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Ulnar Neuropathy is a relatively common diagnosis but it is also commonly misunderstood. By definition it is what happens when your ulnar nerve is entrapped or irritated, causing neck, shoulder, elbow, wrist, or hand symptoms that are painful or abnormal. There are nerve innervations that run from the spinal cord and provide both skin sensation as well as support motor function in the forearm and wrist. If the site of entrapment is occurring at the medial elbow, it is considered cubital tunnel syndrome, and Guyon’s canal syndrome when compressed at the ulnar side of the wrist. Guyon’s canal syndrome is considered an overuse injury that is commonly caused by direct pressure on a handlebar (i.e. bicycle handlebar, weight lifting, construction equipment) and therefore, is sometimes referred to as “handlebar palsy”.
The main causes of Ulnar Neuropathy are repetitive use, such as overhead athletes (baseball, volleyball, etc) as well as paralympic athletes who use their arms excessively. It might even surprise you to find out that Esport gamers are susceptible to acquiring Ulnar Neuropathy as well from the repetitive and prolonged positioning of the gaming controller. Other common causes of ulnar neuropathy are pressure or compression, trauma like a fracture (sprain of elbow, forearm, wrist, or hand), subluxation (dislocation) of the ulnar nerve, and prolonged gripping.
Common Symptoms are:
- Tingling in fingers 4 and 5
- Weak grip strength
- Pain/Sensitivity along the ulnar side of the forearm, wrist, and hand
- Muscle atrophy
- Clawing of digits 4 and 5
Decades ago, steroid injections and NSAIDs were used to numb the area trying to provide some pain relief. However, many studies have proven that not only is there no treatment benefit but also that the steroid itself will deteriorate the joint and tendon. By trying to mask the pain, you weaken it and also make it more susceptible to reinjury and more injections increase the chances of exacerbation.
Patients seeking conservative treatment earlier rather than waiting have a 30% greater chance of avoiding surgery. Conservative management has been proven effective when incorporating a multi-modal approach including neural glides and joint mobilizations. Another modality we have used with great success is Winback Tecar Therapy which can treat the area of entrapment directly via electrothermal technology and also promote motor function via the electrostimulation effects of winback Hi-EMS setting which provides a virtually painless contraction. Effects include deep and superficial muscle recruitment for mobilization, vascularization, and drainage along the area of ulnar nerve entrapment.
If you are not sure if you have Ulnar Neuropathy or how we can up, set up a free Discovery with us to find out at strengthchiro.com!
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