If you've ever whacked your elbow unexpectedly, you may have experienced a numbness, pain and tingling along the side of your hand and into the pinky and ring fingers. You may have even said you hit your "funny bone." In reality, the blow was to your ulnar nerve, located at the elbow end of the ulna. An ongoing compression of this nerve may manifest as chronic pain.
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Ulnar Neuropathy Symptoms
The ulnar nerve runs from behind the collarbone, along the inside of the arm and down through the wrist to the side of the hand near the pinky finger. The nerve gives sensation to the pinky and half of the ring finger, and controls the fine motor muscles in the hand as well as the gripping muscles in the forearm. The most common site of ulnar nerve compression is behind the elbow -- although compression can occur at the collarbone or wrist, or at the point where it descends from the cervical spine, says the American Academy of Orthopaedic Surgeons.
Causes and Symptoms
The American Academy of Orthopaedic Surgeons attributes elbow fractures, bone spurs, inflammation and cysts as possible causes of ulnar neuropathy. For active people, joint trauma from heavy resistance training or activities such as cycling may be at fault. Cyclists know the syndrome by the name "handlebar palsy." Tingling in the pinky and ring fingers, a weakened grip and elbow pain -- especially when bent as in holding a phone -- are common symptoms of a compressed ulnar nerve. In very advanced stages, ulnar neuropathy can result in irreversible muscle atrophy in the hand and forearm.
Exercises for ulnar neuropathy focus on strengthening the muscles innervated by the ulnar nerve and improving range of motion at the wrist. You can do wrist extensions by resting the injured forearm on a table or counter with the hand and wrist hanging over the edge, palm down. Gripping a 1-lb. or 2-lb. dumbbell, lift the knuckles toward the ceiling, then slowly lower. Repeat this 10 to 15 times. Now turn your palms up and curl the knuckles toward the wrist, then slowly lower. To increase range of motion in the wrists, extend your arm, palm up. Grasp the fingers with the opposite hand and gently pull the fingers back toward the floor, hyperextending the wrist. Hold this at the longest length for 30 to 60 seconds. Then turn the palm downward and place the thumb of the opposite hand in the palm as you grasp the injured hand, flexing the wrist and pressing the fingers toward the floor.
Other Treatment and Prevention
As with any injury, the first line of treatment for ulnar neuropathy is to abstain from the activity that initiated it. Avoid leaning or placing pressure on your elbows or palms. To maintain conditioning, substitute cycling and other sports that cause neuropathy with activities such as running that don't involve use of the arms. Avoid repetitive elbow flexion. A splint or brace that keeps you from using the injured arm may be useful. In extreme cases, you may need steroid injections or surgical intervention.