Neuropathy

What is it?

This is a condition affecting the ulna nerve as it passes behind the medial epicondyle, otherwise known as the ‘funny bone’ on the inner aspect of the elbow joint. The nerve is most commonly susceptible to irritation or compression here but can be affected at any point along its track in the arm.


Why does it occur?

Otherwise known as cubital tunnel syndrome, the ulna nerve is affected most commonly as a result of constant pressure over time. This may be resting on the elbows whilst working at a desk or keeping the elbow flexed for long periods when driving. The nerve stretches abnormally in this position and can flick out of the cubital tunnel. Alternatively any previous trauma or injury to the elbow generates scar tissue which can cause compression of the nerve.

 

What are the symptoms?

Pain and altered sensation is recognised in areas supplied by the ulna nerve from the elbow to the hand. Numbness and tingling of the ring and little finger are common symptoms, pain may also be felt on the inner aspect of the elbow radiating to the hand.

How is it diagnosed?

Your clinician will take a thorough history and examination, specifically testing the ulna nerve. You may be referred for nerve conduction studies to assess its function.

How is it treated

1. Non-surgical treatment

Conservative options include rest and anti-inflammatory medication. Your symptoms should settle with lifestyle changes that involve lots of elbow flexion or pressure on the nerve. Frequent breaks are recommended where possible. Some patients benefit from bracing, a splint is particularly useful where symptoms are felt at night. This acts to protect the nerve from external pressure and reduce flexion of the elbow.

2. Surgical treatment

An operation may be considered where conservative management has failed and/or there are signs of increasing damage, such as wasting or weakness in the muscles supplied by the ulna nerve. This day case procedure is known as an ulna nerve decompression and involves releasing any surrounding soft tissues causing restriction.