If you've ever bumped your funny bone, you know what it feels like to irritate your ulnar nerve. Although this structure is not a bone, it sits close to the surface of the skin between two bony bumps on the inside of your elbow. Most ulnar nerve pain can be successfully treated with conservative measures and exercise.
Understand Your Ulnar Nerve
Spinal nerves branch off the spinal cord to supply sensation to the skin of your arms and legs and power the muscles in your extremities. Once these nerves exit your spine, they branch off into peripheral nerves. The ulnar nerve is a branch of two spinal nerves that exit at the bottom of your cervical spine, in your neck.
The ulnar nerve begins in your upper arm, traveling along the inside of your elbow, forearm and pinky side of your hand. It provides sensation to your inner forearm and wrist, front and back sides of your pinky finger and half of your ring finger sitting next to it.
Ulnar Nerve-Powered Muscles
The ulnar nerve powers muscles as it travels down your forearm into your hand. In the forearm, it supplies the flexor carpi ulnaris — a muscle that bends your wrist forward — and the flexor digitorum profundus, or FDP, which flexes the fingers. Although the FDP muscle is in the forearm, it sends tendons all the way to the tips of your fingers, with the exception of the thumb.
In the hand, the ulnar nerve powers small muscles that move your pinky and thumb, as well as deep muscles in your palm.
Recognize Ulnar Nerve Damage
Symptoms of ulnar nerve damage will vary based on the severity of your injury. Most commonly, nerves are injured by compression, or prolonged pressure on part of your arm where the ulnar nerve is close to the surface. Mild injury temporarily causes pain, tingling, and/or numbness, such as occurs when you bump your "funny bone." These symptoms will be felt where your ulnar nerve provides sensation to the arm — the inner forearm, hand, pinky and half of the ring finger.
Early on, ulnar nerve symptoms might only occur at night, particularly if you sleep with your elbow bent. This position increases pressure on the already irritated nerve. As the damage worsens, symptoms begin to occur intermittently during the day.
Ulnar nerves that are compressed for prolonged periods of time or injured through trauma can cause constant pain and tingling, or even complete numbness. Over time, weakness can develop in ulnar nerve-supplied muscles. This can present as decreased dexterity with fine motor skills, or you might notice you are dropping things, due to decreased grip strength. You might even notice decreased muscle bulk in your hand.
Ulnar Nerve Glides
Ulnar nerve entrapment typically occurs at the inner elbow — a condition called cubital tunnel syndrome, or at the wrist. Nerves are surrounded by sheaths, and when inflamed, the nerve isn't able to glide properly, leading to increased symptoms.
Ulnar nerve glides improve flexibility of the ulnar nerve both at the elbow and the wrist. Only move as far as you can without exacerbating your symptoms.
HOW TO DO IT: Begin with your arm straight out to the side, palm up. Slowly bend your elbow and tilt your wrist backward. Keeping your wrist bent backward, slowly straighten your elbow. Repeat three to five times.
Ulnar Nerve Exercises
Wrist flexion exercises strengthen the flexor carpi ulnaris muscle.
HOW TO DO IT: Sit with your forearm resting on a table, palm up. Holding a small dumbbell or similar object such as a can of soup, bend your wrist up toward the ceiling. Hold for two to three seconds, then slowly lower down. Repeat 10 times and work up to three sets in a row.
Exercise putty can be used to strengthen hand muscles powered by the ulnar nerve. Putty is available in a variety of resistance levels to allow easy progression as your strength improves.
HOW TO DO IT: Hold the putty in your palm at the base of your fingers. Keep your thumb out to the side. Bend your fingers down into the putty as far as possible. Reshape it into a ball and repeat 10 times.
Place the putty between your thumb and index finger. Squeeze these fingers together against the resistance of the putty. Repeat, placing the putty between the rest of your fingers, three times each.
Prevent Ulnar Nerve Pain
Ulnar nerve pain can be prevented by avoiding positions that increase pressure on the nerve, according to Brigham and Women's Hospital. Direct compression of this nerve at the elbow can occur from leaning on a desk or chair armrests. At the wrist, the nerve can be irritated with prolonged gripping of a steering wheel or weight-bearing on your palms, as occurs when riding a bike.
Keeping your elbow bent for prolonged periods of time can also aggravate the ulnar nerve. This often occurs at night. Wearing a splint can help keep your elbow straight while sleeping. During the day, position your mouse and keyboard farther away from your body to keep your elbow straighter while working at your desk.
Consider Physical Therapy
Ulnar nerve entrapment is commonly treated with physical therapy. In addition to exercises, physical therapy interventions include modalities such as ultrasound, electrical stimulation, cold laser, hot packs and cold packs to help decrease pain and inflammation. A physical therapist can also help you figure out the underlying cause of your condition.
Early Diagnosis Is Better
If you have symptoms of ulnar nerve entrapment, see a doctor. Nerve conduction studies can be performed to assess the extent of damage to your nerve. Ignoring this problem for too long can cause permanent numbness and muscle atrophy, leading to irreversible functional limitations.
In severe cases, surgical intervention might be required to remove scar tissue that can develop around an inflamed ulnar nerve or move the nerve farther away from the surface of the skin. Surgery is required to repair ulnar nerve lacerations or tears.