The ulnar nerve can come to harm in more than one way. Granted, many people lean on their elbows without damaging their ulnar nerves, but like most things in medicine, an ulnar neuropathy is usually caused by a combination of factors, and it is likely that some people are more vulnerable than others based on their particular anatomies.
As discussed, the ulnar nerve at the elbow is especially vulnerable to injuries, it can also come to harm by getting compressed or pinched by nearby abnormal tissues. The usual culprits are tendons, ligaments, blood scars, cysts and vessels.
Diagnosing an ulnar neuropathy starts with the story of the symptoms and a physician’s examination. The physician might subsequently order nerve conduction testing which looks at the nerve and muscle electricity, and can determine the degree of impairment. Nerve conduction studies can also evaluate other nerves to see if the ulnar nerve is the only one impaired, or merely one of many.
When the ulnar nerve is injured, both motor and sensory symptoms are possible. Most of the muscles of the hand receive their marching orders via the ulnar nerve, so when the ulnar nerve is out of whack, there can be weakness in hand muscles. Damage to the ulnar nerve also causes changes in sensation.
Neurosurgical researchers at Radboud University Nijmegen in The Netherlands conducted a randomized, controlled trial of patients with ulnar neuropathy at the elbow in which half the patients received simple release surgery and the other half received anterior transposition. There were more complications in the patients receiving the anterior transposition procedure, so the results of this study favored the simple release approach.
With “-pathy” as the medical suffix meaning illness or impairment, an “ulnar neuropathy” means an illness or impairment of the ulnar nerve. The ulnar nerve is vulnerable to injury or pinch in the ulnar groove for more than one reason. Most of the muscles of the hand receive their marching orders via the ulnar nerve, so when the ulnar nerve is out of whack, there can be weakness in hand muscles. Granted, many people lean on their elbows without damaging their ulnar nerves, but like most things in medicine, an ulnar neuropathy is usually caused by a combination of factors, and it is likely that some people are more vulnerable than others based on their particular anatomies. Nerve conduction studies can also evaluate other nerves to see if the ulnar nerve is the only one impaired, or merely one of many.
Another way to injure the ulnar nerve is by over-stretching it. In the author’s clinical practice a thin, young lady with loose elbow-joints who worked as an emergency medical technician injured her ulnar nerves repeatedly while lifting heavy patients. For her, it was a problem that wouldn’t go away, and she eventually changed professions.
The part of the nervous system responsible for this annoying symptom is the ulnar nerve, a peripheral nerve-bundle whose individual nerve-fibers originate in the spinal cord where it passes through the neck. The nerve-fibers run most of the length of the arm, including through the “ulnar groove” which you may know as the “funny bone” or “crazy bone.”
What if a simple injury to the ulnar nerve at the elbow is diagnosed? The peripheral nerves have some capacity to heal themselves. If the degree of nerve impairment is not too severe, conservative treatment is called for.
With “-pathy” as the medical suffix meaning illness or impairment, an “ulnar neuropathy” means an illness or impairment of the ulnar nerve. The ulnar nerve is vulnerable to injury or pinch in the ulnar groove for more than one reason.
If the nerve injury is severe, or fails to respond to conservative treatment, then surgery might be beneficial. When the nerve is tied up in scar tissue or compressed by nearby abnormal tissues, a simple release operation might suffice in which the nerve is freed up. Otherwise, in a procedure called “anterior transposition” the nerve is transferred out of the ulnar groove so it is out of harm’s way from leaning on the elbow, and also gets to take to the short way around when the elbow is flexed.
A typical conservative treatment consists of putting a sport-pad (not a medical brace) on the elbow with the foam covering the ulnar groove. In addition, eating nutritious, well-rounded meals, together with vitamins, gives the ulnar nerve the building-blocks it needs in order to make the best possible recovery.
Sometimes, an ulnar neuropathy is the leading symptom of a “polyneuropathy,” meaning that all the peripheral nerves in the body are somewhat impaired, but the ulnar nerve is the first one to cause symptoms noticeable to the affected individual. Polyneuropathy is not the result of injury, but can be seen in a variety of illnesses, including diabetes, alcoholism and also on an inherited basis.
Do you remember what it felt like when you banged your elbow on a hard surface and it sent shocks through your forearm and into your little finger? Not too pleasant, to be sure. On the plus side, the unpleasantness was merely temporary and, for the time being, you remembered not to do that again.
