingers
- Tingling
- Weakness
- Difficulty grasping objects
- Pain in the ring finger, little finger, and/or the wrist
Causes
The most common cause of ulnar tunnel syndrome is the presence of a ganglion cyst, which is a fluid-filled cyst that develops from the wrist joint. Ulnar tunnel syndrome can also result from repetitive use or overuse. This tends to happen from using vibrating tools that cause the surrounding tissue to swell or from constant pressure on the palm of the hand, such as in activities like weightlifting or cycling. Other possible causes of ulnar tunnel compression can include wrist injuries and arthritis.
The cause of your ulnar tunnel syndrome, such as from repetitive use versus extended pressure on the palm, will help your doctor find the most beneficial treatment option for your specific needs.
Treatment
Treatment for ulnar tunnel syndrome will depend on where the compression is occurring—in the wrist or the elbow. Your reconstructive hand surgeon will perform a physical exam to evaluate the arm, which will include evaluating for symptoms like muscle weakness and tingling. Diagnostic tests like X-rays, MRIs, nerve conduction studies may be utilized as well to make sure other problems are not contributing to your symptoms. It is not uncommon for carpal tunnel syndrome to occur at the same time as ulnar tunnel syndrome.
For mild cases of the condition, our surgeons will first recommend a non-surgical approach that may help relieve symptoms. These methods typically include the following:
- Avoiding or modifying the activity that is causing symptoms
- Splinting the wrist to limit movement
- Anti-inflammatory medications to aid with symptoms
Should these conservative options not resolve your symptoms, outpatient surgery may be your best option for restoring optimal function. Surgery typically involves relieving the pressure on the ulnar nerve and/or removing any cysts or other soft tissue growths causing the compression. The ligament covering the Guyon’s canal may be cut to further help with pressure relief.
Symptoms should gradually fade after surgery. As the nerve heals over the course of several months, your surgeon will advise on post-operative care instructions, including physical therapy to rehabilitate the use of your wrist and hand.
