The ulnar nerve travels close to the inner side of the elbow to the hand. it’s the same nerve that gives us sharp electric pain when we “hit the funny bone”. Its main functions are to carry the sensation of the little and ring finger to the brain, supply muscles of the forearm for the finger and wrist movements, and fines function of hand like threading the needle.

Ulnar nerve injury or entrapment can cause dull pain, cold sensitivity, numbness and tingling in fourth and fifth fingers, reduce the power of fingers and wrist, and also an abnormal claw-like posture of hand due to paralysis of small muscles in hand.

The ulnar nerve is mostly entrapped near the elbow (cubital tunnel syndrome) and near the wrist (Guyon’s canal) it’s quite common in office workers and people often use laptops while their hand resting on edge of table or chair, or by holding the handle during prolonged or regular bike riding. Pregnancy is also commonly associated with nerve entrapments.

A detailed history and physical examination are generally required for the diagnosis of nerve entrapment, but your doctor may also order tests like electromyography (EMG) and nerve conduction study (NCS), which basically test the function of the ulnar nerve and also muscles supplied by the nerve.

There are non surgical ways to relieve symptoms of nerve entrapment by using pain killers and splints but you should always consult your doctor first as splints can also aggravate the entrapment.

Surgical options include releasing of ulnar nerve at the wrist/elbow or both. Ulnar nerve releasing at the wrist is a daycare procedure that includes giving anesthesia either locally on the area being operated or anesthesia for complete unconsciousness. There will be a small cut near the palm and wrist which will be later on closed using a few stitches.The hand will be dressed and a splint will be applied for a few days. After 10 to 12 days all the stitches will be removed and resuming of all activities will be allowed after 2 weeks.

Releasing of ulnar nerve near elbow requires a much larger incision hence it will be done under general anesthesia, and a day of hospitalization is required, if required your doctor might change the position of the nerve to a much more comfortable position in order to prevent future compressions. A comfortable dressing and splint are applied for a few weeks. All sutures will be removed in 12 to 14 days and activities will be resumed in 2 to 4 weeks.

After nerve release, return of sensation and function of muscles took from a few weeks to a year depending on the severity of the initial presentation, the more early the release the better will be the outcome.