Ulnar Tunnel Syndrome

What Is Ulnar Tunnel Syndrome?

Ulnar tunnel syndrome is pain, tingling, or numbness in your hand, caused by a pinched nerve in your wrist. It isn’t pleasant, but treatments and simple changes to your routine can help you feel better quickly.

The ulnar nerve starts near where your neck meets your shoulder. It runs through your elbow and down to the outer edge of your hand. It’s one of three main nerves that provide feeling and function to your hand.

Ulnar tunnel syndrome is carpal tunnel’s lesser-known cousin. Like the median nerve passes through the carpal tunnel in your hand, the ulnar nerve passes through Guyon’s canal at your wrist. You might even hear your doctor call it Guyon’s canal syndrome.

 

Ulnar Tunnel Symptoms

When something presses on your ulnar nerve, you’ll feel the effects on the side of your hand by your pinky and ring fingers. Typical symptoms include:

  • Tingling, like your fingers are falling asleep

  • Numbness in your hand when you wake up

  • Weakness in your grip

  • Trouble with complex tasks like typing

  • Pain in your wrist as the condition gets worse

Ulnar Tunnel Causes and Risk Factors

The most common cause of ulnar tunnel syndrome is a ganglion cyst. That’s a noncancerous growth filled with fluid that develops on your wrist and can press on your ulnar nerve. 

But you can get it if you twist the joint a lot or do any type of motion with it over and over. 

A broken hamate bone in your wrist can also bring it on. If you’re a baseball player, you might break this bone while batting. If golf is your game, you could break it if you miss the ball and slam the club into the ground.

Risk factors

You’re more likely to get ulnar tunnel syndrome if you:

  • Work with your hand bent down and out

  • Use machinery that causes trauma to the wrist, like a jackhammer

  • Participate in an activity where you’re constantly applying grip pressure, like bicycling or weight lifting

  • Injure your wrist

  • Have arthritis

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Ulnar Tunnel Diagnosis

Your doctor will ask questions about your medical history and symptoms.

They’ll also check your hand and look for areas that tingle. They may look for dryness or spots where the muscle is weak (you may hear them call it atrophy). While most symptoms will be in your hand, you may have some pain in your elbow. Your doctor will check that joint to make sure the nerve isn’t trapped there instead. The symptoms are the same.

You may get certain imaging tests, including:

  • X-ray to look for a fracture or a bone fragment pressing on the nerve

  • CT scan to look for a growth

  • MRI

  • Ultrasound

  • Nerve conduction study to see if the nerve is working correctly

Ulnar Tunnel Treatment

Treatment depends on what’s causing the problem.You’ll probably need surgery if you have a cyst or an injury that’s putting pressure on the ulnar nerve. After the operation, you may have occupational or physical therapy to help you get back to normal.

If wrist position is to blame, your doctor may give you a brace, splint, or other device to help keep your wrist straight. You might also need occupational therapy to build strength in the ligaments and tendons in your hands and elbow.

There are several things you can try at home, with your doctor's guidance, that may help relieve your symptoms:

  • Change the way you hold your wrists when you type or grip your handlebars

  • Add padding when you put pressure on your wrists

  • Avoid activities that make your symptoms worse

  • Wear a splint

Take over-the-counter medications like aspirin or ibuprofen for pain.

Ulnar Tunnel Complications

If you have mild ulnar tunnel syndrome, your symptoms may improve or progress slowly. But if yours is more serious, it can get worse. You may develop pain in your hand and wrist. Your hand muscles can waste away to the point that you can’t do normal things like open a jar, and your fingers may form a “claw” shape.   

WebMD Medical Reference Reviewed by Arefa Cassoobhoy, MD, MPH on July 15, 2020

Sources

SOURCES:

American Society for Surgery of the Hand: “Brachial Plexus Injury.”

American Academy of Orthopedic Surgeons: “Ulnar Nerve Entrapment at the Elbow (Cubital Tunnel Syndrome),” “Ulnar Tunnel Syndrome of the Wrist.”

National Institute of Neurological Disorders and Stroke: “Carpal Tunnel Syndrome Fact Sheet.”

The Hand and Wrist Institute: “Ulnar Tunnel Syndrome.”

Johns Hopkins Medicine: “Ulnar Nerve Entrapment.”

Basil Besh, MD, orthopedic surgeon, Freemont, CA.

New York University Langone Medical Center: “Preventing Ulnar Nerve Compression.”

“Nonsurgical Treatment for Ulnar Nerve Compression.”

American Society of Hand Therapists: “Cubital Tunnel Syndrome.”

Houston Methodist: “Guyon’s Canal Syndrome.”

StatPearls:“Guyon Canal Syndrome.”

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