Ulnar neuritis, also called cubital tunnel syndrome, is the inflammation of the ulnar nerve that is characterized by weakness and numbness in the hand. The ulnar nerve travels from the neck down into your hand. It is responsible for sensations in the little finger and half of the ring finger as well as helping with grip strength and fine motor movements of the hand.
The ulnar nerve travels through two tunnels – one in the elbow and the other in the wrist. Ulnar neuritis may be caused by any activity or repetitive motion such as bending or leaning on the elbow that produces constant pressure on the ulnar nerve at the elbow or wrist. It can also occur due to fluid accumulation at the elbow, a direct blow or rubbing against the boney prominence.
Symptoms related to ulnar neuritis include elbow, forearm and hand pain, weakness and numbness, and loss of fine finger movements that allow you to play an instrument or grip an object firmly. If left untreated for more than 6 weeks, there may be irreversible muscular atrophy in the hand.
When you present to the clinic with these symptoms, your doctor will review your history and perform a thorough physical examination of your elbow and hand, which would include bending the elbow to observe if the ulnar nerve slides out of position, tapping the elbow over the area of the ulnar nerve, and evaluating the strength and sensation in your hand and fingers. Further investigations may also include electromyograms and nerve conduction studies to fully evaluate the ulnar nerve.
Nonsurgical treatment options for ulnar neuritis include rest, activity modification, use of an elbow splint or sling, nonsteroidal anti-inflammatory medication and steroid injections. If these do not relieve pain, and you experience progressive paralysis of the hand and forearm muscles, muscular atrophy, and clawing of the ring and little finger, your doctor may suggest surgery. Surgical options may include localized decompression of the ulnar nerve by opening the tunnel, moving the nerve to a position where it is less likely to be compressed, or excision of the bony elbow prominence that is compressing the ulnar nerve.