Ulnar nerve damage - Symptoms, Treatment, Surgery, Recovery time
What is Ulnar nerve damage?
The ulnar nerve passes over the elbow near the ulnar bone. It has been found the largest unprotected nerve in the human body and one of the three main nerves in the arm. That explains why injury/damage is common to this body part. This nerve is connected to the little (pinky) finger and half of the ring finger.
Damage to the ulnar nerve can disrupt the communication and will limit motion and sensation in the hand and forearm, greatly affecting the little finger and ring finger.
This condition can be classified into two:
- Guyon’s canal syndrome – (since the ulnar nerve passes through many tunnels, when compressed will result to this). It is a nerve compression affecting the Guyon’s canal. Decreased sensation in the ring and little fingers are complained by patients experiencing this.
- Cubital tunnel syndrome – the ulnar nerve is compressed in the path along cubital tunnel. Usually, tingling sensations of the fingers are felt by the affected.
The pain that is usually felt when you have ulnar damage is striking, may even disturb your sleep. That the numbness felt may limit your usual daily activities. But there are other clinical presentations of ulnar nerve injury:
- Abnormal sensation of the little finger and ring finger.
- Loss of coordination of the fingers.
- Weakness of the hand.
- Difficulty in gripping.
- Tingling and burning sensation in hand, arm or fingers.
- Increased numbness
Presenting symptoms that need immediate care are the change in level of consciousness, chest pain, paralysis or sudden vision loss or eye pain. These manifestations would likely indicate that the damage has worsened and emergency help is needed.
With these presenting symptoms, we can automatically identify the condition. Diagnosis can be done via identifying the signs of ulnar nerve damage. In severe cases, we may observe a claw-like deformity (known as Duchenne’s sign). Usually the two affected fingers are involved in the symptom. Difficulty in moving the fingers can point us to the diagnosis of this condition. Wasting of the hand muscles will indicate less use of the area, mostly found in severe cases. Other signs that indicate ulnar nerve damage are the following:
- Froment’s sign – thumb abduction cannot be performed instead hyperflexion is achieved by the patient.
- Wartenberg’s sign – the little finger is mostly affected with this condition. In severe cases, the little finger will be abducted thoroughly.
Other exams are done such as blood tests, CT scans, MRIs, nerve conduction tests, and recording of the electrical activity in muscles with EMG and x-rays.
Pressure, trauma or illness may be the cause of this damage. But according to study, the most common cause of injury to the ulnar nerve is entrapment. There is compression of the ulnar nerve, resulting to entrapment. An elbow fracture or dislocation can result to entrapment. Unfortunately, there are also instances that the source of injury is unknown.
Ulnar nerve entrapment may be a result from swelling of soft tissue, cysts, or damage to the bones in the arms. Disease causing injuries are arthritis, elbow dislocations and fracture of the wrists. Extensive bending of the elbow and persistent increased pressure on the palm of the hand may cause an injury.
But with a direct trauma to the nerve can give real cause of damage to the nerve.
Determining the cause of the condition is a vital part in the course of treatment. Our goal should be maximizing the function of the fingers, hands, or arms involved. First treat the injury that occurred and have caused the presenting symptoms. Provide a corticosteroid that is essential in decreasing the inflammation of the injured part. Sign up for an occupational therapy or physical therapy, in order to regain the function of the affected fingers or hand. Take pain relievers to ease the discomfort from the pain that the damage emits. To reduce stabbing pain, prescription drugs such as phenytoin, tricyclic antidepressants have been found effective in relieving it. Have your fingers or hands or arms splinted so no further damage will take place.
Surgery is quite recommended in cases of ulnar nerve damage, especially when the case is in a severe state. Surgery is primarily done to alleviate the pressure from the ulnar nerve. When there are deformities, surgical repair is needed to return its function. Surgical procedures where they open the cubital tunnel behind the elbow or wrist have been found effective in relieving the damage. There are instances wherein there is dislocation of the ulnar nerve, prompting the doctor to open and relocate it. Cysts may have caused the condition, removal of them is essential.
Other remedies that can assist in the recovery of the patient and relieving its symptoms are acupuncture and massage therapy.
A full chance of recovery can be attained once early and prompt treatment has been performed. But there are some cases wherein complete loss of sensation are attained if not given action in an earlier time. Partial or complete loss of sensation in the hand or fingers may happen.
We can also prevent this condition from taking place. We have to just maintain good posture and proper usage of the elbow and the arms. Calling a medical professional immediately after having these symptoms should be done. If the sensations are too persistent and the pain is intolerable, going to the emergency room is a must.
With the early and appropriate decompression of the ulnar nerve, the result should be prompt return to normal function. It can be immediate once the damage has been treated immediately. Studies showed that the recovery rate is similar no matter which intervention was done, may it be surgical or a conservative treatment. The return to normal function of the hands and fingers after nerve decompression, operative immobilization and rehabilitation may take up to 3- 6 months. A chronic case of ulnar damage associated with pain is less certain for a good surgical outcome. The result may be limited improvement and a repeat decompression is recommended.