Injury to Ulnar Nerve: Causes, Symptoms, and Treatment Options

The ulnar nerve innervates the ulnar joint. It provides movement in the forearm and hand muscles. Also, it provides skin sensitivity in the area of the little finger and ring finger. Injury to the ulnar nerve impairs these functions. Programmers and athletes are the most common people to see a doctor with signs of injury to the ulnar nerve. Causes of occurrence may be:

• A person frequently puts his or her elbows on a desk;
• The habit of putting the bent arm out the window when driving a car;
• Frequent repetitive movements of bending the arm at the elbow;

For successful treatment for ulnar neuropathy, you need to cut the cause of the disorder. Doctors recommend physiotherapeutic procedures to increase the effectiveness of the medication. Therapeutic exercise, massage, and gymnastics in the pool give good results. Read more in our article below.

Understanding Ulnar Nerve Injury

The ulnar nerve begins in the brachial plexus. It consists of nerve fibers emanating from the spinal canal. They are at the seventh to eighth cervical and first thoracic vertebrae level. It travels along the inner humeral surface, shifting to the elbow. It penetrates the cubital (ulnar) canal there. That is the anatomical tunnel of:

• ligaments;
• muscle tendons;
• surfaces of the epicondyle;
• the ulnar process. 

The nerve then runs along the inner forearm surface to the wrist. A deep branch goes through the Guyon canal.

Injury to the ulnar nerve is a pathology of an inflammatory nature. The ulnar nerve handles the work of the muscles and joints of the hand. It provides movement and sensitivity of the:

• little finger;
• ring finger;
• part of the middle finger. 

Symptoms of this condition are often different types of pain (ulnar nerve neuralgia). To decide exactly how to cure the ulnar nerve, a doctor must determine the condition’s root cause.

There are two types of lesion of the ulnar nerve:

• those caused by physical trauma;
• those caused by lifestyle or comorbidities. 

Read more about things that can cause this problem below.

Causes of Ulnar Nerve Injury

In the first case, the fibers are often injured in the:

• shoulder;
• elbow;
• forearm;
• cervicothoracic spine.

It can be a fracture, joint dislocation, muscle rupture, contusion, or ligament sprain. In any case, the nerve fibers are also affected. The symptoms of ulnar nerve neuritis will also disappear with proper treatment.

Type 2 lesion of the ulnar nerve requires more attention and often lifestyle changes. Causes of inflammation or pinched nerve fibers can be:

• • Unfunctional driving posture. This is when the driver is leaning on the elbow out the window.
  • Improper posture when sitting for long periods. There is pressure on the ulnar fossa and compression of the nerve trunk.  It comes in a position where the body’s weight rests on the elbow. 
  • Frequent sudden movements of the joint during monotonous work or sports activities.

• Riding a bicycle or motorcycle can also cause injury to the ulnar nerve.

• • Working in an environment of constant vibration radiating to the elbow joint.
  • Constant use of a cane while walking.
  • Shoulder, elbow infectious or autoimmune arthritis.
  • New growths, tumors, or deformities of the joint.

• Post-traumatic arthritis.

• Enlarged lymph nodes.

Symptoms of Ulnar Nerve Injury

A characteristic sign of neuralgia of the ulnar nerve is a piercing, burning pain. In the affected elbow, can be:

• weakness in the hand;
• numbness in the palm, fourth (ring finger), and fifth (pinky finger) fingers. 

The wrist muscles weaken, and in severe cases, they become completely paralyzed. The hand resembles a clawed paw (bird’s paw type deformity). Pain is at the carpal base in injury to the ulnar nerve with carpal tunnel syndrome. And the sensitivity of the fingers is often impaired only on the palm side.

Patients find it difficult to bring the fingers together and apart on the hand. When the ulnar nerve has damage or compression, it can result in various symptoms. Here are some common ulnar nerve entrapment symptoms.

Numbness or tingling

One of the primary symptoms of ulnar nerve injury is a sensation of numbness or tingling. It can be on the ring finger, little finger, and the inner side of the hand. This numbness or tingling sensation may extend from the fingers to the forearm. Sometimes, it can even reach the upper arm.

Weakness or muscle wasting

The muscles controlled by the nerve may not function properly. It leads to weakness and a gradual loss of muscle mass over time.

The specific muscles affected by weakness depend on the:

• location;
• severity of the ulnar nerve injury. 

But, certain muscles in the hand and forearm are commonly affected:

• Intrinsic hand muscles. The ulnar nerve provides motor function to the intrinsic muscles of the hand. They are responsible for fine motor movements and control of the fingers. Weakness in these muscles during lesion of the ulnar nerve can result in difficulties with:

• gripping objects;
• manipulating small items;
• performing precise hand movements.

• Flexor muscles of the fingers. The flexor muscles in the forearm are responsible for bending the fingers. Weakness can lead to:

• reduced grip strength;
• difficulties with finger flexion tasks.

• Hypothenar muscles. The hypothenar muscles have a location at the little finger’s base. Weakness in these muscles can reduce the ability to control the little finger. It affects tasks requiring precise movements, such as playing a musical instrument.

Sensitivity to touch

Some individuals with injury to the ulnar nerve may experience increased sensitivity. So, they feel pain from the touch in the affected area. Light touch or pressure on the elbow or inner side of the hand may cause pain or a heightened sensation.

