Ulnar nerve entrapment can occur if the ulnar nerve is compressed. Compression of the nerve prevents it from functioning normally and causes pain and numbness.
ANATOMY
The ulnar nerve is one of the three main nerves in the arm. The path of the nerve is from under the collarbone, along the inside of the upper arm, and through the cubital tunnel behind the inside of the elbow.
The ulnar nerve provides the sensation of location in fingers. It’s also important for grip strength by controlling little muscles in the hand and some of the larger muscles in the forearm, respectively.
CAUSE
There is not a clear understanding for why the ulnar nerve gets compressed at the elbow. However, some factors seem to increase the likelihood of such compression. These factors include: prior elbow fractures, cysts, bone spurs, and elbow joint swelling. Repetitive activities requiring bending of the elbow, direct blows to the elbow, and leaning on the elbow for extended periods can also lead to nerve compression.
SYMPTOMS
Ulnar nerve entrapment leads to fleeting symptoms including numbness and tingling. Weakness of the grip and finger coordination problems are also symptoms of this disorder. Symptoms are usually worse when the elbow bends. For this reason, holding a phone or driving a car can often lead to the experience of these symptoms. Muscle wasting can occur if the nerve is severely compressed and/or is compressed for an extended period. If this occurs, muscle wasting is irreversible.
TREATMENT
Dr. Samimi will most likely recommend nonsurgical initial treatment unless there is a lot of muscle wasting, What Dr. Samimi recommends involves modifying certain behaviors. Some suggestions include avoiding frequently using the arm when the elbow is bent, avoiding the use of armrests, and avoiding putting extra pressure on the arm. Keeping the elbow straight while sleeping can also be helpful. Putting a towel around a straight arm or using a brace can help accomplish this. Additionally, making sure your chair is not too low while you’re typing can also help prevent muscle wasting.
Nonsteroidal-Anti-Inflammatory Medication
Anti-inflammatory medicine such as ibuprofen or Motrin may help reduce swelling around the nerve and alleviate pain.
Surgery
If the strategies listed above do not help improve the condition, Dr. Samimi may recommend surgery to reduce the pressure on the nerve. When Dr. Samimi performs anterior transposition of the ulnar nerve surgery for this condition, he releases the nerve from any adhesions and places the nerve in a new place in front of the elbow where it will not be compressed.
The above figure is an example of an incision. The incision will be similar to this, regardless of where exactly the nerve is located.
If you have this surgery done, you will probably be able to go home the same day. You may have to stay one night in the hospital, and you will likely have to wear a splint for a few weeks following the surgery. Results from this surgery are usually good, but there is a chance that function will not return to normal if the nerve is badly compressed. The worse the compression, the longer it will likely take to heal from the procedure.
