Ulnar neuropathy at the elbow: recognise and treat

Elbow pain and reduced strength

Typical symptoms of ulnar neuropathy are weakness or numbness in the hand, tingling in the palm of the hand or in the fingers 4 and 5, sensitivity to cold and a stiff elbow joint. If there is severe nerve inflammation, permanent and severe pain can occur, even at night.

The symptoms of cubital tunnel syndrome develop gradually. Typical signs are when the ring finger and little finger repeatedly "fall asleep" or the strength in the hand decreases. Pain occurs in the elbow area, which can radiate into the forearm.

As the ulnar nerve consists of sensory fibres on the one hand and strength fibres on the other, both sensations, sensitivity and muscles, can be impaired and affect mobility and the muscles in the hand. The extent of the loss of strength and numbness depends on where the nerve is constricted. If the symptom progresses, even simple hand movements become a problem. For example, opening a can, picking up objects, writing or making music.

Clinical examination of the elbow

A detailed discussion with a precise description of the symptoms is the first step in diagnosing ulnar neuropathy. Our neurologists then carry out a comprehensive clinical examination, during which patients are asked to make certain movements with their hand. This enables our team of experts to find out whether the ulnar nerve is being compressed and where exactly the pain is occurring.

In addition, so-called nerve sonography examinations, i.e. inspections of the nerves using ultrasound, are also carried out. At Bethesda Hospital, you will find specialists in one place who will accompany you from diagnosis to treatment.

What can be done to treat ulnar neuropathy?

Conservative treatment methods

If the symptoms are caused by cycling, for example, the first thing to look at is the holding position. If the hand position is corrected, the symptoms may at best disappear. If this does not help, conservative treatment methods are used. For example, hand or occupational therapy or physiotherapy specially tailored to the hands. Ultrasound treatment including anti-inflammatory medication (such as Voltaren) or neoprene bandages and splints can also be considered.

Surgery is rarely necessary

Surgery may only be necessary if conservative methods do not help. Therefore, the earlier you have the symptoms clarified, the better. Contact us as soon as possible if your two back fingers often fall asleep. The operation is usually performed on an outpatient basis: The carpal tunnel is opened and the nerves are mechanically relieved. However, this procedure is only very rarely necessary.

Ulnar neuropathy

Ulnar neuropathy is not very common. Only 25 out of 100,000 people are affected. The ratio of men to women is 2:1 - so men suffer from it about twice as often.