QUESTION: A 45 year old woman is complaining of pins and needles and numbness in her ring finger and little finger when she is reading and when she is working on her computer. It is keeping her up at night and she is starting to lose dexterity and coordination in her hand. What is the issue?
What Is Ulnar Neuritis?
Ulnar neuritis, also known as ulnar neuropathy or cubital tunnel syndrome, is the inflammation or compression of the ulnar nerve which can cause symptoms such as pins and needles, numbness or weakness in the hand and arm. The ulnar nerve is one of the three main nerves in the arm and it supplies sensation and muscle power to the little finger, ring finger and half of the forearm.
The nerve can be compressed at various points such as the wrist, the elbow or beneath the collar bone. The most common point of entrapment is at the elbow where the condition is named cubital tunnel syndrome.
At the elbow, the nerve runs under a bony area called the medial epicondyle, or more commonly known as the “funny bone.” In this area, the nerve is very close to the skin, which is why bumping it can cause a very uncomfortable electric shock-like feeling.
What causes it?
Ulnar neuritis can be caused by a range of factors including:
• Activities which place prolonged pressure against the elbow or wrist such as resting elbow on a table.
• Activities which cause the elbow or wrist to be bent for long periods such as sleeping with elbows bent.
• Previous elbow fracture or dislocation.
• Arthritic changes such as bony spurs.
• Ganglion cysts or inflammatory joint changes.
The most common symptoms include numbness and tingling in the little and ring fingers which can extend up to the elbow. Eventually the symptoms can become more frequent and can lead to reduced strength and difficulty with co-ordination, with patients often reporting that they drop items such as plates and cups.
If the nerve is compressed for a long time, it can lead to more permanent changes where the muscles supplied by the nerve can waste away.
Treatment from Your Hand Therapist
Your hand therapist can tailor make a program to address your concerns which may include a combination of rest, education regarding activities to avoid, an elbow splint to wear at night, specific nerve exercises and strengthening exercises.
In cases where the symptoms are severe or do not respond to therapeutic treatment, further options may include corticosteroid injection or surgical release of the ulnar nerve.
Your therapist can discuss with you and your GP to arrange a referral to a surgeon if required.
If you are suffering from any of these symptoms, or any other issues with the hand, arm or fingers, please feel free to get in touch with the Hand Therapy Group here, we would be more than happy to help.