Neuropathy - ulnar nerve; Ulnar nerve palsy
Ulnar nerve dysfunction is a problem with the ulnar nerve, which travels from the shoulder to the hand and allows movement or sensation in the wrist or hand.
Damage to one nerve group, such as the ulnar nerve, is called a mononeuropathy. Mononeuropathy means there is nerve damage to a single nerve. Both local and body-wide disorders may damage just one nerve.
The usual causes of mononeuropathy are:
Ulnar neuropathy occurs when there is damage to the ulnar nerve, which travels down the arm. The ulnar nerve is near the surface of the body where it crosses the elbow. The damage destroys the nerve covering (myelin sheath) or part of the nerve (axon). This damage slows or prevents nerve signaling.
Damage to the ulnar nerve can be caused by:
Temporary pain and tingling of this nerve can occur if the elbow is hit, producing the experience of hitting the "funny bone" at the elbow.
Long-term pressure on the base of the palm may also damage part of the ulnar nerve.
In some cases, no cause can be found.
Pain or numbness may awaken you from sleep. Activities such as tennis or golf may make the condition worse.
A careful history of when the problem started and what you might have been doing that could have injured the nerve is important.
An exam of the hand and wrist can reveal ulnar nerve dysfunction. Signs may include:
Tests may be needed, depending on your history, symptoms, and findings from the physical exam. These tests may include:
The goal of treatment is to allow you to use the hand and arm as much as possible. The cause should be identified and treated. Sometimes, no treatment is needed and you will get better on your own.
Medications may include:
A supportive splint at either the wrist or elbow can help prevent further injury and relieve the symptoms. You may need to wear it all day and night, or only at night.
Surgery to relieve pressure on the nerve may help if the symptoms get worse, or there is proof that part of the nerve is wasting away.
Other treatments may include:
If the cause of the dysfunction can be found and successfully treated, there is a good chance of a full recovery. In some cases, there may be partial or complete loss of movement or sensation. Nerve pain may be severe and last for a long period of time.
If pain is severe and continues, see a pain specialist to be sure you have access to all pain treatment options.
Early diagnosis and treatment increase the chance of curing or controlling symptoms.
Call your health care provider if:
Avoid prolonged pressure on the elbow or palm. Casts, splints, and other appliances should always be examined for proper fit.
Vallarino R, Santiago FH. Ulnar neuropathy (wrist). In: Frontera WR, Silver JK, Rizzo TD Jr., eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier;2008:chap 35.
Weiss LD, Weiss JM. Ulnar neuropathy (elbow). In: Frontera WR, Silver JK, Rizzo TD Jr., eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier;2008:chap 23.
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