People who suffer from Ulnar nerve Neuritis experience dull aching pain into the elbow coupled with shooting pain into the small finger and ring finger. The Ulnar nerve runs from the shoulder to the elbow joint, along the bony ridges of cubital tunnel which is often termed the “Funny bone”. From here it innervates and controls the movement and sensation of different muscles in the forearm and fingers. Impingement of the Ulnar nerve in the cubital tunnel affects the nerve sensation and muscle control in the forearm and hand leading to dull aching forearm pain on elbow bending movement. Shooting pain, numbness can be felt also into the little finger and ring finger.
The condition is caused by periods of prolonged elbow flexion which overtime can cause inflammatory changes of the fascia sheath that covers the ulnar nerve leading to narrowing of the cubital tunnel within which flows the ulnar nerve. The narrowing of the cubital tunnel brings about compression of the Ulnar nerve. Trauma to the elbow joint from a blow or repeated leaning on the elbow can also bring about Ulnar nerve compression as the elbow joint angle can change leading to a gradual stretching of the nerve resulting in degeneration of the nerve against the groove of cubital tunnel.
Signs & Symptoms
Shooting Pain & pins & needles can be felt into the small finger the outside area of the finger.
Feeling of weakness, clumsiness and even cramping of the hand.
Numbness or a hypersensitive feeling of touch in the hand.
Pain radiating from the hand to the elbow and even up to the shoulder
Symptoms are aggravated by activity & often relieved by rest.
Dull ache into the elbow during an activity and even at rest.
Visible clawing of the small finger and wastage of muscles in the palm of the hand in some cases.
Weakness experienced when pushing small finger against Index (ring) finger.
Treatment & Management
When a patient attends my clinic with the above Cubital Tunnel syndrome symptoms, my immediate advice is to rest the elbow joint by avoiding elbow movements where possible and also to wear a soft elbow pad over the “Funny bone” to cushion the ulnar nerve. Manual treatment to release the tightness of the forearm muscles and tendons coupled with gentle nerve stretching once pain has reduced is then gently carried out. Once progress is noted, I then initiate a gentle strengthening rehabilitation program of the elbow and forearm muscles.
Next week I will discuss further painful elbow conditions.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles.
Contact Number: 086 3275 753
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Injury Solutions Clinic
Physiotherapy & Injury Rehabilitation Clinic in Tipperary