Ulnar neuropathy is compression or irritation of the ulnar nerve, most often at the elbow (cubital tunnel syndrome) and less commonly at the wrist (Guyon's canal).
Key Statistics
- Cubital tunnel syndrome is the 2nd most common upper-extremity compression neuropathy after carpal tunnel
- Annual incidence: ~25 per 100,000 person-years
- Risk factors: prolonged elbow flexion (phone use, sleeping with bent elbow), prior elbow trauma, diabetes, repetitive elbow activity
- Surgery (in situ decompression or transposition) provides symptom improvement in 80–90% of moderate to severe cases
Symptoms
- Numbness and tingling in the ring and little fingers
- Weak grip and pinch
- Pain along the inner elbow
- Hand clumsiness, dropping objects
- Severe / chronic: muscle wasting (intrinsic hand muscles), "claw hand"
Treatment
- Activity modification, elbow padding, night splinting (extension splint) — effective for mild cases
- In situ ulnar nerve decompression at cubital tunnel
- Anterior transposition (subcutaneous or submuscular) for unstable nerve
- Medial epicondylectomy in select cases
Common Symptoms
- Numbness in ring and little fingers
- Weak grip
- Inner elbow pain
- Hand clumsiness
- Muscle wasting (severe)
- Symptoms worse with bent elbow
Treatment Options
Night splinting
In situ decompression
Anterior transposition
Activity modification
Dr. Jerry Walters II
Board-Certified Neurosurgeon
Providing expert ulnar neuropathy treatment at Nova Brain and Spine of GA in Hampton, Georgia. Serving patients throughout Southern Georgia and the Atlanta metro area.