Ulnar neuropathy, or ulnar nerve dysfunction, is a form of peripheral neuropathy. Ulnar tunnel syndrome is a specific ulnar neuropathy. The ulnar nerve travels from the shoulder down the outside of the arm, supplying flexion to the wrist and aiding in movement and sensation of the wrist and hand, to the 4th and 5th fingers in particular. Ulnar neuropathy is marked by numbness and tingling in the 4th and 5th fingers and the outer side of the palm. Common causes of this condition are:

  • direct trauma, such as fracture or dislocation of the elbow
  • prolonged external pressure on the nerve at the elbow, where the ulnar nerve is close to the surface of the body, or at the base of the palm
  • compression of the nerve at the elbow or wrist from soft-tissue swelling, bone spurs, or damage to the myelin sheath that encases the nerve

Diagnosis
Diagnostic testing, including X-ray, MRI and nerve conduction tests, focus on determining the cause of neuropathy, so that the patient and doctor may pursue the correct course of treatment.

Treatment
Ulnar neuropathy may be treated conservatively with simple nerve flexing exercies, night-time braces to hold the arm straight and over-the-counter medications, such as ibuprofen, to lessen swelling and pain. The patient is advised to avoid using the hand, especially for activities involving small muscle movement of the hand. In more extreme cases corticosteroids may be injected to reduce swelling and pressure on the nerve. If symptoms are unresponsive to more conservative treatment, or there is evidence of nerve degeneration, surgical intervention may be called for.

Prognosis
If the cause is correctly identified and treated, the patient can make a full recovery and regain complete use and sensation of the hand, though the possiblity of partial disabilty also exists. If left untreated, ulnar neuropathy, like other nerve dysfunction disorders, can result in loss of sensation and atrophying of muscles.

Just the facts: WebMD.com, my neurologist and personal experience.

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