Ulnar Neuropathy (Cubital Tunnel Syndrome or Tardy Ulnar Palsy):

Definition:

An ulnar neuropathy (also called a cubital tunnel syndrome) is the name of an injury to the ulnar nerve at the elbow. The ulnar nerve is a large nerve in the arm that controls the fine movements of the hands and the sensation of the smaller two fingers. The nerve is usually injured at the elbow.

The nerve is just below the skin of the elbow. If you hit your elbow, you can bruise the nerve which causes a shock in the hand. It is commonly called “hitting the funny bone.”

Some types of work will cause repeated damage to the nerve. The nerve can become swollen and trapped between bands of scar tissue and muscle. The damage, in turn, causes chronic pain in the hand and arm.

The Diagnosis of Ulnar Neuropathy:

The most common symptom is pain. The pain usually goes from the elbow to the smallest two fingers of the hand. Numbness is common in the small fingers. Weakness and wasting of the small muscles in the hand is also common.

A careful history and physical will usually find the cause of the pain. As part of the examination, the doctor will gently tap over the nerve at the elbow. This reproduces the usual hand tingling and pain (and feels like a “funny bone”). An EMG test will confirm the diagnosis. X-rays are not usually needed.

Occasionally one can have two problems that overlap. If you have a pinched nerve in the neck along with an ulnar neuropathy, the same nerve can be damaged in two places. This is called a “double-crush” syndrome. The history, examination, and EMG will also sort this out.

The Treatment of Ulnar Neuropathy:

Ulnar neuropathies can be caused by chronically leaning on the elbows at work or at the table. Many patients can cure their ulnar neuropathy by avoiding elbow leaning. If that does not work, a brace can be tried. Braces rarely work. They are uncomfortable and few patients are willing to wear them. Surgery works 80% to 90% of the time. This outpatient procedure takes about 30 minutes. To do the surgery, the doctor will move the nerve away from the elbow to a more protected location. The healing time is a few weeks and most patients have almost immediate relief of symptoms.

Alternative Therapy:

Acupuncture may be of help for this problem. Chiropractic has not been shown to help. Reiki therapy and Pranic healing may help but have not been proven to do so in scientific studies.

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