What is Ulnar Tunnel syndrome?
Ulnar tunnel syndrome is a compression of the ulnar nerve at the wrist. The compression of this major nerve at the wrist is a relatively uncommon condition. The nerve usually is compressed at the elbow, in the cubital tunnel leading to a condition called cubital tunnel syndrome.
Anatomy of Ulnar Tunnel:
The ulnar nerve passes through Guyon’s canal in the wrist. From here, the nerve innervates to the digits. This is the most distal end of the nerve. The ulnar nerve becomes vulnerable to compression while traveling through this narrow tunnel.
It is important to remember that clinically, the cubital tunnel is most frequently seen ulnar nerve compression. The compression of the Ulnar nerve at Guyon’s canal is a relatively uncommon condition.
Causes of Ulnar Tunnel Syndrome:
- A benign tumor is the most important cause of ulnar tunnel syndrome.
- A ganglion cyst in the wrist can also compress the nerve at the wrist area.
- Repetitive trauma and chronic pressure to the area can also lead to compression of the nerve.
- Ulnar artery Thrombosis or aneurysm.
- Fracture of the hook of Hamate bone
- Repetitive trauma of the hypothenar muscle is a condition called Hypothenar Hammer Syndrome. This condition also leads to ulnar nerve compression in Guyon’s canal.
Clinical presentation of Ulnar Nerve Compression:
- A person reports with an onset of a gradual weakness and numbness of the little finger and partial ring finger. This is the area of the hand that innervated by the Ulnar nerve.
- A patient may or may not complain of pain.
- The patient also complains of difficulty with gripping, pinching, typing or playing a musical instrument. Opening a jar, holding objects as well as tasks that require finger coordination becomes difficult to perform.
Diagnosis of Ulnar Tunnel syndrome:
Physical examination and clinical presentation are crucial in the case of ulnar tunnel syndrome. Additionally, a physician may ask for a nerve conduction velocity test to identify the function of the nerve. In some cases, a patient needs to get an MRI or CT.
Treatment of Ulnar Tunnel:
Treatment of the ulnar tunnel syndrome is to find the root cause that compresses the nerve and attempt to remove it. Anti-inflammatory and analgesic medications help to relieve the symptoms temporarily.
Ergonomics are crucial especially if the nerve is getting compressed due to a faulty position or improper biomechanics. For example, typing or playing musical instruments with improper wrist support can compress the nerve. Correcting the biomechanics not only relieve the symptoms but also prevent the recurrence.
There are a variety of the braces available in the market that can help reduce the symptoms as well as prevent further compression. These braces help maintain the correct ergonomics of the wrist and digits.
Exercises for Ulnar nerve compression:
Nerve gliding exercises help to maintain normal nerve course and prevent any physical symptoms. Also, wrist and finger strengthening and stretching exercises help to perform daily activities in a pain-free range.
I describe exercises specific to the ulnar nerve in the article Cubital tunnel syndrome.
Additionally, you can find strengthening and stretching exercises for wrist and fingers in my previous article exercises for carpal tunnel syndrome.