Claw-like deformity

The fingers appear to spread out and slightly curled, resembling a clawed paw. The ring finger and little finger are particularly affected. As the ulnar nerve primarily controls these fingers. The middle and end joints flex or bend, while the other fingers may remain extended. It is one of the most common ulnar nerve entrapment symptoms. 

The exact positioning of the fingers may vary depending on the severity and extent of the injury. The claw-like deformity is most noticeable when the hand is at rest. But, it may correct or improve when the individual tries to straighten their fingers.

Painful sensations in the pinky, ring, and middle fingers

Painful sensations in these fingers are usual ulnar nerve entrapment symptoms. It can cause sharp or shooting pain, a burning or tingling sensation, and aches or throbbing pain. Increased sensitivity to touch may also be present. Consulting a healthcare professional is highly recommended for proper diagnosis and treatment options. They may include medication, physical therapy, or surgery. As it depends on the severity of the condition.

Diagnosis of Ulnar Nerve Injury

A neurologist conducts a series of tests to understand treatment for the ulnar nerve.  The doctor needs it to identify:

• the condition of the nerve tissue itself;
• the causes that led to the development of inflammation.

First, a series of neurological tests are always performed to confirm the problem:

• Testing skin sensitivity in the affected hand.
• Bending all fingers into a fist. The little finger lags slightly behind the others. It indicates the presence of neurological disease.
• A picture of the affected hand with an “okay” sign.
• The patient’s task is to spread the fingers. Then they must scratch the table a little in a mobility test in which the hand lays flat.

After the initial screening, hardware tests are usually ordered to establish the cause of injury to the ulnar nerve :

• Ultrasound of the soft tissues at the site of the muscle bundle.
• Radiographs of the elbow joint, forearm, and wrist canal.
• Nerve fiber nerve conduction velocity testing.
• MRI of the cervicothoracic spine, hand.
• Blood tests.
• Physical examination of the joint.

After receiving the results, you can determine exactly what caused the inflammation. And, based on the findings, build a treatment scheme.

Treatment Options for Ulnar Neuropathy

Treatment for ulnar neuropathy is primarily aimed at:

• eliminating the pain syndrome;
• identifying and eliminating the causes that led to the development of the disease.

The professionals at our clinic take a comprehensive approach to solving such problems. It includes both traditional and innovative non-surgical methods.

The most effective way to eliminate even severe pain is treatment blocks. It introduces a set of drugs based on anesthetics in the zone of maximum pain. Pain relief develops in minutes and lasts for several hours. Doctors may also use special techniques to relieve pain. Sometimes the situation may require surgery.

Surgical Intervention for Ulnar Nerve Injury

Surgical intervention is an ulnar nerve pain relief option for severe or persistent ulnar nerve injuries. They do not respond to conservative measures, as a rule. It involves surgical procedures to:

• relieve compression;
• repair damage to the ulnar nerve. 

Here are some common surgical interventions for ulnar nerve injuries:

• Ulnar nerve decompression. This procedure involves releasing any tissues that are compressing the ulnar nerve.
• Ulnar nerve transposition. This helps to protect the nerve from further damage. The nerve is typically moved from its original position behind the medial epicondyle to a location in front of it.
• Nerve grafting. This treatment for ulnar neuropathy involves:

• taking a section of the nerve from another part of the body (usually a sensory nerve);
• using it to bridge the gap, facilitating nerve regeneration.

• Nerve transfer. This allows the healthy nerves to provide innervation to the muscles and areas. As the damaged ulnar nerve previously controlled them.

Ulnar Nerve Pain Relief Techniques

Pain relief techniques are an important component of the treatment plan for ulnar nerve injury. These techniques include:

• Medications. Nonsteroidal anti-inflammatory drugs can help reduce pain and inflammation. In some cases, physicians may prescribe stronger pain medications or corticosteroids.
• Splinting. Wearing a splint or brace can support and immobilize the affected area. As it reduces strain on the ulnar nerve and minimizes pain.
• Physical therapy. Specific exercises and stretching techniques prescribed by a physical therapist can help improve strength and flexibility and reduce pain. 
• Cold or heat therapy. Applying ice packs or cold compresses can help reduce inflammation and numbness. So, it provides temporary pain relief.
• Transcutaneous electrical nerve stimulation (TENS). This technique involves applying mild electrical currents to the skin. They can help block pain signals and provide relief.

Conclusion

In conclusion, injury to the ulnar nerve can result from various causes and lead to symptoms such as numbness, weakness, and pain in the hand and fingers. Remember that early diagnosis and appropriate management are essential for optimal recovery. So, do not hesitate to contact us for high-qualified medical help.

FAQ

• What happens when the ulnar nerve is damaged?

When the ulnar nerve is damaged, it can lead to various symptoms, such as numbness, tingling, weakness, pain, and loss of muscle control in the hand and fingers.

• What are the symptoms of ulnar nerve entrapment?

Symptoms of ulnar nerve entrapment include numbness or tingling in the ring finger, little finger, and the inner side of the hand, weakness in the hand grip, clumsiness or difficulties with coordination, and pain in the elbow or forearm.

• What muscle would be affected if the ulnar nerve was damaged?

If the ulnar nerve is damaged, the muscles controlled by the nerve, such as the intrinsic hand muscles and the flexor muscles of the fingers, can be usually affected, resulting in weakness and loss of muscle function in the hand and fingers.

• What diagnostic methods can the doctor prescribe?

The neurologist prescribes an electroneuromyography. Special electrodes connected to a machine evaluate the passage of nerve impulses. This helps to determine the blocked nerve signal.